A report released Thursday by the U.S. Government Accountability Office says nursing homes and the federal agency overseeing them are falling well short of the mark.
The GAO study said federal monitoring of nursing homes does not give a clear picture of the level of care provided. Instead, it found "a continued understatement of serious care problems" and oversight weakness on the part of the Centers for Medicare & Medicaid Services.
Since 1998, the GAO has repeatedly shown that state nursing home quality inspectors understate the seriousness of what they find. This newest GAO study examined CMS federal oversight of state surveys from 2002 through 2007 and found the agency has taken steps to improve its monitoring of state surveys, but weaknesses remain.
By law, the CMS conducts comparative surveys of state surveys. For starters, GAO officials recommended that the CMS do a better job of monitoring its database of comparative survey information. The CMS is not currently ensuring that regional offices are entering data accurately and reliably, GAO officials said.
In addition, comparative federal surveys are often conducted after too much time, more than 30 days, has lapsed since the state survey. Too much harm can take place during the gap, the GAO said. The most common problems for nursing home residents are lack of proper nutrition, dehydration and serious bed sores.
Senators Chuck Grassley (R-Iowa), ranking member and former chairman of the Senate Committee on Finance, and Herb Kohl (D-Wisc.), chairman of the Special Committee on Aging, said the GAO findings give Congress more reason to pass their bill, the Nursing Home Transparency and Improvement Act. The act would give consumers more information and nursing homes more incentive to comply with federal quality of care standards.
"We need to make sure state surveyors have an improved survey methodology and adequate investigative skills to identify problems," Grassley said. "Federal penalties need to be strong enough to achieve accountability and encourage compliance. Above all, consumers need access to accurate, meaningful and current data."
Kohl said the report makes it clear that the nation is due for an overhaul in nursing home standards. He and Grassley plan to push to have their bill included in any upcoming Medicare package.
A House panel began an series of investigations yesterday to look at nursing home care. Some members of the panel question whether profit plays more into nursing home management now than it did some 30 years ago, when nursing home regulations were established.
Do you think it's possible for the federal government to get a handle on nursing home quality of care? Email me at diana.manos@medtechpublishing.com.