Doctor and senior woman wearing facemasks during coronavirus and flu outbreak. Virus protection. COVID-2019..

Provider advocates are bracing for backlash from a letter Sen. Charles Grassley (R-IA) sent Friday to the head of Centers for Medicare & Medicaid Services, Mark McClellan, calling for stricter federal regulations on nursing home inspections. Grassley said inspectors are pressured to overlook or downplay problems. He suggested CMS allow the inspectors to anonymously report the pressure they face to manipulate data.

Grassley had his staff review the inspection process following hearings last year. His staff found inspectors who felt pressure from their bosses to downgrade problems rewrite negative findings in a more positive light or do not write them up at all.

“The survey process upon which we rely for accurate, objective and independent data … has been corrupted … and we need to restore the integrity of the system,” the letter said.

CMS said it will take action to improve the quality of nursing home care, and that it already made changes, such as focusing inspections on bed sores, malnutrition, dehydration and staffing levels.