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CMS Risk-Based Survey (RBS) Process

Posted May 24, 20244 min Read

Regulatory & Clinical
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The Centers for Medicare & Medicaid Services is piloting a new approach to the survey process that could be available the nation’s best performing nursing homes. The process would also benefit the state agencies across the county to compensate for backlogs and staffing shortages in the survey world.  

Things you need to know:  

  • Indiana is one of the states evaluating the RBS, and the first Indiana risk-based survey was conducted the week of 5/20/2024. As more information is available, IHCA/INCAL will share that information with providers.  
  • The risk-based survey will allow “consistently higher-quality facilities” to receive a more focused survey, while also ensuring compliance with health and safety standards.  
  • CMS would limit the maximum number of participants, most likely to around 10% of the highest quality performers in each state.  

Higher quality could be indicated by the following:  

  • History of fewer citations for non-compliance 
  • Higher staffing  
  • Fewer hospitalizations  
  • No citations related to resident harm or abuse. 
  • No pending investigations for resident at immediate jeopardy for serious harm  
  • Compliance with staffing and data submission requirements (PBJ (Payroll Based Journal) and NHSN) 
  • Any concerns about resident safety during a risk-based survey, the survey would be expanded.  

The risk-based survey would free up staff in high performing facilities instead of tying up clinical and leadership staff for days in a standard survey. The surveyor teams would also have more time for timely oversight of facilities where risks to residents’ health and safety are greater. 

Forward questions to ldavenport@ihca.org  

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