Nursing Homes: Sustained Efforts Are Essential to Realize Potential of the Quality Initiatives

Nursing Homes: Sustained Efforts Are Essential to Realize Potential of the Quality Initiatives

Date: September 28, 2000
Creator: United States. General Accounting Office.
Description: A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO provided information on federal and state initiatives to improve the quality of nursing homes, focusing on: (1) progress in improving the detection of quality problems and changes in measured nursing home quality; (2) the status of efforts to strengthen states' complaint investigation processes and federal enforcement policies; and (3) additional steps taken at the federal level to improve oversight of states' quality assurance activities."
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Nursing Homes: Despite Increased Oversight, Challenges Remain in Ensuring High-Quality Care and Resident Safety

Nursing Homes: Despite Increased Oversight, Challenges Remain in Ensuring High-Quality Care and Resident Safety

Date: December 28, 2005
Creator: United States. Government Accountability Office.
Description: A letter report issued by the Government Accountability Office with an abstract that begins "Since 1998, GAO has issued numerous reports on nursing home quality and safety that identified significant weaknesses in federal and state oversight. Under contract with the Centers for Medicare & Medicaid Services (CMS), states conduct annual nursing home inspections, known as surveys, to assess compliance with federal quality and safety requirements. States also investigate complaints filed by family members or others in between annual surveys. When state surveys find serious deficiencies, CMS may impose sanctions to encourage compliance with federal requirements. GAO was asked to assess CMS's progress since 1998 in addressing oversight weaknesses. GAO (1) reviewed the trends in nursing home quality from 1999 through January 2005, (2) evaluated the extent to which CMS's initiatives have addressed survey and oversight problems identified by GAO and CMS, and (3) identified key challenges to continued progress in ensuring resident health and safety. GAO reviewed federal data on the results of state nursing home surveys and federal surveys assessing state performance; conducted additional analyses in five states with large numbers of nursing homes; reviewed the status of its prior recommendations; and identified key workforce and workload issues confronting ...
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Nursing Homes: More Can Be Done to Protect Residents from Abuse

Nursing Homes: More Can Be Done to Protect Residents from Abuse

Date: March 1, 2002
Creator: United States. General Accounting Office.
Description: A letter report issued by the General Accounting Office with an abstract that begins "Often suffering from multiple physical and mental impairments, the 1.5 million elderly and disabled Americans living in nursing homes are a highly vulnerable population. These individuals typically require extensive help with daily living, such as such as dressing, feeding, and bathing. Many require skilled nursing or rehabilitative care. In recent years, reports of inadequate care, including malnutrition, dehydration, and other forms of neglect, have led to mounting scrutiny from state and federal authorities, which share responsibility for overseeing the nation's 17,000 nursing homes. Concerns have also been growing that some residents are abused--pushed, slapped, or beaten--by the very individuals to whom their care has been entrusted. GAO found that allegations of physical and sexual abuse of nursing home residents are not reported promptly. Local law enforcement officials said that they are seldom summoned to nursing homes to immediately investigate allegations of abuse and that few allegations are ever prosecuted. Some agencies use different policies when deciding whether to refer allegations of abuse to law enforcement. As a result, law enforcement agencies were never told of some incidents or were notified only after lengthy delays. GAO found ...
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Nursing Homes: Efforts to Strengthen Federal Enforcement Have Not Deterred Some Homes from Repeatedly Harming Residents

Nursing Homes: Efforts to Strengthen Federal Enforcement Have Not Deterred Some Homes from Repeatedly Harming Residents

Date: March 26, 2007
Creator: United States. Government Accountability Office.
Description: A letter report issued by the Government Accountability Office with an abstract that begins "In 1998 and 1999 reports, GAO concluded that enforcement actions, known as sanctions, were ineffective in encouraging nursing homes to maintain compliance with federal quality requirements: sanctions were often rescinded before being implemented because homes had a grace period to correct deficiencies. In response, the Centers for Medicare & Medicaid Services (CMS) began requiring immediate sanctions for homes that repeatedly harmed residents. Using CMS enforcement and deficiency data, GAO (1) analyzed federal sanctions from fiscal years 2000 through 2005 against 63 homes previously reviewed and (2) assessed CMS's overall management of enforcement. The 63 homes had a history of harming residents and were located in 4 states that account for about 22 percent of homes nationwide."
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Nursing Homes: Complaint Investigation Processes in Maryland

