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Highlights

GAO was asked to review the Centers for Medicare & Medicaid Services (CMS) initiative to publicly report additional information on its "Nursing Home Compare" Web site intended to help consumers choose a nursing home. GAO examined CMS's development of the new nursing home quality indicators and efforts to verify the underlying data used to calculate them. GAO also reviewed the assistance CMS offered the public in interpreting and comparing indicators available in its six-state pilot program, launched in April 2002, and its own evaluation of the pilot. The new indicators are scheduled to be used nationally beginning in November 2002.

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Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Centers for Medicare and Medicaid Services 1. To ensure that publicly reported quality indicator data accurately reflect the status of quality in nursing homes and fairly compare homes to one another, the Administrator of CMS should delay the implementation of nationwide reporting of quality indicators until there is greater assurance that the quality indicators are appropriate for public reporting--including the validity of the indicators selected and the use of an appropriate risk-adjustment methodology--based on input from the NQF and other experts and, if necessary, additional analysis and testing.
Closed - Not Implemented
Although CMS stated it would use GAO's report to help improve the initiative over time, the agency implemented the national reporting of quality indicators during November 2002, prior to gaining greater assurance that the quality indicators are appropriate for public reporting.
Centers for Medicare and Medicaid Services 2. To ensure that publicly reported quality indicator data accurately reflect the status of quality in nursing homes and fairly compare homes to one another, the Administrator of CMS should delay the implementation of nationwide reporting of quality indicators until a more thorough evaluation of the pilot is completed to help improve the initiative's effectiveness, including an assessment of the presentation of information on the Web site and the resources needed to assist consumers' use of the information.
Closed - Not Implemented
Although CMS stated it would use GAO's report to help improve the initiative over time, the agency implemented the national reporting of quality indicators during November 2002, prior to completing a more thorough evaluation of the pilot.

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