Nursing Homes Lack Inspections, Put Residents at Risk

Staffing shortages at nursing homes continue to put residents in harm's way.

By Mackenna Moralez, Associate Editor

Decades of underfunding has led to a significant staffing shortage and inadequate oversight, putting nursing home residents at risk, according to a recent report by U.S. Senate Special Committee on Aging Chariman Bob Casey. 

The report found that 32 survey agencies have vacancy rates of 20 percent or higher, while nine states have vacancy rates of 50 percent or higher, causing a delay in inspections. Federal data shows that 28 percent of the U.S.’ nursing homes are behind schedule for standard inspections, which are required to be done every 15 months. One in nine facilities claim that they have not had a standard inspection in two years.  

Meanwhile, the survey found that every state respondent said that they were unable to effectively do their job due to staff shortages, high turnover and inexperienced workforce. It is reported that agencies have not received an increase in federal funding to complete oversight responsibilities since 2015. Facilities are unable to compete with competitive wages from hospitals, nursing homes and the private sector.  

The investigation also found that states are now turning to costly contractors to fill labor gaps. According to the report, three national companies paid more than $52 million since 2018 to conduct nursing home surveys on behalf of the state. Inspections are meant to ensure that nursing homes are meeting federal standards for medical care, adequate staffing, emergency preparedness and safeguarding residents from abuse and neglect. These contractual arrangements may contribute to conflicts of interest related to survey agency use of third-party inspectors.  

“We appreciate the Senate Committee on Aging’s focus on this important issue and share concerns surrounding the backlog of nursing home surveys,” says Holly Harmon, senior vice president of Quality, Regulatory, and Clinical Services at AHCA/NCAL. “Conducting timely surveys of nursing homes is important for consistency in the regulatory process. The shortage of state surveyors is indicative of a larger workforce crisis facing the entire long term care profession. As the committee’s report signals, addressing this labor crisis requires significant investments, not mandates. We need a concerted, supportive effort to help recruit more individuals to serve our nation’s seniors, and we have proposed a comprehensive set of policies that would help grow and strengthen the nursing home workforce. “ 

Mackenna Moralez is the associate editor for the facilities market. 

June 8, 2023

Topic Area: Maintenance and Operations , Safety

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