Health Care:

Administration of Hill-Burton Assurances and Loan Assistance Program Needs To Be Improved

HRD-82-87: Published: Jun 3, 1982. Publicly Released: Jun 3, 1982.

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GAO summarized the informal recommendations which were made to program officials during a recent review of the administration of the Hill-Burton Program by the Department of Health and Human Services (HHS).

GAO felt that HHS Bureau of Health Facilities (BHF) should formally dismiss uncompensated care complaints on file for over 12 months to reduce the large backlog of complaints and allow individuals to pursue legal action promptly. In the future, BHF should formally dismiss complaints not resolved within 6 months. BHF should develop systematic followup procedures to ensure that facilities correct violations noted during complaint investigations and compliance assessments. BHF should obtain uncompensated care compliance information from the hundreds of facilities which are scheduled to reach the end of their 20-year obligation to determine why they have not requested closeout assessments and whether they have reached their compliance levels. BHF and the Office of Civil Rights should also develop procedures for routinely sharing pertinent reports and data relating to compliance assessments and complaint investigations. BHF should focus on verifying the Loan Early Warning System's database and collecting other necessary data. BHF should arrange to systematically receive information on facility ownership changes as it becomes available, finalize its draft title VI waiver/recovery manual, and develop regulations for title XVI waiver and recovery actions to implement the legislation.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: BHF should develop regulations for title XVI waiver and recovery actions to implement the 1975 legislation.

    Agency Affected: Department of Health and Human Services: Health Resources Administration: Bureau of Health Facilities

  2. Status: Closed - Implemented

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: BHF should, to reduce the large backlog of complaints and allow individuals to pursue legal actions promptly, formally dismiss uncompensated care complaints on file for over 12 months. In the future, BHF should strictly adhere to its procedures to formally dismiss complaints not resolved within 6 months.

    Agency Affected: Department of Health and Human Services: Health Resources Administration: Bureau of Health Facilities

  3. Status: Closed - Implemented

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: BHF should arrange with the Health Care Financing Administration to systematically receive information on facility ownership changes as it becomes available, rather than relying on regional staff to periodically request the information.

    Agency Affected: Department of Health and Human Services: Health Resources Administration: Bureau of Health Facilities

  4. Status: Closed - Implemented

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: BHF should finalize its draft title VI waiver/recovery manual.

    Agency Affected: Department of Health and Human Services: Health Resources Administration: Bureau of Health Facilities

  5. Status: Closed - Implemented

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: BHF and the Office of Civil Rights should develop procedures for routinely sharing pertinent reports and data relating to compliance assessments and complaint investigations.

    Agency Affected: Department of Health and Human Services: Health Resources Administration: Bureau of Health Facilities

  6. Status: Closed - Implemented

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: BHF should develop systematic followup procedures to ensure that facilities correct violations noted during complaint investigations and compliance assessments.

    Agency Affected: Department of Health and Human Services: Health Resources Administration: Bureau of Health Facilities

  7. Status: Closed - Implemented

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: BHF should focus on verifying the Loan Early Warning System's database and collecting other necessary data.

    Agency Affected: Department of Health and Human Services: Health Resources Administration: Bureau of Health Facilities

  8. Status: Closed - Implemented

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: BHF should obtain uncompensated care compliance information, from the hundreds of facilities scheduled to reach the end of their 20-year uncompensated care obligation since September 1979, to determine: (1) why they have not requested closeout assessments; and (2) whether they have reached their compliance levels. In the future, BHF should obtain uncompensated care information from facilities as soon as they reach the scheduled completion of their 20-year obligation.

    Agency Affected: Department of Health and Human Services: Health Resources Administration: Bureau of Health Facilities

 

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