The Office of the Inspector General (OIG) added a new report to its Work Plan in January. The report, “Audit of CMS Oversight of States’ Use of Third-Party Contractors to Conduct Nursing Home Surveys,” will review the Center for Medicare & Medicaid Services’ (CMS) reliance of third-party contractors to conduct nursing home surveys. The report seeks to identify if CMS is providing adequate oversight regarding States’ use of contract surveyors.
Given the historical variation in the survey process throughout the country since the Long-Term Care Survey Process (LTCSP) was implemented, this report could find that different states provide varying levels of oversight to the third-party contractors who conduct their surveys. It is already evident in OIG’s multitude of reports about its unannounced visits to various states’ nursing homes to assess their compliance with certain Federal requirements that the Agency sees variability among states and the way deficiencies are identified.
This report about CMS oversight of contractors conducting surveys is not expected until FY 2025 – so we will have to wait to see what the OIG determines. The consistent survey backlog, such as in New York, where approximately only a third of providers had a recertification survey in 2023, is not likely to get better when the states are struggling to find surveyors – regardless of oversight.
Overdue Recertification Surveys
According to CASPER data from January 14, 2024, 11.9% of providers (1,770) have not been surveyed in 24 months or more. For certain CMS regions, the number of providers who haven’t been surveyed in double the Federally required timeframe or greater, is significant, such as Atlanta (20.6%), New York (24.50%) and San Francisco (26.4%).
This isn’t just a CMS problem, it’s a problem for providers too. Facilities look forward to the opportunity to be surveyed on a routine basis, and not have issues from years prior be looked at by surveyors as part of their “annual” review.
Per the same CASPER, 26.9% of providers haven’t been surveyed in 16 months or more, which amounts to more than 4,000 nursing homes – and nearly half of the providers in some CMS Regions.
Let’s see if the OIG report and recommendations can help get the process back up to speed.