The Centers for Medicare & Medicaid Services needs to improve the tools it uses to evaluate the quality of nursing home care, a federal report asserts.

At the request of senators Charles Grassley (R-IA) and Herb Kohl (D-WI), the Government Accountability Office conducted an investigation to determine whether CMS was doing an adequate job in monitoring implementation of the Quality Indicator Survey process. It found CMS has not established quality measures or performance goals to evaluate if QIS objectives are being met.

For example, the GAO found that during resident interviews, surveyors did not consistently probe for further information when provided with incomplete responses.

As of September 2011, only roughly half of the states had begun training on the QIS.

The QIS has “the potential to make a positive difference in the consistency and accuracy of state survey work across the country,” Kohl said. “But implementation needs to be done well, and the agency’s goals need to be realized sooner rather than later.”