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Nursing homes could soon be relieved of a federal requirement to report weekly COVID-19, influenza, and RSV cases among residents, potentially ending a national source of respiratory virus surveillance as the country enters another respiratory illness season.
A draft Trump administration plan would end the weekly reporting requirement, according to a summary The New York Times obtained. The plan has not been formally proposed, and no reporting requirements have changed.
The potential rollback comes less than two years after the Centers for Medicare & Medicaid Services (CMS) expanded respiratory illness reporting requirements for long-term care facilities.
Beginning Jan. 1, 2025, CMS required facilities to electronically report COVID-19, influenza, and respiratory syncytial virus data to the Centers for Disease Control and Prevention’s National Healthcare Safety Network. The requirement includes resident vaccination status, confirmed infections, and hospitalizations.
For nurses working in long-term care, the debate raises a broader question about balancing reduced administrative work with standardized surveillance of infections affecting a medically vulnerable population.
What Nursing Homes Report Now
Approximately 15,000 CMS-certified nursing homes currently submit respiratory virus data through the CDC’s National Healthcare Safety Network.
The CDC publishes national and state-level summaries through its Nursing Home Data Dashboard, providing ongoing insight into respiratory illness among nursing home residents.
Recent numbers demonstrate how quickly conditions can change.
COVID-19 cases among nursing home residents declined to 13.8 per 100,000 residents in June before increasing to 171.7 per 100,000 as of Sept. 17, according to data reported by McKnight’s Long-Term Care News. That remains well below the two-year peak of 717.6 cases per 100,000 residents recorded in January 2025.
The reporting system also tracks vaccination coverage. As of mid-September, 56.9% of nursing home residents had received an influenza vaccine, 35.3% were up to date on COVID-19 vaccination, and 23.2% had received an RSV vaccine. COVID-19 vaccination among nursing home staff stood at 19.6%.
The draft summary, as reported, does not identify a comparable national replacement for tracking those infections and vaccination levels if the reporting requirement ends.
Nursing Home Industry Says Reporting Creates Unnecessary Work
Nursing home operators have pushed to end the requirement, arguing that weekly reporting consumes staff time and duplicates information provided through other public health systems.
“It would be reasonable and prudent of CMS to eliminate this requirement,” Holly Harmon, senior vice president of quality, regulatory and clinical affairs for the American Health Care Association, told McKnight’s.
Harmon said the COVID-19 public health emergency ended more than three years ago and nursing homes “remain committed” to vaccination efforts.
LeadingAge, which represents nonprofit aging-services providers, has also argued that respiratory illnesses are already reported through other federal, state and local public health channels.
For nurses and other clinicians working in facilities already confronting staffing pressures, eliminating the requirement could reduce administrative work. The tradeoff is potentially losing a standardized national system for tracking respiratory infections among nursing home residents.
Advocates Warn About Losing Nursing Home Surveillance
Resident advocates have raised concerns about eliminating the requirement, particularly because nursing homes continue to face staffing and infection-control challenges.
Toby Edelman, senior policy attorney at the Center for Medicare Advocacy, questioned whether infection prevention has improved enough since the pandemic to justify eliminating the surveillance requirement.
“I don’t think there is any reason to believe they have beefed up what they are supposed to be doing,” Edelman told The New York Times.
Advocates argue that the weekly data give regulators, researchers and the public another way to identify respiratory illness trends.
The current reporting requirements were established after pandemic-era COVID-19 reporting rules expired at the end of 2024. CMS replaced them with a broader system covering COVID-19, influenza, and RSV, with reporting for all three required beginning Jan. 1, 2025.
Another COVID-19 Requirement Could Also Change
The draft plan would also eliminate a requirement that nursing homes educate staff about COVID-19 vaccination and offer the vaccine to employees, according to McKnight’s.
Facilities would still be required to offer COVID-19 vaccines to residents.
CMS has separately finalized removing two COVID-19 vaccination measures from the Skilled Nursing Facility Quality Reporting Program. The draft under consideration would go further by eliminating weekly reporting of resident respiratory infections and hospitalizations.
What the Proposal Could Mean for Nurses
If CMS moves forward, nurses and infection-prevention teams could spend less time collecting and submitting federally required data. At the same time, they could have less standardized national information to track how COVID-19, influenza, and RSV are affecting residents across long-term care facilities.
Facility-level surveillance would remain important regardless of whether federal reporting continues. Nurses are often among the first clinicians to recognize changes in residents that may signal respiratory illness, particularly in older adults whose symptoms may not follow typical patterns.
For now, nothing has changed.
The administration’s plan remains a draft, and CMS has not formally proposed it. Nursing homes must continue complying with existing respiratory illness reporting requirements unless and until federal rules are changed.
