The United States Government Accountability Office (GAO) recently issued a report regarding oversight of long term care hospitals (LTCHs) and quality of care issues within LTCHs. In examining the extent to which the Centers for Medicare and Medicaid Services (CMS) oversees survey activities at LTCHs, the GAO found that CMS oversight of state agency and accreditation organization (AO) survey activities in LTCHs is limited. Currently, CMS analyzes data on survey activities at LTCHs with the data gathered for other types of hospitals rather than analyzing results separately for LTCHs. Additionally, although it is CMS policy to include approximately one percent of AO-surveyed hospitals in a traditional validation survey each year, CMS does not include LTCHs systematically in the survey sample. The GAO also reports that while state survey agencies conduct a large number of complaint validation surveys at LTCHs surveyed by The Joint Commission, the results of the surveys may not always be shared with The Joint Commission, which limits the effectiveness of CMS oversight.
In making recommendations to CMS, the GAO proposed, among other things, that CMS should conduct traditional validation surveys of a sample of LTCHs each fiscal year and improve sharing of information on complaint validation surveys with The Joint Commission. While U.S. Department of Health & Human Services agreed with all of the GAO recommendations to CMS, The Joint Commission questioned whether validation surveys of LTCHs were of value, noting, for example, that the GAO previously found that state surveyors missed serious deficiencies for nursing home surveys. Additionally, while reviewing the extent to which CMS collects quality of care data on LTCHs, the GAO noted that such data is extremely limited, in part because LTCHs are not yet required to report quality measures. However, LTCHs will be required to report such quality data beginning in 2014. The GAO recommended that in seeking to improve data collected on LTCHs, CMS should improve accuracy of databases that track the results of LTCH surveys. A copy of the report is available by clicking here.