Report: CMS needs to improve public access to nursing home expenditures

Skilled nursing facilities' expenditure data needs to be made more accessible to public stakeholders, according to a new report from the Government Accountability Office.

GAO investigators created the report to determine how the Centers for Medicare & Medicaid Services collects and shares skilled nursing expenditure data, as well as how facility costs vary by characteristics such as for-profit or nonprofit ownership. The report also looked into how staffing levels may vary based on facility characteristics and margins.

The report's main finding was that while CMS collects expenditure reports from skilled nursing facilities and posts the data online, that information is not readily accessible to the public or checked to ensure it is accurate and complete.

“Until CMS takes steps to make reliable SNF expenditure data easier to use and locate, public stakeholders will have difficulty accessing and placing confidence in the only publicly available source of financial data for many SNFs,” the report's authors said.

Between 2011 and 2014, care costs amounted to a lower percentage of total revenue at for-profit skilled nursing facilities — which make up about 70% of the 15,000 facilities in the United States — than those operated by nonprofit or government providers, the report showed. Direct and indirect care costs were found to be lower at chain-owned facilities.

Similar patterns were noted in the relationship between margins and staffing levels, with for-profit facilities reporting lower nurse staffing levels than nonprofit or government-run facilities. Nurse staffing levels were also forecasted to decline slightly as facilities' margins increased, the GAO found.

The expenditure data provided by skilled nursing facilities — and a guarantee that it's easily available and understandable by the public — is a part of keeping health data transparent, the report's authors concluded

The GAO recommended that CMS work to improve the accessibility of its skilled nursing expenditure data, as well as improving the accuracy and completeness of the data that it currently puts online “raw.”

Officials with the Department of Health and Human Services agreed with the GAO's first recommendation, but said the time and resources necessary to ensure the data's accuracy could be “substantial,” but “might not create significant benefit to the agency or the public.”

Click here to read the GAO's full report on skilled nursing facility expenditure data.