Majority of nursing homes missing broad safety, quality inspections due to the pandemic

States have fallen behind on federally mandated surveys of quality and safety measures at nursing homes during the coronavirus pandemic.

While the standard surveys, which check for quality and federal compliance, are required at least every 15 months, 71% of Centers for Medicare & Medicaid Services-certified nursing homes nationally had gone at least 16 months without one as of May 2021, according to a report from the Office of Inspector General.

Though it kept in place more narrow surveys such as infection control and targeted complaint investigations, CMS had suspended standard surveys due to the COVID-19 pandemic in March 2020. However, despite announcing in August 2020 that states should resume the surveys, resources allowing, the backlog grew from 8% in June of 2020 to 71%, the OIG’s latest examination of CMS administrative data found.

“Our updated analysis underscores the importance and urgency of our previous recommendation to CMS to clarify expectations for states to complete backlogs of standard surveys,” OIG wrote in its report, noting that in December 2020, CMS said it would continue working with states to address the issue.

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According to the report, Connecticut had the highest percentage of nursing homes without a standard survey for at least 16 months as of May 2021, at 96%, followed by Georgia at 93% and Oregon at 92%. Of all 50 states surveyed, 43, plus Washington, D.C., had at least half or more of their nursing homes missing a survey in at least 16 months.

Low-quality care and understaffing have historically been pervasive problems in the sector, in part due to limited public funding in the U.S.

An OIG report released in June found that more than 2 in 5 Medicare beneficiaries living in a nursing home were diagnosed with or likely had COVID-19 during 2020.

And, U.S. nursing homes were frequently hit with repeat COVID-19 surges with about 94% experiencing two or more outbreaks of the disease among residents or staff through January, data from the U.S. Government Accountability Office (GAO) revealed.

Nursing homes constitute nearly a third of COVID-19 deaths in the U.S., with death rates peaking last December. The Trump administration had implemented a policy that limited the fines facilities could receive for violating safety standards. The Biden administration reversed that rule last week.