News Article

Senate Special Committee on Aging Report: Nursing Home Survey Agencies are Severely Understaffed

May 18, 2023

Today, the Senate Special Committee on Aging, led by Chairman Bob Casey, released a new report, “Uninspected and Neglected: Nursing Home Agencies are Severely Understaffed, Putting Residents at Risk.”  The report details a nationwide staffing crisis at state survey agencies that is directly impacting the health and well-being of nursing home residents. In addition, the Senate Special Committee on Aging held a hearing on the issue today, at which State Long-Term Care Ombudsman Leah McMahon testified regarding how inadequate staffing at state survey agencies is impacting resident care in Colorado.

The importance of state survey agencies cannot be understated. They are charged with enforcing federal and state regulations to ensure the safety of nursing home residents. Inadequate state surveying activity allows facilities to continue to operate in a manner that harms residents or puts them at risk of harm.

Key findings from the report include:

• One-third of the 15,000 nursing homes in the United States are behind on their annual surveys, with 11% of homes not having had a survey in over two years.
• 31 of 52 state survey agencies are experiencing vacancy rates of 20% or higher, with nine survey agencies having vacancy rates over 50%.
• Low salaries and burnout lead to high staff turnover in state agencies, which results in inexperienced surveyors.
• Many states have turned to hiring third-party companies to conduct surveying activities and are paying exorbitant fees for their services. The report also calls for increased oversight of these third-party survey companies.

The Committee’s report made several recommendations, including:

• Increased funding from Congress. Funding for state survey agencies has been flat for years, despite calls for increases from both Presidents Trump and Biden.
• Congress and state governments should take action to support state surveyors, including providing educational opportunities and mental health support.
• Congress should increase funding for State Long-Term Care Ombudsman programs. The report relies heavily on input from Ombudsman program representatives and notes their critical role in advocating on behalf of residents and calls for increased funding for these critical programs.

Consumer Voice has long been concerned about inadequate enforcement activities in nursing homes and delays attributable to staffing shortages and has repeatedly called for increased funding for state survey agencies. Consumer Voice is grateful to the Senate Special Committee on Aging and Chairman Casey for drawing attention to this important issue, and we urge Congress, the Centers for Medicare & Medicaid Services (CMS), and state governments to adopt the report’s recommendations.