Nearly 20% of Long Island nursing homes qualify for less rigorous state inspections, data shows. Here is why.

Nearly 1 in 5 nursing homes on Long Island will be eligible for a less rigorous and more "streamlined" inspection under the new nationwide "risk-based survey" process, according to data released by the Trump administration.

The plan, announced in July by the Centers for Medicare & Medicaid Services, allows highly rated nursing homes that are deemed "lower risk" to receive a more "focused" inspection that addresses fewer issues, takes roughly half the time to complete and requires a smaller inspection team.

Data released in late September by CMS shows that 15 of the 51 nursing homes statewide found eligible for a risk-based survey — almost 30% of the total — are on Long Island, according to a Newsday analysis. 

Currently, state agencies — in the case of New York, the state Health Department — are required to conduct recertifications of nursing homes at least once every 15 months. Additional inspections are conducted based on complaints from residents, watchdogs or family members.

A "dangerous" plan

Critics contend the new process will reduce oversight of already understaffed nursing homes, exacerbating residents’ exposure to avoidable harm, including abuse and neglect.

"It would be ridiculous if it wasn't so dangerous," said Richard Mollot, executive director of the Long Term Care Community Coalition, a Manhattan group that advocates for nursing home residents.

But Stephen Hanse, president and chief executive of the New York State Health Facilities Association, which represents the nursing home industry, said the plan makes sense, transitioning from a one-size-fits-all inspection model to one that matches regulatory intensity with actual potential risk.

"Reducing routine surveys for the highest performers doesn’t reduce accountability," Hanse said. "It frees surveyors to respond faster to complaints and spend more time in the buildings that need it. That’s a better outcome for residents and for the public dollars funding oversight."

Last week, Sen. Kirsten Gillibrand (D-N.Y.), ranking member of the Special Committee on Aging, co-authored a letter to CMS Administrator Mehmet Oz, expressing concern that the plan puts the health and safety of vulnerable New Yorkers at risk.

"Nursing home residents depend on comprehensive, thorough, and unannounced surveys to detect, correct, and prevent abuse, neglect, and substandard care," the letter stated. "By allowing these minimal inspections, the new CMS approach weakens oversight and puts nursing home residents at greater risk of mistreatment, injury and abuse."

CMS did not respond to requests for comment.

Comprehensive nursing home inspections, which Newsday has reported on for years — along with fines and penalties that go along with them — are one of the key methods for holding nursing homes accountable for cases of abuse, neglect and substandard care, experts said.

Earning a golden trophy

On Long Island, 15 of the region's 78 largely for-profit nursing homes — eight in Nassau and seven in Suffolk — met the criteria for a risk-based survey and received a golden trophy icon on CMS' website.

Five of the 15 facilities operate as part of larger hospital chains, including Northwell Health, Stony Brook Medicine, Catholic Health System and Mount Sinai South Nassau. The RBS designation lasts for six months before facilities are re-evaluated. 

To qualify, nursing homes must have a five-star rating from CMS, have at least a three-star staffing rating, have received a standard survey during the previous 18 months and cannot have received a citation during their most recent inspection for "actual harm," "immediate jeopardy" or "substandard quality of care." 

And while the new RBS surveys must focus on infection control requirements, they're not required to review medical, nursing, and rehabilitative care, dietary and nutrition services or a facility's financial condition.

Steve Schwartz, administrator of the Grandell Rehabilitation & Nursing Center in Long Beach, which made the list, said inspectors typically know what areas they plan to focus on before arriving for their survey. 

"For example, if you have a lot of weight loss in your facility, [inspectors] are going to come in and know what they're looking for," Schwartz said. "They come in knowing which charts they're going to look at. ... So, a good majority [of issues] are not going to slip through the cracks because quality measures dictate the type of care you provide."

The Long Island State Veterans Home in Stony Brook, which also qualified, said in a statement that the "designation reflects our ongoing commitment to delivering safe, compassionate, and high-quality care to the veterans we are honored to serve."

Meanwhile, Matthew Levy, vice president of post-acute care-skilled nursing facilities at Catholic Health, celebrated Good Samaritan Nursing & Rehabilitation Care Center qualifying for the risk-based surveys, calling it a "testament to the entire team’s hard work."

Statewide, less than 9% of all nursing homes earned a RBS distinction, while nationally the number was about 12%, records show.

In a statement, the state Health Department said it is "committed to ensuring the health, safety and well-being of all nursing home residents and that facilities in the state consistently provide high-quality care."

Reducing survey backlogs

CMS has defended the new process, noting the federal budget to fund nursing home surveys has not increased since 2015 while the obligations to conduct complaint-based inspections has grown by 20%.

Without the staffing to conduct these inspections, federal officials contend a backlog has grown nationwide among nursing homes waiting for their standard survey.

The agency said states can continue to conduct traditional inspections at RBS-qualifying facility if there are specific concerns related to residents' health and safety.

But the National Consumer Voice for Quality Long-Term Care, a Washington, D.C.-based nonprofit which opposes the new plan, identified major flaws in how CMS identified qualified nursing homes.

For example, the group found 46% of the 1,699 nursing homes eligible for a risk-based survey nationwide would not have met the criteria a year earlier.

In fact, roughly 1 in 10 RBS-qualifying facilities nationwide were cited for failing to protect residents from abuse and neglect in the 15 months before earning the golden trophy, Consumer Voice found.

On Long Island, 10 of the 15 nursing homes that made the cut wouldn't have met the criteria at some point in the year prior to September 2026, said Sam Brooks, Consumer Voice's director of public policy.

In fact, 14 of the local 15 facilities — the lone exception was Northwell Health Stern Family Center — were cited by inspectors in the 18 months before qualifying for CMS' eligibility list, although none of the citations were rated as "actual harm," the group found. 

"Any consumer who sees a gold trophy on Care Compare would likely not expect these types of things to have occurred in those homes," Brooks said. "Consumers are being misinformed and misled. Consumer Voice is calling on CMS to immediately end the RBS program."

Those are not the only concerns.

A report last month by the Long Term Care Community Coalition found nearly 96% of all New York nursing homes, including RBS-qualifying facilities, are staffed below levels expected to meet residents’ basic needs.

Meanwhile, of the 8,350 health deficiency citations issued to New York nursing homes between 2022-2024, only 3.1% were classified as causing actual resident harm or putting them in immediate jeopardy — which would prevent them from securing a RBS distinction, Mollot said.

During that same period, the group found, New York issued the lowest rate of nursing home fines per resident nationwide.

"New York is doing a particularly poor job in finding problems," Mollot said. "That means far too many facilities have five star for their surveys, but are not really providing five star quality."