CMS report shows Great Recession led to less nursing home oversight

The Great Recession led to a notable drop in nursing home enforcement actions over a five year period, according to a new report from the Centers for Medicare & Medicaid Services.

The latest Nursing Home Enforcement Reports, which shows enforcement data from 2006 through the end of 2014, tracks the impact the recession had on survey activities, initiatives and deficiency citations.

Between 1996 and 2008, the years leading up to the recession, the average number of deficiencies cited per nursing home survey jumped from 5.1 to 7.1. That leap is due in part to several CMS nursing home oversight initiatives launched during that time, including increased surveyor training, the Nursing Home Action Plan and the Special Focus Facility Program, the report said.

Although the recession officially lasted from 2007 to 2009, its effects on state budgets were felt for years afterwards, and many state survey agencies were negatively impacted as a result. Many agencies had to resort to layoffs, furloughs, hiring freezes and other money-saving measures that cut back on their capacity for oversight, the report found.

The average number of deficiencies dipped between 2009 and 2014 as a result of that limited oversight, from 7.1 to 5.7. Surveys also resulted in a “notable” decline in actual harm and immediate jeopardy citations. The drop in citations and deficiencies led to fewer opportunities for enforcement, and a lower number of enforcement actions taken against noncompliant facilities, CMS said.

The report, which was released Friday, also shows the total amount of civil monetary penalties for all regions of the U.S. grew between 2006 and 2014, from $19 million to more than $55 million.

To read the full report, which also breaks down enforcement remedies by state and region, click here.