CMS Shares Information on New Risk-Based Survey Pilot

On April 3, 2024, the Centers for Medicare and Medicaid Services (CMS) shared long-awaited information on the new risk-based survey pilot that was first announced in December 2023. This approach would allow providers with consistent track records of high quality to receive a more focused survey that takes less time and fewer resources than a standard survey. CMS is exploring several indicators of high quality such as citation history – for example, a history of fewer citations for noncompliance and an absence of citations related to abuse or resident harm; staffing and compliance with staffing data submission requirements; quality metrics such as hospitalizations; and other indicators.

Estimates by CMS indicate that the scope of the new survey approach would be limited, only impacting approximately 10 percent of providers in a state. While the targeted survey would replace the standard survey for these selected providers, complaint surveys would not be affected, and a risk-based survey could be expanded to a regular standard survey as indicated by findings at the time of survey.

More information about this process is available here and on the CMS Nursing Homes page. CMS will continue to work with states to test this process over the next several months. They will provide updates as things progress, and any official or formal memoranda will be posted to the CMS Policy & Memos to States and CMS Locations page. LeadingAge National will be working to learn more about this process and encourages any providers selected to participate in the pilot to email Jodi Eyigor at jeyigor@leadingage.org to share your experience.

Contact: Carrie Mosley, cmosley@leadingageny.org, 518-867-8383 ext. 147