The Centers for Medicare & Medicaid Services (CMS) publicly posted information on a risk-based survey pilot on the CMS Nursing Homes page on April 3. First announced in December 2023, CMS has been tight-lipped about the pilot up until this point. LeadingAge reached out to CMS at the time of the announcement, then followed up with a letter in January 2024, encouraging CMS to work with providers, surveyors, and the associations on this initiative.

The risk-based survey approach will allow providers with consistent track records of high quality to receive a more focused survey that takes less time and fewer resources than a standard survey. CMS is exploring several indicators of high-quality including citation history, such as a history of fewer citations of noncompliance and an absence of citations related to abuse or resident harm, staffing and compliance with staffing data submission requirements, quality metrics such as hospitalizations, and other indicators.

CMS estimates that the scope of the new survey approach would be limited, impacting approximately 10% of providers in a state. While the targeted survey would replace the standard survey for these providers, complaint surveys would not be affected and a risk-based survey could be expanded to a regular standard survey as indicated by findings at the time of survey.

LeadingAge will learn more about this process and encourages any providers selected to participate in this pilot program to email Jodi Eyigor (jeyigor@leadingage.org) to share your experience.