Close up image of a caretaker helping older woman walk

If nothing else, we have to give Centers for Medicare & Medicaid Service Administrator Seema Verma credit for building a plan and sticking to it. So far. But be careful what you ask for.

Rumors have flown in recent years that federal regulators would like to give strong-performing nursing homes a break on survey frequency. This, of course, would allow the government to shift more resources to inspecting and shaping up poor-scoring facilities.

That seems to be coming a lot closer to reality and Verma, true to the five-point plan she announced this spring, announced it in a blog about the first leg of that plan.

She noted in an Aug. 28 post that her agency is proposing surveying top-performing facilities every 30 to 36 months — more than twice as long as the current interval for all nursing homes.

To that I refer to the Will Rogers’ famous quote, “It takes a lifetime to build a good reputation, but you can lose it in a minute.” Good reputations — and track records — would be at a premium under this CMS proposal.

Hopefully, it would take more than a minute to lose one’s good standing, though given some of the severe lapses in judgment by the rare rogue caregiver, one never knows. The point is that the good will be rewarded and the bad will get leaned on even more. In a nod to CMS, I have to agree the idea has merit.

Of course, this Will Rogers quoting can be instructive to providers in other ways. Given how CMS has decided to continually move the goalposts on Five-Star Ratings and heighten quality benchmarking markers, “good” won’t always be good enough, something regulators openly admit.

That’s kind of eerily reminiscent of the Rogers chestnut, “Even though you are on the right track — you will get run over if you just sit there.”

CMS itself has taken this line of thought to heart. In Verma’s blog post, she noted that the agency has moved to a single, computer-based survey process and paired it with updated guidance.

Expect Verma’s next four blog posts to clarify and confirm that providers are going to be asked for even more. While this first in a series focused on “Strengthen Oversight,” the others will explore efforts to “Enhance Enforcement,” “Increase Transparency,” “Improve Quality” and “Put Patients Over Paperwork.”

Hold on to your hats, everybody.