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GAO-02-431R 1 (2002-06-13)

handle is hein.gao/gaobaalzq0001 and id is 1 raw text is: I Accountability * Integrity * Reliability United States General Accounting Office Washington, DC 20548 June 13, 2002 The Honorable John B. Breaux Chairman The Honorable Larry E. Craig Ranking Minority Member Special Committee on Aging United States Senate The Honorable Charles E. Grassley Ranking Minority Member Committee on Finance United States Senate Subject: Nursing Homes: Quality of Care More Related to Staffing than Spending Since 1990, national expenditures for nursing home care have almost doubled, climbing from $53 billion to $92 billion in 2000. An increasing amount of that spending has been financed with public monies. Under the Medicare and Medicaid programs, the federal government financed 39 percent of the nation's nursing home spending in 2000, up from 28 percent in 1990. As federal outlays have grown, the Congress has focused attention on the quality of care delivered and the level of staffing in nursing homes. Questions have arisen about how federal dollars are being spent and the relationship between nursing homes' spending and quality of care. To better understand what public monies are purchasing, whether nursing homes with high total expenditures spend more on nursing care, and how individual nursing homes' expenditures relate to the quality of care they furnish, you asked us to examine (1) nursing home expenditures, particularly those devoted to resident care, and (2) whether there is any relationship among nurse staffing levels, quality of care, and expenditures. We examined the spending and staffing for freestanding' nursing homes in three states-Mississippi, Ohio, and Washington-that are geographically diverse and that collect the necessary information to adjust homes' spending for differences in residents' care needs. We analyzed 1999 cost data included in Medicaid cost reports, which include nursing homes' spending for all residents. We adjusted these spending data to account for differences in the resource needs of residents across homes and 'Freestanding nursing homes are not part of another facility such as an acute care or rehabilitation hospital. GAO-02-431R Nursing Home Expenditures and Quality

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