GAO highlights obstacles, benefits of nursing home temporary management sanctions

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GAO highlights obstacles, benefits of nursing home temporary management sanctions
GAO highlights obstacles, benefits of nursing home temporary management sanctions

Temporary management sanctions for troubled nursing homes can be an effective approach to improving quality in the short term, but more should be done to provide guidance for implementing the sanctions, and to ensure long-term quality improvements, according to a new government report.

The report, compiled by the Government Accountability Office (GAO), examines states' experience with the use of federal temporary management and its effectiveness in achieving compliance in the short and longer term and obstacles to the use of federal temporary management and how such obstacles could be addressed.

Temporary management is a rare occurrence, having only been employed at 14 facilities in 10 states between 2003 and 2008, according to the GAO. In 11 of the 14 homes, officials used the sanction with the objective of returning the home to compliance with federal quality requirements. The sanction was in fact effective at bringing 10 of the 11 facilities back to compliance in the short term. As of August 2009, however, one of those facilities had closed and four had been cited for immediate jeopardy, indicating a need to address long-term quality improvement through the sanctions, according to the report.

The GAO concludes that more can be done to offer guidance to states and Centers for Medicare & Medicaid Services regional offices to help implement the sanction against underperforming nursing homes. Obstacles such as time constraints, a lack of qualified temporary managers, and inadequate funding to pay for a temporary manager, often prevent states from implementing the sanction.

Sens. Herb Kohl (D-WI) and Charles Grassley (R-IA), along with Reps. Henry A. Waxman (D-CA), Pete Stark (D-CA), and Jan Schakowsky (D-IL) requested the report. It is available online at the Senate Special Committee on Aging Web site.