Skinner Robert J, Stevenson David G
Department of Health Policy, Vanderbilt University Medical Center, Nashville, USA.
Geriatric Research Education and Clinical Center (GRECC), Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, USA.
J Aging Soc Policy. 2024 Nov;36(6):1529-1543. doi: 10.1080/08959420.2024.2384335. Epub 2024 Jul 31.
Since the Nursing Home Reform Act of 1987, regular oversight of United States nursing home activities has been a key strategy to ensure minimum levels of care quality for residents. Oversight activities have included "standard" survey visits - that is, annual unannounced visits by state survey agencies (SSAs) that directly observe resident care and interview nursing home residents and staff. This study provides an overview of these activities, focusing on oversight delays arising from policy changes brought on by the pandemic. Data from the Centers for Medicare and Medicaid Service's (CMS) Quality, Certification and Oversight Reports, Survey Summary Files, and Provider Information Files were used to measure delays in survey completion across SSAs. Study findings reveal delays in inspection activities, which have resulted in a large backlog of uncompleted standard surveys far exceeding regulatory requirements. These delays exist across nursing homes with high and low levels of quality. As SSAs work through the backlog of surveys, they may prioritize the completion of surveys based on prior performance. This precedent may be expanded as CMS explores opportunities to produce processes that target the completion of surveys in the poorest performing nursing homes.
自1987年《疗养院改革法案》颁布以来，对美国疗养院活动进行定期监督一直是确保居民获得最低护理质量水平的关键策略。监督活动包括“标准”调查访问，即由州调查机构（SSA）进行年度不预先通知的访问，直接观察居民护理情况并采访疗养院居民和工作人员。本研究概述了这些活动，重点关注疫情引发的政策变化导致的监督延迟。来自医疗保险和医疗补助服务中心（CMS）的质量、认证和监督报告、调查摘要文件以及提供者信息文件的数据被用于衡量各SSA在调查完成方面的延迟情况。研究结果显示检查活动存在延迟，这导致大量未完成的标准调查积压，远远超过监管要求。这些延迟在质量高低不同的疗养院中都存在。随着SSA处理积压的调查，他们可能会根据以往表现优先完成调查。随着CMS探索制定针对最差表现疗养院调查完成情况的流程的机会，这一先例可能会扩大。
