U.S. Sen. Chuck Grassley (R-Iowa) has introduced new legislation aimed at increasing transparency in inpatient psychiatric facilities. The proposed Psychiatric Hospital Inspection Transparency Act would permit the Secretary of Health and Human Services (HHS) to disclose hospital accreditation inspection reports, which are currently not accessible to the public in most states. The bill also requires that information from inspections conducted by accreditation organizations or state survey agencies be published.
“My oversight has shown alarming neglect at a handful of inpatient psychiatric facilities across the country. Unfortunately, the public, patients and lawmakers are currently left in the dark without access to clear and accessible information. By making psychiatric hospital inspection reports publicly available and comprehensible, my legislation would provide meaningful support for patients and families and help raise the standard of care. It would also support the ability of inpatient psychiatric facilities that are doing a good job to show off their good work,” Grassley said.
Grassley has previously advocated for improved oversight at health care facilities serving vulnerable populations, including nursing homes and IPFs. He noted that his past investigations found significant issues such as understaffing and misuse of restraints in some facilities, but these findings were often hidden from consumers due to current regulations on report disclosure.
In 2017, Grassley identified serious problems at a psychiatric hospital in Oklahoma—such as insufficient staffing levels and inappropriate use of physical restraints on children—yet inspection reports remained inaccessible because of accreditation status. That same year, he urged the Centers for Medicare & Medicaid Services (CMS) to make such reports public; however, CMS withdrew its proposal after determining it conflicted with provisions in the Social Security Act prohibiting disclosure of “any accreditation survey.”
Earlier this year, Grassley again pressed CMS to enhance online tools that help families compare inpatient psychiatric facilities using inspection findings. In response, CMS stated its hands were tied by existing law but pointed out that Congress had made similar transparency improvements before—for example, amending Section 1865(b) through the Consolidated Appropriations Act of 2021 to allow release of hospice accreditation inspection reports.
CMS’s Fiscal Year 2026 final rule recognized broad public support for a star rating system focusing on facility inspections and patient safety measures such as incidents involving assaults or unexpected deaths—a system only possible if current legal barriers are removed by new legislation like Grassley’s proposal.
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