Friday, May 13, 2011

GAO: CMS Needs to Get Tougher with Complaint Investigations

A new report out of the Government Accountability Office (GAO) calls on CMS to put more oversight into nursing home complaint investigations.

The report says that 19 states had trouble investigating high-harm complaints within the established time table and that CMS' oversight of complaint investigation is flawed because of unreliable data. The information in the report was gathered after the GAO received inquiries from Congressional leaders.

Additionally, the GAO report found that state survey agencies received 53,313 complaints about nursing homes during fiscal year 2009. The complaints varied widely from state to state. Eleven states received 15 or fewer complaints per 1,000 residents while 14 states received more than 45 complaints per 1,000 residents.

In light of their findings, the GAO recommended that:
  • CMS identify issues with data quality
  • CMS clarify guidance to states about how particular fields in the complaint database should be be interpreted
  • State survey agencies prioritize complaints based on their level of egregiousness
To learn more, click here.

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