DES MOINES — As anticipated, the Iowa Department of Inspections, Appeals, and Licensing (DIAL) announced today that its health facilities surveyors have met the federal mandate for nursing home inspections outlined by the Centers for Medicare and Medicaid Services (CMS) for federal fiscal year 2024, which began Oct. 1, 2023, and ended Sept. 30, 2024.
Federal fiscal year 2024 performance measures
For FFY 2024, CMS required state survey agencies (SSAs) like DIAL to conduct recertification surveys for each nursing home no more than 15.9 months after the last survey it completed. DIAL met this requirement.
While the inspection material is being uploaded to the federal databases, DIAL’s health facilities website maintains the most updated information regarding a long-term care facility’s inspection frequency. A recent State audit relied on outdated numbers and incorrect federal performance measurements, which could have been avoided if the auditor’s office engaged with DIAL before issuing its inaccurate report. In line with DIAL’s mission to be transparent and provide accurate and updated information to the public, all long-term care facilities’ inspection histories are available on this site.
"I am incredibly proud of the work our dedicated staff has done to inspect Iowa nursing homes in a timely manner. We expect to meet CMS' performance guidance for federal fiscal year 2025 as well," said DIAL Director Larry Johnson, Jr.
CMS adjusts performance measures annually
In March 2020, in an effort to control the spread of COVID, CMS halted most nursing home surveys, which resulted in a backlog of complaint and recertification surveys to be investigated nationwide.
Each year, CMS publishes an administrative memo for SSAs called the "State Performance Standards System," and this memo determines how the SSAs will be measured on their performance for that year.
- For FFY 2021 (Oct. 1, 2020-Sept. 30, 2021), CMS determined there were several normal performance measures that it would not evaluate for any state, as CMS and the states continued to respond to the COVID-19 pandemic. CMS did not evaluate SSAs on survey frequency. Instead, CMS required SSAs to conduct at least one infection-control survey at each long-term care facility, and a new infection-control survey within 3-5 days at a facility with a new outbreak. DIAL met both of these performance measurements.
- For FFY 2022 (Oct. 1, 2021-Sept. 30, 2022), CMS again did not evaluate states on survey frequency. Instead, CMS required SSAs to reduce their past-due standard recertification surveys by 50%. DIAL exceeded this requirement by reducing past-due surveys by 67.7%.
- For FFY 2023 (Oct. 1, 2022-Sept. 30, 2023), CMS again did not evaluate states on survey frequency. Instead, CMS required SSAs to reduce their past-due standard recertification surveys by 50%. DIAL exceeded this requirement by reducing past-due surveys by 90%.
State to provide more frequent updates
To assist in the public's general understanding of the nursing home survey process, DIAL plans to provide more information and materials. To this end, the department will release quarterly updates on its progress with recertification surveys and how it is meeting CMS guidelines. Additionally, DIAL has published a new podcast called "DIALED IN," to address some of the lingering questions the public may have. The first podcast addresses the fine and citation process of both the State and federal government. The second podcast discusses CMS' changing performance measure guidance since 2020. The podcast soon will be available on Spotify, Apple Podcasts, Amazon Music, iHeart Media, and more.
Inspection reports and fine information for nursing homes and other health care facilities regulated by DIAL can be found on the Health Facilities database site.