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GAO-22-105422 1 (2022-01-14)

handle is hein.gao/gaomqf0001 and id is 1 raw text is: Over 1.4 million Americans, including veterans, receive care in about 15,500 nursing homes. Most of these homes are overseen by the Centers for Medicare & Medicaid Services (CMS), while homes that serve veterans are overseen by the Department of Veterans Affairs (VA). Some homes are overseen by both. CMS defines the quality standards the homes it oversees must meet in order to participate in Medicare and Medicaid. CMS-certified nursing homes are regularly inspected, and if a home violates a federal standard, a deficiency is cited and must be corrected. VA generally follows a similar oversight process for the homes it oversees-its community living centers and state-owned and -operated veterans homes. Both CMS and VA provide some nursing home quality information to consumers through their websites. NURSING HOME QUALITY OF CARE: BEFORE AND DURING COVID-19 The COVID-19 pandemic has brought into sharper focus problems with nursing home quality that GAO has reported on-and made recommendations to address-for many years, and some of these recommendations have yet to be implemented. Specifically, GAO has identified gaps in CMS's oversight that made it harder to protect nursing home residents from abuse and concerns about VA's oversight of the nursing home inspection process it uses to ensure quality of care. In addition, in the years prior to the pandemic, infection prevention and control deficiencies, such as failure to use proper hand hygiene, were the most common type of deficiency cited by surveyors in nursing homes. (See fig. 1) Many of the same nursing homes were repeatedly cited for these infection prevention and control deficiencies year after year, indicating persistent quality of care problems. Nursing homes have experienced a disproportionately high number of COVID-19 deaths when compared to the general U.S. population. Efforts to reduce the spread of COVID-19 in nursing homes led to changes in infection prevention and control practices, including restricting loved ones and friends from visiting during critical points in the pandemic to prevent transmission. The resulting isolation raised concerns about unintended harm to residents, since isolation can increase loneliness, anxiety, and depression. Additionally, resident advocates, such as ombudsmen, were restricted from entering, limiting oversight of facilities during the pandemic. Nursing home visitation was allowed again for all residents beginning in November 2021, and public health officials emphasize the need for nursing homes to remain vigilant in maintaining proper infection prevention and control practices while balancing the psychosocial health needs of residents. Figure 1: Top 3 Nursing Home Deficiencies Cited by CMS and VA Source: GAO analysis; Pixel-Shot, weavebreak3/stock.adobe.com (photos). I GAO-22-105422 GAO-22-105422 Improving Nursing Home Quality and Information

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