McKnights Long-Term Care News reported the contents of a letter sent by the Centers of Medicare and Medicaid (CMS) to the state agencies that handle nursing home inspections. The letter communicated that the pandemic has created a massive staff shortage of inspectors across the country, creating the delays in what should be annual inspections. There are typically inspections also when there is a reported problem. The staffing shortage is putting a great deal of stress on the inspectors who remain, which is forcing many of them to leave the profession and making a bad situation worse.
According to data from CMS in August of 2022, roughly a third of the nation’s nursing homes were overdue for an inspection. That means that some 4,500 nursing homes have gone over a year without an inspection. According to McKnight’s research into CMS data, Maryland has the worst inspection gap in the nation at nearly three-years (1,021 days) between standard surveys.
These unannounced inspections are crucial to ensuring the safety and well-being of nursing homes residents, as well as staff members. Without them, there is no one minding the store. The nursing home industry has shifted over the past few decades, as private-equity groups have gobbled up independently owned nursing home. Their motive is to drive profit by cutting corners everywhere they can. This trend has led to increases in infectious spread (even before COVID), preventable injuries, deaths, and general misery for elderly residents.
Without a watchdog to provide unannounced inspections and fines for infractions, there is very little to motivate nursing homes to meet national and state nursing home regulations—laws that already set a miserably low standard for safety and quality. Yet, even with regular inspections and the threat of fines (and potentially losing their license), most nursing homes violate regulations repeatedly. One can only imagine how much worse they are without the burden of inspections.
The nursing home industry has a mission to provide care for the vulnerable elderly for which they receive millions in tax dollars, but too many nursing homes are siphoning off money intended for residents into the pockets of owners and investors. Without a strong inspection system, there is not much to encourage many nursing homes to provide quality care, other than the threat of a lawsuit for nursing home abuse or negligence.