It was first announced in mid-June that the U.S. House of Representatives Select Subcommittee on the Coronavirus Crisis sent letters to five of the country's largest for-profit nursing home companies, as well as the Centers for Medicare and Medicaid Services (CMS). Concerned about "lax oversight," the committee demanded detailed data and reports on their handling of the Covid crisis. 

"We write today to seek documents and information regarding CMS's actions to protect vulnerable Americans in nursing homes." wrote Chairman James E. Clyburn. 

The letter went on to state how CMS imposed only limited reporting requirements on nursing homes. On May 1, 2020, CMS implemented an interim rule requiring nursing homes to begin reporting weekly data on coronavirus infections and deaths, tests, and equipment. Inexplicably, CMS did not require comprehensive data prior to May 8, 2020—even though the first nursing home outbreak began in February. Some facilities failed to report any data in their initial submission.

Despite CMS's broad legal authority, the agency largely deferred to states, local governments, and for-profit nursing homes to respond to the coronavirus crisis. This was where things went from bad to worse. 

On March 13, CMS issued 'Covid' guidance. It was intended to be a blueprint for individual states to follow while determining how to best 'cocoon' the most vulnerable to the virus amongst our population, and control any outbreaks. This guidance did not direct any nursing home to accept a COVID-19-positive patient, if they were unable to do so safely.