In a report entitled "Efforts to Strengthen Federal Enforcement Have Not Deterred Some Homes From Repeatedly Harming Residents," the GAO advises the Centers for Medicare & Medicaid Services to develop an administrative process to collect civil monetary penalties before facilities exhaust the appeals process, seeking legislation to implement it, and addressing "due process concerns," as appropriate.
The GAO also suggests CMS strengthen its immediate sanctions policy, and expand a program of "enhanced efforts" to oversee homes with a history of harming residents. And it recommended CMS improve its data enforcement systems. CMS generally agreed with the GAO's recommendations.
The GAO report is based on the federal watchdog agency's review of 63 nursing homes with a history of actual harm citations in four states -- California, Pennsylvania, Michigan and Texas, which collectively have about 22 percent of the nation's nursing homes. Access the report at www.gao.gov/highlights/d07241high.pdf.