Federal law tasks the Maryland Department of Health with inspecting nursing homes at least once every 16 months, but some of Maryland’s 222 nursing homes have not had one of these “annual surveys” since 2020.

“It doesn't mean that we've never been to a facility in that time frame, but it does mean we haven't done a comprehensive annual survey,” Deputy Health Secretary Nilesh Kalyanaraman said during a hearing before a state legislative committee Wednesday.

He said 95 nursing homes are up to date on their annual surveys.

“Our backlog started before the pandemic and worsened post pandemic,” Kalyanaraman told lawmakers.

The federal Centers for Medicare and Medicaid Services told states to pause annual surveys during the pandemic, he said, and other challenges, including staff shortages, also contributed to the backlog.

The agency is also catching up on nearly 6,000 nursing home complaints and incidents it has not investigated.

Kalyanaraman said catching up on both annual surveys and complaint investigations could take more than two years, even though the agency is working at a faster pace now than it has in the past few years.

He assured lawmakers that none of the outstanding complaints are considered urgent.

However, some legislators expressed concerns that the Health Department needs to be doing more to ensure nursing homes are providing acceptable care to patients, some of whom may be afraid to file formal complaints about problems.

“An inspection once a year, I guess is OK, but honestly, they need it more often, and they need to be pop-up visits to make sure, because these are the most vulnerable people that are out here,” said Del. Andrea Harrison, from Prince George’s County. “They are reliant on those people who are supposedly, you know, changing them and changing their bedding and feeding them and giving them treatment.”