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The Surveyors Just Walked In!

November 11, 2022 by Diane Leave a Comment

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Drawing of male detective wearing a trench coat & holding a magnifying glass.

When you saw the title of this article, did you feel a twinge of panic? If so, you’re not alone.

During the many years I worked in nursing homes, my stomach always did a flip when I heard the surveyors had entered our building. No matter what wonderful care you provide, it’s always unnerving to be watched and questioned by surveyors.

So, who are these people? Today we’ll look at the purpose, backgrounds, and responsibilities of nursing home surveyors.

Why do nursing homes get surveyed? 

Surveys (inspections) started way back in the 1970s in response to significant concerns about the care provided to residents in nursing homes. Today, all nursing homes that receive funding from Medicare and Medicaid receive routine inspections.

The surveyors look at a myriad of areas related to resident care and safety. They follow up with a report highlighting any problems (deficiencies) they observe. (Did you know anyone can read these reports? Simply go to the Medicare.gov website.) In most cases, the nursing home responds with a plan for correcting the problems, and the survey team approves it.

However, depending on the severity of the deficiencies, the government might also impose penalties on a nursing home. This could include monetary fines. Or, in more serious cases, the government could ban admissions of new residents until the nursing home corrects the problems.

Note that it’s unusual for a nursing home to receive zero deficiencies during a survey. That’s not surprising, considering the enormous number of regulations they must follow. According to KFF.org, the average U.S. nursing home receives eight deficiencies during a state survey.

Who is on the survey team?

The number of people on a survey team varies depending on the size of the nursing home being inspected. There is always a nurse on the team. Other team members could include various healthcare professionals, such as dieticians, social workers, or physical therapists.

Qualifications of team members often vary a bit depending on the state. For example, states may require different work experience for surveyors. Each team member also receives extensive training on the survey process and state/federal regulations.

What are the surveyors’ responsibilities?

The surveyors follow a specific protocol throughout their visit. This helps assure fairness between facilities. Some of their responsibilities include:

  • Tour the building and look for safety issues
  • Observe meals, medication administration, and resident cares
  • Review residents’ medical records
  • Interview residents and family members
  • Meet with resident council members
  • Check staffing levels and staff licenses
  • Meet with administrators and other staff

When are the surveyors coming?

Contrary to what some people believe, nursing homes do not know when surveyors are coming to their buildings. (Although they might make a good general guess based on the date of the previous survey.)

While surveyors usually arrive during daytime business hours, regulations require a certain percentage of surveys to begin during odd hours. This means the team might arrive in the middle of the night or on the weekend.

The most common type of inspection is a state survey. These happen approximately once a year. Surveyors may appear at a nursing home at other times for various reasons.

For example, they do surveys in response to complaints they receive about nursing homes. They also follow up on deficiencies after the nursing home has had time to correct the problem. In addition, a nursing home with a history of significant deficiencies might have more frequent surveys.

Besides state surveys, a federal team might also come to your nursing home. They follow a similar process, but they visit much less often. During the twenty years I worked at my most recent nursing home, we only had two federal surveys.

Characteristics of an effective surveyor

Are you interested in a career as a nursing home surveyor? Then you’ll need these traits:

  • Excellent verbal and written communication skills
  • Proficient on computer
  • Able to travel frequently
  • Thick-skinned (Few people are excited to see surveyors enter the building!)
  • Attention to detail
  • Team player
  • Objectivity

What did I miss? If you’ve worked as a nursing home surveyor, I would love to see your comments.

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