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Casey, Colleagues Urge Medicare Agency to Improve Nursing Home Oversight

Letter to CMS follows Casey investigation that revealed staffing shortages leading to nursing home inspection delays across Nation

28 percent of the Nation’s 15,000 nursing homes have not received a comprehensive annual inspection for 16 months

Washington, D.C. - Today, U.S. Senate Committee on Aging Chairman Bob Casey (D-PA) led his colleagues Finance Committee Chairman Ron Wyden (D-OR) and Budget Committee Ranking Member Chuck Grassley (R-IA) in a letter to the U.S. Centers for Medicare & Medicaid Services (CMS), urging the agency to take immediate steps to strengthen the Nation’s nursing home oversight system.

The senators called on CMS to increase transparency and improve monitoring of state survey agencies, which are responsible for ensuring the health and safety of the Nation’s 1.1 million nursing home residents. The letter follows Senator Casey’s release of “Uninspected and Neglected,”  an investigation that found 32 state survey agencies have vacancy rates of 20 percent or higher, an issue states directly linked to nursing home inspection delays. The investigation recommended CMS track and report these shortages to improve the nursing home oversight system.

“CMS has an integral role to play in addressing many of the current failures of the nursing home oversight system, especially to improve monitoring and reporting on the capacity of state survey agencies to carry out statutorily required inspections in mandated timeframes,” the Senators wrote, “The Nation’s 1.1 million nursing home residents should expect high quality care to be delivered in an environment that prioritizes health, safety, and human dignity. Thorough and timely nursing home inspections are key to ensuring these goals are met.” 

As of May 2023, federal data show that 28 percent of the Nation’s 15,000 nursing homes have not received a comprehensive annual inspection for 16 months or more, placing them behind on statutorily mandated annual inspection schedules. One in nine nursing homes have not received an annual inspection in at least two years. 

In the letter, the Senators requested CMS provide detailed information on how the agency intends to take action to address these shortfalls by state survey agencies. Specifically, the Senators requested information about CMS’ efforts to increase transparency around survey agency staffing shortages and the use of contractors to conduct nursing home surveys. 

Senator Casey has a long history of fighting to increase and improve nursing home oversight. In August 2021, Casey and Wyden introduced the Nursing Home Improvement and Accountability Act,whichwould address gaps in staffing, transparency, accountability and oversight of long-term care facilities. And in 2020, Chairman Casey secured a one-time $100 million funding boost for nursing home oversight in the Coronavirus Aid, Relief, and Economic Security (CARES) Act, which is set to expire in September 2023.