Which CMS citations became more, less common since 2017

Over the past five years, hospitals received fewer citations among a dozen categories, while two became more popular, according to CMS data obtained by Becker's

In a review of the 25 most frequent reasons for a citation between 2017 and 2023, trends among 12 citations remained steady, including patient rights and RN supervision of nursing care, which have been in the top five citations since at least 2017. 

Others have been decreasing in frequency, with most downward trends starting between 2019 and 2020 or 2020 and 2021. For example, about 3.5% of the providers were cited for the administration of drugs between 2017 and 2019, but in 2020, that figure dropped to 1.3%, and the citation's prevalence has since hovered below 2%. 

The same is true for infection control program citations, which averaged around 6% of surveyed hospitals between 2017 and 2020. The next year nearly halved the trend to 3.5%. In 2022, that figure was 2.3%, and in 2023 it was 1.4%. 

During the COVID-19 pandemic, though, some citations rose to prominence. Problems related to supervision of contract staff didn't clear the top 25 list until 2021, when 1.5% of hospitals were cited. Two percent were cited in 2022, and 1.6% in 2023. 

Citations for patient rights related to restraints or seclusion also grew at the start of the pandemic. From 2017 to 2020, about 2% of hospitals each year received the citation, then in 2020, this dropped to 0.8%. The citation's frequency has since steadily increased to about 2%. 

In 2022, there were 126 COVID-19 vaccination of facility staff citations, making it the ninth most popular citation that year. In 2023, the citation didn't make the top 25 list, nor did it appear on past years' lists. 

Here are the citations that changed in frequency:

Two citations became more common:

1. Patient rights: Restraint or seclusion

2. Supervision of contract staff

Twelve citations became less common:

1. RN supervision of nursing care

2. Infection control program

3. Nursing care plan

4. Administration of drugs

5. Governing body

6. Physical environment

7. Facilities, supplies, equipment maintenance

8. Infection prevention control antibiotics stewardship

9. Maintenance of a physical plant

10. Patient rights: Grievances

11. Data collection and analysis

12. Patient rights: Notice of rights


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