The Centers for Medicare & Medicaid Services has not penalized some nursing homes that have compromised patients’ safety or have long-standing problems, a new government report says.

Medicare contracts should have been terminated at 55 nursing homes between 2000 and 2002, according to the report from the inspector general for the Department of Health and Human Services. Yet CMS did not end the contracts in 30 cases. Investigators who looked at follow-up surveys of the 30 nursing homes found that the facilities had subsequent problems that required federal action.

Sen. Charles Grassley (R-IA), chairman of the Senate Finance Committee, said the findings indicated a lack of enforcement against poor performing nursing homes. CMS Administrator Mark McClellan defended his agency, saying it made significant improvements after the 2000-2002 period, a span when he was not yet in charge. McClellan also said his agency has worked with the nursing homes to improve their performance.