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