CMS Mandates Enhanced Barrier Precautions in Nursing Homes Effective April 1, 2024

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The Centers for Medicare and Medicaid Services (CMS) has issued a new directive aimed at curbing the spread of multi-drug resistant organisms (MDROs) in nursing homes. The guidance, outlined in QSO-24-08-NH, requires skilled nursing facilities to implement enhanced barrier precautions (EBPs) as part of their infection prevention and control programs.

MDROs, such as certain types of drug-resistant bacteria, pose a significant threat to vulnerable nursing home residents. These organisms can cause severe infections that are difficult to treat due to their resistance to multiple antibiotics. Proper infection control measures are crucial in preventing the transmission of MDROs within healthcare settings.

Under the new CMS mandate, nursing homes must ensure the following EBPs are in place:

  1. Hand Hygiene: Strict adherence to hand hygiene protocols, including the use of alcohol-based hand rubs or soap and water, before and after resident contact.
  2. Personal Protective Equipment (PPE): Appropriate use of PPE, such as gowns and gloves, when providing care to residents colonized or infected with MDROs.
  3. Dedicated Equipment: Dedicated, disposable, or disinfected reusable medical equipment for residents with MDROs to prevent cross-contamination.
  4. Resident Screening: Screening residents for MDROs upon admission and during routine clinical encounters to identify carriers.
  5. Staff Education: Ongoing training and competency assessments for staff on the proper implementation of EBPs.


Failure to comply with the new EBP requirements could result in citations and potential enforcement actions from CMS.

Healthcentric Advisors offers comprehensive infection prevention and control services, including policy development, staff training, and on-site assessments, to help nursing homes meet regulatory requirements and protect their residents from the threat of MDROs. Contact us for more information.

For more information on CMS’s QSO-24-08-NH directive, please refer to the official announcement: https://www.cms.gov/files/document/qso-24-08-nh.pdf

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