Forum Session

Ensuring Nursing Home Quality: Continuing Challenges to Oversight and Enforcement of Nursing Home Reform
March 25, 2010


Carol V. O'Shaughnessy, MA


Twenty-three years ago, Congress passed landmark legislation aimed at improving the quality of care in Medicare- and Medicaid-certified nursing facilities. The legislation, known as nursing home reform, set minimum conditions that nursing homes must meet to receive Medicare and Medicaid funds and required improvements in federal and state government oversight and enforcement of nursing home compliance with quality standards. Yet today, many challenges to oversight and enforcement remain, and a significant proportion of homes do not meet quality standards. This Forum session covered the Government Accountability Office's most recent findings on the oversight and enforcement of quality standards by the Centers for Medicare & Medicaid Services and states. Speakers discussed the role of states in the survey process and the role of nursing home ombudsmen in investigating and resolving resident complaints as well as the challenges they face.


Walter Ochinko, Assistant Director, Health Care Team, Government Accountability Office; Rick Harris, JD, Director, Bureau of Health Provider Standards, Department of Public Health, State of Alabama; Becky Kurtz, Esq., Long-Term Care Ombudsman, State of Georgia

Slides from the presentations by Mr. Ochinko, Mr. Harris, and Ms. Kurtz are available for download, as are speakers' biographies.

Related Materials

See "The Role of Ombudsmen in Assuring Quality for Residents of Long-Term Care Facilities: Straining to Make Ends Meet" (Background Paper No. 71, December 2, 2009).

The Government Accountability Office also has three documents of particular interest to this topic: "Nursing Homes: Addressing the Factors Underlying Understatement of Serious Care Problems Requires Sustained CMS and State Commitment" (GAO-10-70, November 2009); "Nursing Home Reform: Continued Attention Is Needed to Improve Quality of Care in Small but Significant Share of Homes" (GAO-07-794T, May 2, 2007); and "Medicare and Medicaid Participating Facilities: CMS Needs to Reexamine Its Approach for Funding State Oversight of Health Care Facilities" (GAO-09-64, February 2009).

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