The Office of the Inspector General (OIG) will be auditing nursing home survey practices this year with results expected in 2025, following concerns that third-party contractors may not have sufficient oversight in the space.
OIG suggested closer scrutiny of the Centers for Medicare & Medicaid Services (CMS) regulatory practices when it came to surveys, given the federal agency’s reliance on such contractors for conducting both state and federal surveys, on top of tackling survey backlogs.
“Prior OIG reviews of nursing homes have identified multiple issues related to the backlog of required nursing home surveys conducted by State survey agencies,” OIG said in a recent work plan announcement. “To combat this backlog, State survey agencies have increasingly used third-party contractors to conduct surveys.”
CMS has relied on third-party surveyors too to ensure that states meet Section 1864 requirements, or to determine provider compliance with conditions of participation, according to OIG.
OIG will be looking into training and qualifications among third-party surveyors, team size and composition, potential conflicts of interest and other factors that could impact the quality of surveys.
The move comes after OIG issued a report in January 2022, urging CMS to take further action to address states with poor performance in conducting nursing home surveys.
Just over half of states – 28 of 52 – repeatedly failed to meet one or more performance measures for conducting nursing home surveys between 2015 and 2018, the report found, with timeliness requirements being the most common.
Staffing shortages among state surveyors was the reason for failed performance measures; action plans were issued by CMS to correct failures, but 10% of such plans were missing from CMS files while others lacked “substantive detail,” OIG said at the time.