The Government Accountability Office has issued a report critical of federal efforts to improve poorly performing nursing homes.
According to the GAO, the Special Focus Facility Program, under the oversight of the Centers for Medicare and Medicaid Services, has shown signs of improvement, but still needs revamping.
Under the program, CMS designates "special focus facilities" from among the poorest performing nursing homes in each state. States then survey those facilities twice as frequently as other homes.
The GAO would like CMS to propose a more robust enforcement policy, including closing facilities that do not improve within 18 months.
The GAO report also calls on CMS to:
- help states design the criteria for selecting SFFs;
- evaluate CMS' regional offices and state adherence to program guidance and the program's impact on homes' performance;
- identify other strategies that have been used to improve poorly performing homes;
- notify homes that are on the SFF candidate list.
GAO researchers said they based their report on analysis of CMS data from 2005 through 2009 on SFFs and other homes, as well as interviews with officials in 14 states selected based on the number of SFFs in each state and other factors.
The GAO said the fault doesn't lie entirely with CMS because the program lacks resources. The GAO has recommended that CMS officials seek legislative authority to charge SFFs for the costs of conducting additional surveys.
The Department of Health and Human Services said it "generally agrees" with most of the GAO's recommendations.