OIG Found CMS Dropping The Ball Regarding Nursing Home Surveys: In its January 2022 report entitled “CMS Should Take Further Action To Address States With Poor Performance in
Conducting Nursing Home Surveys,” the U.S. Department of Health and Human Services Office of Inspector General (“OIG”) stated: “Just over half of States—28 of 52—failed to meet the same performance measure or measures in 3 or 4
consecutive years during FYs 2015–2018. States most commonly missed performance measures related to survey timeliness, which CMS and States often attributed to staffing shortages. The remedy that CMS consistently imposed on States for missing performance measures was requiring them to submit corrective action plans, but 10 percent of plans were missing from CMS files and many others lacked substantive detail. In addition to requiring States to submit
corrective action plans, CMS used other remedies, such as providing training and technical assistance, to address State performance problems.”
“Although CMS sometimes imposed financial penalties when States failed to meet the timeliness requirement for surveys, it frequently offset these penalties with one-time funding adjustments. In three States, CMS escalated concerns about performance to senior State officials, but it rarely imposed formal sanctions and has never initiated action to terminate any of its agreements with States for conducting surveys.”
Recent work by OIG has found problems with performance by some States—for example, one study found that States did not always verify whether nursing homes corrected deficiencies cited during the surveys. Another study found that
several States fell far short in conducting timely surveys following serious complaints about nursing homes, such as complaints alleging serious injury. These findings raise questions about the effectiveness of CMS oversight of State performance in conducting nursing home surveys, and the ability of CMS to hold States accountable when problems arise.
OIG recommended that CMS: (1) actively monitor States’ corrective action plans, (2) establish guidelines for progressive enforcement actions, (3) engage with senior State officials earlier and more frequently to address problems, and (4) revise the State Operations Manual to reflect current CMS oversight practices. CMS concurred with these recommendations. OIG also recommended that CMS: (5) disseminate the results of State performance reviews more widely. In response, CMS stated that its current practices already fulfill the recommendation. OIG revised the recommendation to clarify the new and expanded dissemination of results OIG recommended.
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