The survey process for nursing homes could be tougher under a new Centers for Medicare & Medicaid Services initiative to improve nursing home safety and quality.

The initiative’s five-part approach focuses on more oversight, enhanced enforcement, increased transparency, improved quality and “putting patients over paperwork,” according to CMS Administrator Seema Verma in a blog post on Wednesday. 

State Survey Agencies must “fairly and consistently” apply CMS’ rules when evaluating nursing home compliance, Verma said. She noted that President Donald Trump’s proposed 2020 budget includes a request to increase the Survey and Certification budget by $44.9 million.  

“We hope Congress will honor this request and allow CMS to ensure appropriate survey oversight of all Medicare and Medicaid certified providers and suppliers,” Verma wrote.

The American Health Care Association supports more funding to strengthen the survey process, said David Gifford, M.D., AHCA’s Chief Medical Officer and senior vice president of quality of regulatory affairs.

“The consistency and timeliness of the survey process is important and we support CMS’ work to address those issues,” Gifford said. “We share the CMS commitment to improving the lives of every resident in nursing homes across the country.”

Verma also said in recent years CMS has found “variation” across states on issues with nursing homes’ compliance. The agency is now taking steps to provide additional guidance and resources to SSAs — like updating Immediate Jeopardy guidelines — and has moved to a single, computer-based survey process that allows it to monitor data received from SSAs and address any outliers in their results. 

Other plans included better using regional CMS offices and providing better feedback to SSAs and state officials. 

“The health and safety of America’s nursing home patients is at the forefront of our minds, and is at the heart of all of our work in this area,” she wrote. “Every action we take is because it will ultimately benefit the patient.”