Survey Readiness…More Important Than Ever!
Published: April 9, 2024
April 2024 Update: CMS Survey Process Notice: Testing Risk-Based Survey Approach
By modifying some surveys based on compliance and quality history, CMS will be able to devote more time and resources to nursing homes with lower quality whose residents are at higher risk of harm. This effort to prioritize resources for nursing home surveys has become more pressing as the budget for survey and certification has remained at $397 million since 2015.
CMS is testing a risk-based survey (RBS) approach that allows consistently higher-quality facilities to receive a more focused survey that takes less time and resources than the traditional standard recertification survey, while ensuring compliance with health and safety standards. Higher quality could be indicated by a history of fewer citations for noncompliance, higher staffing, fewer hospitalizations, and other characteristics (e.g., no citations related to resident harm or abuse, no pending investigations for residents at immediate jeopardy for serious harm, compliance with staffing and data submission requirements). The number of nursing homes that could meet these criteria would be limited, such as up to 10 percent of nursing homes within a state. The survey resources saved by performing a more focused review of the required areas of a standard survey in these higher quality facilities would then be available to perform more timely oversight of facilities where the risks to residents’ health and safety are greater. If any concerns about resident safety were encountered during the RBS, it would immediately be expanded. Resident safety will always be prioritized, regardless of the type of survey process. The RBS process would not apply to complaint surveys.
CMS is working with states to test this process over the next several months. We will provide updates as we progress, and any official or formal memoranda will be posted to the CMS website for Policy & Memos to States and CMS Locations.