Changes to Federal Nursing Home Survey on the Way
Representatives from LeadingAge met with key staff from the Centers for Medicare and Medicaid Services (CMS) regarding changes in the nursing home survey process that may take place as soon as November 2017. There has been discussion that elements of the traditional survey process will be combined with components of the QIS survey to create the new process. LeadingAge staff shared the following notes regarding the recent meeting:
- CMS confirmed that they will be ‘rolling out’ a new survey process for implementation in November 2017.
- The new survey will be computer-based with 2 major components/parts.
- Sample selection will be based on an MDS algorithm and consist of 70% identified off-site; 30% will be identified on-site and will include vulnerable residents, new admissions, complaints, and residents ‘that are concerning.’
- There will be a heavy reliance on interviewing. A change from the current QIS process allows for more flexibility in addressing the questions; i.e., surveyors can ‘adjust’ the questions. Questions will no longer have to be posed verbatim.
- CMS has conducted 5 rounds of testing in states including OH, MD, OR, VT, PA, AL, WI [and MN?].
- In addition to SA staff, 9 of the 10 Regional Offices and some contracted surveyors participated, followed by extensive debriefing. Debriefing with providers was ‘informal.’
- The 1st four testing rounds were announced, with no formal citations and the exit used for quality assurance purposes. The 5th round was conducted in 3 states with unannounced surveys that included complaints and that are ‘surveys of record.’
- CMS is still analyzing the data from the 5th round of testing, but indicated that they are seeing an increase in citations under the new process.
In addition to the changes to the survey process, changes to the federal nursing home regulations are also anticipated. These changes, proposed in 2015 by CMS, contained a series of new and modified regulations and generated thousands of comments from stakeholders. LeadingAge NY commented on the proposed regulations. The new regulations may be issued as soon as September 2016.
Contact: Elliott Frost, efrost@leadingageny.org, 518-867-8832