A new opportunity for nursing home oversight: unlocking system-level 2567 data with natural language processing

The launch of the current nursing home (NH) oversight system, following implementation of the Omnibus Budget Reconciliation Act in 1987, sought to improve how onsite inspections evaluate NHs’ compliance with quality and safety regulations. Despite these updates, accurate and consistent NH safety and quality assurance through state and federal inspections continues to be an elusive goal. The U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG), the Government Accountability Office (GAO), and, more recently, the U.S. Senate Special Committee on Aging, have documented how states have variable survey practices that may lead to inconsistent NH survey outcomes—in part due to understaffing and underfunding (United States Senate, May 18, 2023). Moreover, according to GAO (May 2008), CMS may not adequately track, report, or respond to shortcomings in the survey process. The situation is exacerbated by the fact that Congress has not increased funding for survey and certification activities since 2015 (HHS, 2022).