In the past year, Missouri has made significant strides in reducing its backlog of overdue nursing home inspections, providing a potentially instructive model for other states grappling with similar challenges.

According to recent data from the Centers for Medicare & Medicaid Services (CMS), the percentage of nursing homes in Missouri that had not been inspected in at least two years has dropped dramatically from 25% to approximately 3%.

For other states struggling with similar backlogs, Missouri’s approach offers several important strategies. First, expanding staffing resources – both through internal hires and external contracts – can provide the necessary manpower to tackle large volumes of inspections. Additionally, adjusting budget allocations to increase compensation for surveyors can attract and retain skilled staff, further alleviating delays, experts said.

The improvement in Missouri follows concerted efforts by the Missouri Department of Health and Senior Services (DHSS) to address the massive survey backlog, following a suspension of standard inspections during the COVID-19 pandemic, an article in the Missouri Independent states. When inspections resumed in January 2021, Missouri faced over 4,000 pending complaint investigations. Today, that number has shrunk to 265.

Lisa Cox, a spokesperson for the DHSS, attributed this progress to the relentless dedication of Missouri’s surveyors and inspectors. “Our team has gone above and beyond by investigating complaints at all hours—nights, early mornings, weekends, and holidays,” Cox said in the article. The state has also bolstered its inspection capacity by hiring certified part-time staff, securing additional funding to increase nurse surveyor salaries, and contracting with private agencies to enhance staffing levels.

However, while Missouri has made leaps in reducing inspection delays, concerns about nursing home staffing levels persist.

Recent data indicates that Missouri’s nursing homes provide an average of 3.3 hours of daily care per resident, falling short of the forthcoming federal staffing mandate of 3.48 hours. This shortfall highlights the need for continued focus on improving the number of workers and care quality in addition to reducing inspection backlogs.

For states facing similar issues, Missouri’s experience shows that investment is needed in the survey inspection processes, enhancing staff compensation for both surveyors and nursing home workers, and addressing staffing shortages.