Out of 15,295 nursing homes nationally, 10,913, or 71%, have gone at least 16 months without a standard survey as of May 31, according to an updated report filed by the U.S. Department of Health and Human Services Office of Inspector General.
The report suggests that the Centers for Medicare and Medicaid issue guidance for states on prioritization of surveys and required timeframes to complete these backlogs.
“Due to the COVID-19 pandemic, states have conducted substantially fewer of these standard surveys, which help to identify and address deficiencies,” the addendum from the Office of Inspector General reads. “Our updated analysis underscores the importance and urgency of … CMS to clarify expectations for states to complete backlogs of standard surveys.”
In a previous report, released on December 2020, the OIG found states faced backlogs of standard surveys of nursing homes early in the pandemic, with 8% of nursing homes having gone at least 16 months without a standard survey as of June 2020.
The addendum released this week serves as an update to the extent to which states face backlogs of standard surveys of nursing homes and the backlogs appear to have worsened nationwide.
Connecticut was shown to be lagging behind the most on its standard survey of nursing homes from Feb. 1, 2020, through May 31, 2021, after completing just eight surveys in a state with a total of 209 nursing homes, as 96% of the state’s nursing homes went without a standard survey during that time frame.
California — with 88% of nursing homes without a standard survey — completed just 146 nursing home standard surveys with 1,037 nursing homes unsurveyed.
Overall, the backlog ranged from 22% to 96% by state.
Despite the drop in standard surveys conducted, previous data has indicated that nursing homes surveys are up overall.
Federal data from April 2020 showed that the number of surveys conducted nationwide had risen 132% since 2020, with dramatic increases seen in infection control surveys.
States complete standard surveys on behalf of CMS and are required to do so at least once every 15 months in order to ensure that they meet federal requirements.
Each survey includes an onsite inspection where nursing homes that are violating a federal requirement can be identified, which can result in CMS imposing civil monetary penalties.
CMS suspended standard surveys in Mach 2020 and shifted oversight to infection control surveys, which are more limited in scope than the former, the OIG report said.
“Comprehensive nursing home inspections — standard surveys — are CMS’s main tool to ensure that nursing homes meet the minimum standards necessary for the safety and wellbeing of residents,” it went on to say.
OIG previously recommended that CMS to clarify its expectations for states to complete backlogs of standard surveys in its December 2020 report. It suggested that CMS include guidance on the prioritization of surveys and require timeframes for completion.
CMS responded to that request by saying it would continue to work with states on how to address these backlogs, the OIG added.
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Centers for Medicare & Medicaid Services, Office of Inspector General, U.S. Department of Health and Human Services
