Policy & oversight
Federal Watchdog Says CMS Needs Better Oversight of Contract Workers Who Inspect Nursing Homes
States have leaned more heavily on outside contractors to conduct nursing home inspections, but a new OIG audit finds CMS lacks adequate controls over how those contractors perform their work.
By the Goodsurance editorial teamSeptember 5, 2026
A federal audit released by the Department of Health and Human Services Office of Inspector General (OIG) on September 4, 2026, concludes that CMS could do more to ensure states are properly overseeing the contractors they hire to inspect nursing homes.
State survey agencies are responsible for conducting regular inspections, called surveys, to determine whether nursing homes comply with Medicare and Medicaid participation requirements. In recent years, a growing backlog of required inspections has pushed many states to contract with private firms to fill the gap, a practice federal rules allow. CMS itself can also commission these same third-party firms to run comparative surveys that check whether state agencies are doing their jobs correctly.
CMS is not watching nursing home inspection contractors closely enough, a federal audit finds.
The OIG found that this arrangement creates a potential conflict and that CMS has not put in place sufficient monitoring to ensure contractors conducting surveys on behalf of states meet the same standards required of state survey agencies. The audit, identified as report A-04-24-08105, calls on CMS to strengthen its oversight framework for these contract surveyors.
For the roughly 1.4 million people who live in Medicare- and Medicaid-certified nursing homes at any given time, the quality and independence of facility inspections are a primary consumer protection. If contractors are not held to the same standards, the reliability of the results that feed into public quality ratings, including those displayed on the Care Compare website, could be affected.
In plain words
The government checks nursing homes to make sure residents are safe. States are supposed to do these checks, but many states are behind on inspections. So they are hiring outside companies to help. A government watchdog looked at this and said the main Medicare office, CMS, is not watching those outside companies closely enough. That could mean some inspection results are less reliable. This matters to anyone who lives in, or has a family member in, a nursing home.
Understand the basics first
Source: HHS Office of Inspector General
Read at the source →