A proposed bill in Maryland could shift the responsibility of nursing home surveys to local county officials, sparking both support and scrutiny within the long-term care industry. Proponents argue this change would bolster oversight and ensure resident safety, while others express concerns about potential duplication of efforts and the long-term implications.
The Maryland Association of Counties (MACo) is a strong advocate for the bill, with Associate Policy Director Karrington Anderson testifying before the Senate Finance Committee. “The provisions of this bill reflect a strong state-local partnership,” Anderson stated in a MACo memo. “Allowing local governments to assist with inspections ensures that no facility goes unchecked simply due to limited state resources.” MACo emphasizes that this collaborative approach is crucial, especially given the varying number of nursing homes in each county.
This proposed shift comes at a time when staffing shortages and high attrition rates are plaguing the nursing home industry, making regulatory enforcement a significant challenge. As Anderson noted in her testimony, these workforce issues have made it difficult to maintain consistent oversight. LifeSpan Network, Maryland’s largest senior care provider, supports the bill’s aim for stronger enforcement. “We are working with the bill sponsors to ensure that any delegation of authority in the survey process does not result in a duplication of surveys by a county and the State,” said Kevin Heffner, President and CEO of LifeSpan Network, to McKnight’s Long-Term Care News.
The bill’s potential impact extends beyond Maryland’s borders. Nationally, states have struggled to conduct timely nursing home surveys, a problem exacerbated by the pandemic. According to data from CMS, as of May 2024, the average annual recertification survey was delayed by 578 days. This backlog highlights the need for innovative solutions to ensure consistent oversight. The Maryland bill, sponsored by Senator Benjamin F. Kramer (D), could serve as a model for other states grappling with similar challenges. It may also help address the nationwide surveyor shortage by potentially generating more local talent.
The timing of this bill coincides with the Centers for Medicare & Medicaid Services (CMS) recently releasing its 2025 surveyor priorities. While CMS has pushed back the implementation of new surveyor guidance until March 24, this delay provides states like Maryland with valuable time to refine their processes and potentially enact supporting legislation. The outcome of this bill could significantly reshape the landscape of nursing home oversight, both in Maryland and potentially across the nation.