Editorial| Volume 21, ISSUE 12, P1818-1820, December 2020

Download started.


Time for an Upgrade in the Nursing Home Survey Process: A Position Statement From the Society for Post-Acute and Long-Term Care Medicine

Published:November 05, 2020DOI:
      A few weeks after getting hit by the first known cases of COVID-19 in the United States, Life Care Center of Kirkland received 3 “immediate jeopardy” deficiencies (with a civil monetary penalty of $611,323): (1) a failure to have emergency physician services available 24 hours a day or to have an alternative emergency plan when the primary care physician, who is also the Medical Director, is unavailable; (2) a failure to have an appropriate infection control surveillance program; and (3) a failure to provide quality care and services for residents during a respiratory outbreak.
      Centers for Medicare & Medicaid Service
      CMS announces findings at Kirkland Nursing Home and new targeted plan for healthcare facility inspections in light of COVID-19.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of the American Medical Directors Association
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Centers for Medicare & Medicaid Service
        CMS announces findings at Kirkland Nursing Home and new targeted plan for healthcare facility inspections in light of COVID-19.
        (Available at:)
        • Emanuel E.J.
        • Emanuel L.L.
        What is accountability in health care?.
        Ann Intern Med. 1996; 124: 229-239
        • Brinkerhoff D.
        Accountability and health systems: Overview, framework, and strategies. 2003.
        (Available at:)
        • Institute of Medicine, Committee on Quality of Health Care in America
        Crossing the Quality Chasm: A New Health System for the 21st Century.
        National Academy Press, Washington, DC2001
        • Nazir A.
        • Arling G.
        • Katz P.
        Incentivizing nursing home quality and physician performance.
        J Am Med Dir Assoc. 2012; 13: 91-93
        • Centers for Medicare & Medicaid Services
        Medicare and Medicaid programs; reform of requirements for long-term care facilities.
        (Available at:)
        • Anderson K.S.
        • Bjorklund P.
        Demystifying federal nursing home regulations to improve the effectiveness of psychopharmacological care.
        Perspect Psychiatr Care. 2010; 46: 152-162
        • Lockhart C.
        • Klopfenstein K.
        • Giles-Sims J.
        Distinguishing quality of nursing facility long-term care from stringency of enforcement.
        in: Kronenfield J.J. Social Sources of Disparities in Health and Health Care and Linkages to Policy, Population Concerns and Providers of Care. Emerald, Bingley, UK2009
        • Levenson S.A.
        Survey deficiencies are not reliable for drawing conclusions about aspects of quality.
        J Am Med Dir Assoc. 2014; 15: 82-84
        • Williams A.
        • Straker J.K.
        • Applebaum R.
        The nursing home five star rating: How does it compare to resident and family views of care?.
        Gerontologist. 2016; 56: 234-242
      1. Government Accountability Office (GAO). 2008.
        (Available at:)
        Date: 2008
        Date accessed: June 10, 2020
        • Lee R.H.
        • Gajewski B.J.
        • Thompson S.
        Reliability of the nursing home survey process: A simultaneous survey approach.
        Gerontologist. 2006; 46: 772-779
        • Harrington C.
        • Mullan J.T.
        • Carrillo H.
        State nursing home enforcement systems.
        J Health Politics Policy Law. 2004; 29: 43-74
        • AMDA, the Society of Post Acute and Long Term Care Medicine
        White paper on the survey process.
        (Available at:)
        • Stevenson D.
        The future of nursing home regulation: Time for a conversation?.
        Health Affairs Blog. 2018;
        • Chassin M.R.
        • Loeb J.M.
        The ongoing quality improvement journey: Next stop, high reliability.
        Health Aff. 2011; 30: 559-568
        • Mortensen A.H.
        • Nordhaug M.
        • Lohne V.
        Nudging in nursing.
        Nurs Ethics. 2019; 26: 1601-1610
        • Ondřej K.
        • Ruggeri K.
        Nudging intrinsic motivation in environmental risk and social policy.
        J Risk Res. 2019; 22: 581-592
        • Kostick K.M.
        • Trejo M.
        • Volk R.
        Using nudges to enhance clinicians' implementation of shared decision making with patient decision aids.
        MDM Policy Pract. 2020; 5 (2381468320915906)
        • Center for Clinical Standards and Quality/Quality, Safety & Oversight Group
        COVID-19 survey activities, CARES Act funding, enhanced enforcement for infection control deficiencies, and quality improvement activities in nursing homes.
        (Available at:)

      Related Podcast

      December 22, 2020

      December 2020 Issue

      Featuring Dr. Philip Sloane, Dr. Mallory Brown

      Loading ...