If that title makes you nervous, it probably should. Nursing home survey team challenges are very real right now. We have all heard horror stories of “bad surveyors,” and sure, some of it could be true. However, did you ever think surveyors would be in the same boat as we are? I kind of smiled when I first read it, but then I stopped because it really is not funny.

Did you know that in 2023, less than half of surveyors, only 45 percent, had four or more years of experience? In Kentucky, that number fell to just 18 percent. According to McKnight’s Long-Term Care News coverage examining inexperience and RN shortages on nursing home survey teams, these workforce gaps are affecting both adequacy and timeliness of surveys. That should sound familiar to anyone working in senior living communities who is also navigating staffing shortages and turnover.

Adding insult to injury, in 2025 a federal court found that the Centers for Medicare & Medicaid Services and its state partners were no longer required to have a registered nurse on every survey. I remember when, to assess a resident’s skin integrity, the surveyor had to be a licensed nurse. Not anymore. As explained in McKnight’s coverage of the decision, CMS still requires a nurse for standard surveys, but shorter complaint investigations and rechecks may proceed without one present.

“It is hard to know how this change in standards will impact state decisions about who participates in nursing home surveys; if states struggle to hire and retain RNs on their survey teams, states will have to weigh any potential tradeoffs in completing required surveys and complaint investigations with non-RNs,” said Robert Skinner from Vanderbilt University. His comments were included in a study published in the Journal of the American Geriatrics Society analyzing survey team composition and experience, which further highlights the complexity of these issues.

Maybe we should share some of our staff retention ideas with the survey team during their next visit. The reality is that workforce instability affects everyone, including regulators. These nursing home survey team challenges remind us that the people walking through our doors are navigating many of the same pressures we are.

Let’s be kind to the surveyors who visit our communities. It may look like they have a “cake” job, but trust me, they work hard too.

Stay well and stay informed!