GAO to CMS: Step Up Your Game and Improve Nursing Home Quality Oversight

There needs to be improved oversight of a new system that the Centers for Medicare & Medicaid Services (CMS) is creating to monitor quality standards in nursing homes, according to a Government Accountability Office report on nursing home quality control.

The report, “Nursing Home Quality: CMS Should Improve Efforts to Monitor Implementation of the Quality Indicator Survey,” was recently released by two U.S. Senators, Chuck Grassley (R-Iowa) and Herb Kohl (D-Wisc.), both of whom echo GAO’s recommendations.

“The report shows CMS doesn’t do enough to monitor and facilitate states’ implementation progress,” Grassley said in a statement.  “After six years of implementation, 26 states had trained or started training surveyors to use the system, but uncertainty about progress by these states led CMS to suspend implementation for the rest of the country.  If CMS were better tracking state implementation from the beginning, the agency could have identified these problems earlier and helped the states that are struggling.”


Back in 2005, CMS began looking for ways to implement a quality indicator survey (QIS) after reports which indicated a need to improve the traditional survey process, but then the agency temporarily suspended implementation pending resolution of a number of concerns raised by states and regional CMS offices.

There’s an obvious need for a consistent and efficient quality control system, according to Senator Kohl, but in order for QIS to succeed, it needs to be implemented well—and sooner rather than later.

While CMS has taken some steps to monitor and facilitate states’ implementations of the QIS-based routine survey, says GAO, those efforts haven’t been systematic or comprehensive.


CMS should “develop a means to routinely monitor the extent to which progress is being made in meeting the objectives of the QIS and systematic methods for monitoring and facilitating states’ efforts to implement the QIS,” says GAO.

View the full report here.

Written by Alyssa Gerace

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