Long-Term Care:

Status of Quality Assurance and Measurement in Home and Community-Based Services

PEMD-94-19: Published: Mar 31, 1994. Publicly Released: Mar 31, 1994.

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Pursuant to a congressional request, GAO reviewed the methods for: (1) measuring the quality of home and community-based long-term care services; and (2) assuring quality long-term care services for disabled persons.

GAO found that: (1) the complex financing structure that supports home and community-based care services has resulted in different quality assurance requirements for similar services; (2) program administrators and service providers do not articulate goals for home and community-based long-term care, especially at the individual service level; (3) goals for personal care services are less formal; (4) states are facing challenges in extending access to home and community-based services to all those in need; (5) service providers have emphasized several factors in measuring the quality of home care including coordination of care, appropriateness of treatment, and provider training and experience; (6) state and federal agencies have implemented a variety of quality assurance standards, but these standards are not sufficient to ensure quality long-term care services; (7) Medicare has developed several service requirements to ensure the health and safety of its patients; (8) most states require home care agencies to obtain a license before providing home care services; and (9) on-site inspection and supervision varies due to the lack of specific regulations and funding.

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