Official Site of The State of New Jersey

November 2026

Shortcut Surveys + Reduced Resident Input = Bad Policy
A Message from Laurie Facciarossa Brewer, Long-Term Care Ombudsman

The Centers for Medicare and Medicaid Services (CMS) pitched the new Risk-Based Survey policy as streamlined and modern. Instead of the old way, in which all nursing homes faced a thorough inspection every year or so, CMS will reward so-called high performing nursing homes with less intensive surveys.

This policy looks questionable even in the best light. Quality of care and the residents' quality of life are constantly in flux. Nursing homes that perform well today may take a turn for the worse overnight. We need more scrutiny, never less.

Under the new policy, nursing homes that hold a 5-star rating and meet 10 other criteria qualify for the Risk-Based Survey. As of Sept. 1, CMS reports show that 1,699 nursing homes nationwide qualify for Risk-Based Surveys — or about 12% of all nursing homes. In New Jersey, 46 of 348 nursing homes qualify.

According to the National Consumer Voice for Quality Long-Term Care, Infection Control is the only mandatory subject area in a Risk-Based Survey. Crucial topics such as resident rights, staffing levels, medication errors, and food will not be surveyed unless it is needed based on information from other parts of the survey or resident interviews. Unfortunately, surveyors interview fewer residents as part of the process. They also skip reviewing records of residents who died or were discharged or hospitalized.

Regardless of the new policy, residents can still make their voices heard. Our advice: Ask administration if your nursing home qualifies for a Risk-Based Survey. Raise the subject at Resident Council. Report concerns about your care and living conditions to the Long-Term Care Ombudsman, which can share them with surveyors. If you are interviewed, raise any concern you like with the surveyors. You are not limited by the questions they ask. And you can still ask to speak privately with surveyors, even during a Risk-Based Survey.

For more details on Risk-Based Surveys, visit the Consumer Voice website

New Jersey Resident Advocate Receives National Award

Ray DiFrancesco (left), a former nursing home resident and an original member of the group NJ Nursing Home Residents United, received the Janet Tulloch Memorial Advocacy Award during the 2026 National Consumer Voice for Quality Long-Term Care conference in St. Louis, Mo.

The award, presented by Consumer Voice Executive Director Lori Smetanka, honors a citizen advocate, family caregiver, or a resident who works to improve the lives of long-term care residents.

Also, during the Consumer Voice conference, Ray and Texas resident Cindy Napolitan presented at a resident empowerment luncheon.

Resident Voices: What is one of your most favorite things to eat on the Thanksgiving table?

• Ham, NEVER turkey! – Herman E.
• Oh, I am Italian! We start with a big antipasto, then move onto homemade manicotti, then the meatballs and finally braciole…AND THEN we have the turkey! – Jill M.
• My favorite things are everything because I am the one that cooks them all. No one will ever beat my potato salad, or my apple pie, or banana pudding…and save room for the collard greens! – Jean B.