Nursing Homes: Complaint Investigation Processes in Maryland

Date: June 15, 1999
Creator: United States. General Accounting Office.
Description: Testimony issued by the General Accounting Office with an abstract that begins "GAO discussed its recent findings on the effectiveness of federal and state nursing home complaint investigation processes, with a specific focus on its work in Maryland."
Contributing Partner: UNT Libraries Government Documents Department
Nursing Homes: CMS Needs Milestones and Timelines to Ensure Goals for the Five-Star Quality Rating System Are Met

Nursing Homes: CMS Needs Milestones and Timelines to Ensure Goals for the Five-Star Quality Rating System Are Met

Date: March 23, 2012
Creator: United States. Government Accountability Office.
Description: A letter report issued by the Government Accountability Office with an abstract that begins "CMS developed and implemented the Five-Star System largely during an 8-month period in 2008 with input from long-term care stakeholders, CMS’s Five-Star System contractor, and members of a technical expert panel—a panel composed of nine individuals that CMS identified as experts in long-term care research. CMS made numerous methodological decisions during the development of the Five-Star System, including three key methodological decisions. GAO defines key methodological decisions as those that at least six technical expert panel members—of the nine that GAO contacted—recalled as eliciting the most intense review and discussion during the development of the Five-Star System. One key methodological decision was how to combine the component ratings to create an overall rating. The other two key methodological decisions pertained to how to create ratings that account for variation in the type of care provided across nursing homes."
Contributing Partner: UNT Libraries Government Documents Department
Nursing Homes: Additional Steps Needed to Strengthen Enforcement of Federal Quality Standards

Nursing Homes: Additional Steps Needed to Strengthen Enforcement of Federal Quality Standards

Date: March 18, 1999
Creator: United States. General Accounting Office.
Description: A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO provided information on the enforcement of federal nursing home standards, focusing on: (1) national data on the existence of serious deficiencies in nursing home compliance with Medicare and Medicaid standards; and (2) the use of sanction authority for homes that failed to maintain compliance with the standards."
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Nursing Homes: Proposal To Enhance Oversight of Poorly Performing Homes Has Merit

Nursing Homes: Proposal To Enhance Oversight of Poorly Performing Homes Has Merit

Date: June 30, 1999
Creator: United States. General Accounting Office.
Description: A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO reviewed the Health Care Financing Administration's (HCFA) proposal to expand the definition of "poor performing" nursing homes to include homes with repeated actual harm violations (G-level deficiencies)."
Contributing Partner: UNT Libraries Government Documents Department
Nursing Homes: Complaint Investigation Processes Often Inadequate to Protect Residents

Nursing Homes: Complaint Investigation Processes Often Inadequate to Protect Residents

Date: March 22, 1999
Creator: United States. General Accounting Office.
Description: A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO provided information on how states implement the federal requirement that establishes a process for nursing home complaint investigations, focusing on the: (1) effectiveness of state complaint investigation practices as a component of the system to ensure sustained compliance with federal nursing home quality-of-care standards; and (2) Health Care Financing Administration's (HCFA) role in establishing standards and conducting oversight of states' complaint investigation practices and in using information about the results of complaint investigations to ensure compliance with nursing home standards."
Contributing Partner: UNT Libraries Government Documents Department
Nursing Homes: Public Reporting of Quality Indicators Has Merit, but National Implementation Is Premature

Nursing Homes: Public Reporting of Quality Indicators Has Merit, but National Implementation Is Premature

Date: October 31, 2002
Creator: United States. General Accounting Office.
Description: A letter report issued by the General Accounting Office with an abstract that begins "GAO was asked to review the Centers for Medicare & Medicaid Services (CMS) initiative to publicly report additional information on its "Nursing Home Compare" Web site intended to help consumers choose a nursing home. GAO examined CMS's development of the new nursing home quality indicators and efforts to verify the underlying data used to calculate them. GAO also reviewed the assistance CMS offered the public in interpreting and comparing indicators available in its six-state pilot program, launched in April 2002, and its own evaluation of the pilot. The new indicators are scheduled to be used nationally beginning in November 2002."
Contributing Partner: UNT Libraries Government Documents Department
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