Connected Problems Require Connected Solutions: Addressing Top Hospital CMS Citations

As revealed by recent Centers for Medicare & Medicaid Services (CMS) data published by Becker’s, challenges in care delivery remain stubbornly prevalent. The data shows that hospitals continue to struggle with fundamental aspects of care delivery, from protecting patient safety to providing oversight and support for the next-generation workforce. While healthcare leaders recognize the urgent need to address these challenges, they also understand that the best path forward requires novel and innovative solutions.   The emergence of artificial intelligence has strengthened the capabilities of healthcare technologies, offering healthcare organizations promising new models of care delivery that can address multiple challenges simultaneously.  

In the latest CMS survey data, “Patient rights: Care in safe setting” emerged as the most frequent regulatory citation, with 172 hospitals receiving deficiencies in this category so far this year. This standard reflects a hospital’s fundamental obligation to provide a safe environment while maintaining patient dignity and autonomy—a complex balance that many facilities struggle to achieve. These citations encompass a wide range of safety concerns: delayed response to patient calls and clinical deterioration, inadequate monitoring of confused or agitated patients, poor care coordination during transitions, and insufficient observation during high-risk periods, including overnight or immediately post-procedure. Addressing these important standards of care through traditional staffing models has proven challenging. 

Emerging virtual solutions offer a promising path forward by augmenting current staff capabilities. When virtual care is enhanced by human-centered AI technology, trained virtual healthcare professionals can support multiple aspects of patient safety: proactively preventing falls and other adverse events, proactively identifying early signs of deterioration, supporting timely rounding, providing prompt reorientation for confused patients, and facilitating communication between patients, families, and care teams. This multi-faceted approach helps bridge gaps in traditional care models, ensuring that patients receive consistent care and timely response regardless of the time of day. 

Ranking second in CMS citations with 160 occurrences, “RN supervision of nursing care” represents the essential role of Registered Nurses in overseeing patient care delivery, including proper delegation, assessment review, and mentorship of less experienced staff. One contributing factor to these citations is the growing exodus of experienced nurses from bedside roles due to the increasing demands of bedside nursing. As a result, hospitals struggle to retain the decades of clinical expertise these seasoned professionals possess—expertise that is crucial for mentoring the next generation of nurses and ensuring optimal patient care. 

An evolving solution to this longstanding challenge lies in virtual care models that enable experienced RNs to provide supervision and mentorship across multiple units simultaneously. Through virtual platforms, senior nurses can offer real-time consultation, review care plans, mentor newer staff, and support critical decision-making without being physically present at each bedside. This model not only maximizes the reach of experienced nurses but also creates new career pathways for seasoned professionals who might otherwise leave the profession entirely.  

Rounding out the top ten CMS citations, “Staffing and delivery of care” garnered 50 citations, but its impact reverberates far beyond this number, directly contributing to the two most frequent citations mentioned above. In an era where healthcare facilities grapple with unprecedented nursing shortages, maintaining safe nurse-to-patient ratios and providing consistent, high-quality care has become increasingly challenging. The traditional staffing model, which relies solely on physical bedside presence, is proving increasingly unsustainable as patient acuity rises and the workforce shortage looms.  

A hybrid care delivery model that utilizes virtual solutions is one approach to addressing these interconnected challenges. By integrating virtual support with bedside care, hospitals can optimize their existing workforce, providing additional layers of clinical expertise without requiring physical presence. This approach not only addresses direct staffing challenges but simultaneously tackles all three citation categories through a single, integrated solution. Virtual team members can assist with admissions, discharges, patient education, and documentation (some of the most time-consuming aspects of nursing care), allowing bedside nurses to focus more directly on hands-on patient care and critical interventions. 

While healthcare leaders’ cautious approach to new technology is understandable, the choice not to engage in virtual care integration may leave some organizations behind the innovation curve.  The citations discussed above don’t just represent regulatory compliance issues—they translate directly to real patient harm, financial penalties, increased liability risks, and potential reputational damage. Moreover, the staffing and resource shortages that contribute to the root cause of non-compliance with these important standards contribute to a cycle of staff burnout and turnover that further strains already limited resources. As healthcare continues to evolve, the strategic integration of virtual solutions enhanced by AI represents not just an innovative approach to addressing persistent challenges but an essential path forward. By embracing these technologies thoughtfully and integrating them seamlessly with existing care models, healthcare organizations can simultaneously address multiple regulatory challenges while creating more sustainable care environments for both patients and staff.