(The Center Square) – A commission tasked with inspecting Tennessee’s nursing home and assisted living facilities is behind on mandatory on-site inspections, and 22 facilities have not been visited in more than five years, a legislative committee was told Wednesday.
The Health Facilities Commission inherited a backlog of 270 overdue federal surveys when it was created in July 2022, state auditors told the Government Operations Joint Evaluation Committee on Education, Health and General Welfare. By April of 2025, the number increased to 192.
The audit found that 341, about 51% of the state’s 670 facilities, had not been surveyed in the 15-month federal and state required time frame.
The backlog is not limited to surveys, according to the audit. The commission received an increased influx of complaints due to a federal change that gave the public the ability to file complaints about nursing home and assisted living facilities.
Between July 1, 2022, and April 17 of this year, the commission received 13,096 complaints. Auditors said 5,534 of them were not investigated within the federal time frame.
“All these late complaints were classified as either immediate jeopardy, high risk but not immediate jeopardy, or medium risk but not immediate jeopardy,” the audit said.
Logan Grant, executive director of the Health Facilities Commission, said the commission implemented a number of strategies to deal with the backlog.
“For example, we’ve been able to improve our recruitment by shutting down the Middle Tennessee regional office where it was very challenging to be able to recruit surveyors because our surveyor have to be licensed health care professionals and generally with experience in the field before they can become surveyors,” Grant said. “By eliminating the Middle Tennessee regional office and shifting those survey positions out to the east and west regions, we’ve been able to reduce our number of survey vacancies from 24 down to three.”
But the extra surveyors may not help the commission meet a Dec. 31, 2026, deadline to have all nursing homes with a current survey, auditors said. The federal government shutdown is also slowing progress, Grant said.
“We have been informed by CMS, that we cannot go out and do recertifications during the government shutdown,” Grant said. “So the only thing we can investigate, because we are partially federally funded, are IJ complaints. So until the federal government is operating again, we won’t be able to work on that backlog, which is very problematic for us.”
CMS is the acronym for the Centers for Medicare and Medicaid Services. IJ means immediate jeopardy.
Lawmakers said they were troubled by the audit, but agreed to recommend extending the commission for four years.
“I’m willing to give you the time to fix this problem with the understanding that you guys know that we are very concerned about them,” said Rep. John Crawford, R-Bristol/Kingsport. “And if you all can’t get the job done, then we have to answer to our constituents on why their family members or friends or neighbors are being mistreated.”
The recommendation goes to the full Government Operations Committee for consideration.
