Q: I read that the Office of Inspector General is going to audit CMS oversight of states’ use of contractors to conduct nursing home surveys. Why is this needed?
A: In January, the OIG added to its 2024 Work Plan by announcing its intent to audit oversight of states’ third-party contractors conducting surveys, with a report expected in 2025.
The OIG indicated that in prior reviews, it had identified multiple issues related to the backlog of required surveys conducted by state agencies, including those conducted by contractors.
According to a recent report by the US Senate Special Committee on Aging, 32 states have surveyor vacancy rates of 20% or higher. The report indicated that, because of such vacancies, many states are relying on third-party contractors or extra-agency employees to conduct annual surveys and complaint surveys.
Although these surveyors must meet the same Federal Minimum Qualifications Standards requirements as state-employed surveyors, states nonetheless reported to the Senate that contractor work significantly deviated from state quality standards and is an area worth further scrutiny and clarity in oversight.
While it is unclear whether the quality issues negatively impacted the nursing homes being surveyed, it is certainly beneficial to operators if there is qualitative consistency when it comes to the surveyor methodology and interpretation of federal and state regulatory requirements.
In its work plan announcement, the OIG did not go into detail about the upcoming audit.
The agency said only that it will be looking at third-party surveyors’ training and qualifications, team size and composition, potential conflicts of interest and other factors that could impact the quality of surveys.
Norris Cunninghm, Esq., is a member at Stoll Keenon Ogden, PLLC. Send him your legal questions at [email protected].
