Home Health Care:

HCFA Evaluation of Community Health Accreditation Program Inadequate

HRD-92-93: Published: Apr 20, 1992. Publicly Released: May 11, 1992.

Additional Materials:


David P. Baine
(202) 512-7101


Office of Public Affairs
(202) 512-4800

Pursuant to a congressional request, GAO reviewed the Health Care Financing Administration's (HCFA) evaluation of the Community Health Accreditation Program's (CHAP) ability to assure that home health agencies meet Medicare conditions of participation.

GAO found that: (1) HCFA inadequately compared CHAP accreditation standards with Medicare conditions of participation; (2) where the CHAP standards were not comparable to the Medicare conditions, CHAP made appropriated changes in its standards to assure comparability and HCFA assured that those changes were appropriately documented; (3) HCFA did not examine CHAP survey files, did not fully evaluate the CHAP training process, did not obtain any information from CHAP about its staff size, and did not examine the CHAP financial statements; (4) HCFA has taken action to resolve those issues, by agreeing to change the CHAP time frames for notifying home health care agencies of survey findings to make them more comparable with HCFA and to train all CHAP surveyors; (5) CHAP has agreed to allow HCFA to perform on-site monitoring which will allow HCFA to determine whether CHAP resources hamper its ability to conduct an expanded number of surveys and to assure that CHAP meets Medicare conditions of participation; and (6) HCFA does not plan to perform any further evaluation of CHAP.

Recommendation for Executive Action

  1. Status: Closed - Implemented

    Comments: HCFA disregarded the GAO recommendation and granted CHAP "deemed status".

    Recommendation: The Secretary of Health and Human Services should direct the Administrator, HCFA, to defer any action on granting CHAP deemed status until HCFA conducts a thorough evaluation and analysis of the CHAP ability to assure that home health agencies meet Medicare conditions of participation.

    Agency Affected: Department of Health and Human Services


Explore the full database of GAO's Open Recommendations »