The CMS citations becoming more, less common

For decades, CMS-approved accrediting organizations have surveyed and cited hospitals for deficiencies in care and operations. In the last eight years, 13 citations decreased in frequency while one saw a consistent increase in prevalence. 

Many citations increased and decreased in frequency during this time frame. But in the last four years, the citation that grew in prevalence without seeing a decrease was "supervision of contract staff," according to data obtained by Becker's

Issues related to contract staff did not appear in the 25 most frequent reasons for a citation before the COVID-19 pandemic exacerbated workforce shortages. This spurred hospitals to hire more contract employees. In 2021, 1.5% of providers were cited for supervision deficiencies, followed by 2% in 2022, 1.6% in 2023, and then a jump to 3.6% in 2024 — despite hospitals' efforts to decrease their reliance on contract staff. 

Most downward trends occurred after 2019, which coincided with pandemic-era exemptions to reporting requirements. 

These 13 citations have become less common since 2017: 

  • Infection control program

  • Nursing care plan

  • Administration of drugs

  • Governing body

  • Patient rights: Restraint or seclusion (Tag A0168)

  • Physical environment

  • Facilities, supplies, equipment maintenance

  • Infection prevention control antibiotics stewardship

  • Maintenance of physical plant

  • Patient rights: Grievances

  • Data collection and analysis

  • Patient rights: Notice of rights

  • Quality improvement activities

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