The Centers for Medicare and Medicaid Services is rolling out a major overhaul of how it inspects nursing homes, and the changes could reshape daily life for operators across the country.
Starting in September, CMS will launch a nationwide Risk-Based Survey process that streamlines inspections for high-performing facilities while directing more resources toward homes with weaker track records. The agency announced the move Thursday, framing it as a way to modernize oversight amid years of budget strain.
The problem isn’t new. Federal funding for state survey agencies has stayed flat for a decade even as complaint investigations have jumped more than 20% since 2015, according to CMS. That squeeze has left surveyors struggling to keep up, and delays have piled up. CMS says those delays put residents at risk.
Under the new system, nursing homes that meet strict quality benchmarks will qualify for a shorter, streamlined standard recertification survey. The RBS process takes about half the time and requires fewer surveyors, but it still covers all required compliance areas. All facilities will still get a standard survey at least every 15 months, and CMS can still conduct traditional inspections at qualifying homes if complaints arise.
To make the cut, a facility needs a five-star overall rating on Care Compare, accurate data reporting, no citations for resident harm or substandard quality of care from the last survey cycle, and no recent ownership changes. CMS estimates roughly 12% of nursing homes will initially qualify.
High performers will also get a new icon on Medicare.gov’s Care Compare tool, making them easier to spot for families shopping for care.
The move has been years in the making. CMS tested the approach in a 22-state pilot program, and industry groups have been pushing for this kind of reform for a while.
“CMS’ decision to implement a Risk-Based Survey process nationally following years of careful testing and evaluation is a significant win for nursing home residents and families; for providers, including our nonprofit and mission-driven members; and for state regulators,” Katie Smith Sloan, president and CEO of LeadingAge, said in a statement.
Clif Porter, president and CEO of the American Health Care Association and the National Center for Assisted Living, said the expansion is something his group has long supported.
“This initiative upholds accountability while further incentivizing quality improvement by recognizing high-performing facilities,” he said.
The shift arrives as part of the agency’s broader regulatory reform push, including other efforts to cut red tape that operators have called obsolete and burdensome.
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