GAO Report Calls for More CMS Oversight of Nursing Home Facilities

Some of the nation's worst nursing homes have improved their quality of care, but CMS should improve how it identifies and tracks such facilities' problems, according to a report from the Government Accountability Office released on Monday, CQ HealthBeat reports.

The GAO report found that certain facilities on the Special Focus Facility list improved and were able to leave the focus program, despite CMS' failing to survey them as often as required or to provide tougher enforcement for the worst-performing facilities. The report also noted that nursing homes that improved their quality and moved off the list often did not sustain their improvements.

In addition, the report found that a "troubling" amount of homes stayed on the SFF list for longer than the desired 18 months, delaying federal efforts to include other problematic facilities.

GAO Recommendations

According to the GAO report, CMS should compile a list of the worst homes in the U.S., rather than of the most problematic facilities in each state. The report also found problems with CMS' "vague" guidance, noting that regional and state offices often interpret CMS guidance in different ways.

GAO recommended that CMS tell homes that they are at risk of being included on the SFF list, ensure that states have stricter enforcement standards and monitor the facilities more closely.

CMS officials said they agreed with five of GAO's six recommendations and they would consider the sixth recommendation, which said facilities should charge nursing homes for additional evaluations that are required for the most problematic facilities (Norman, CQ HealthBeat, 4/16).