You Asked: Are Risk-Based Surveys expected to continue?
We Answered: Yes. The Centers for Medicare and Medicaid Services (CMS) has indicated that it intends to expand the use of Risk-Based Surveys (RBS) beyond the current pilot, with additional eligibility criteria expected to be released in the coming months.
Evan Shulman, Director of the Division of Nursing Homes at the Centers for Medicare & Medicaid Services (CMS), has shared that approximately 10% of skilled nursing facilities could ultimately qualify for a Risk-Based Survey. While CMS has not yet released the final qualifying criteria, facilities that consistently demonstrate strong performance, such as higher Five-Star ratings, strong staffing, fewer hospitalizations, no history of resident harm or abuse, successful compliance with required data submissions, and no failed schizophrenia audits, are expected to be among those eligible.
It is important to remember that a Risk-Based Survey can be expanded into a full standard survey if surveyors identify concerns during the inspection. Complaint investigations will also continue to be conducted separately and are not replaced by the Risk-Based Survey process.
According to CMS, the goal of the Risk-Based Survey initiative is to better align limited survey resources with resident risk. By conducting shorter, focused surveys in consistently high-performing facilities, survey agencies can dedicate more time and resources to nursing homes where residents may be at greater risk for poor outcomes. LeadingAge Ohio will keep members informed as CMS releases official updates and additional guidance.