According to a Government Accountability Office (GAO) report, state nursing home survey inspectors frequently miss care problems in nursing homes. The findings stated that 15 percent of state surveys failed to cite at least one G through L deficiency. In nine states, the federal surveyors found missed serious deficiencies in 25 percent or more of the surveys.

At the D through F tag level, missed deficiencies were over 50% in all but five states. Surveys failed to identify 2.5 D through F level deficiencies per survey. The most frequently missed deficiencies were quality of care standards.

In response the GAO intends to:

  1. Require regional [CMS] offices to determine why state surveyors cite a deficiency at a lower scope and level than federal surveyors do.
  2. Establish quality controls to improve the accuracy and reliability of information and survey data.
  3. Analyze federal comparative and observational survey results.