This report originally appeared in the February 2010 issue of DOTmed Business News

Senators Herb Kohl (D-WI) and Chuck Grassley (R-IA), and Representatives Henry A. Waxman (D-CA), Pete Stark (D-CA) and Jan Schakowsky (D-IL), have released a report by the U.S. Government Accountability Office (GAO) examining the federal government's use of sanctions on negligent nursing homes. The report specifically reviewed the temporary management sanction, in which the administration of a nursing home is replaced for a period of time in situations where the nursing home in question places residents at risk of death or serious injury.

The GAO report found that the sanction was successfully used in the short term in facilities with a combination of immediate jeopardy, a history of noncompliance with CMS quality requirements, or the failure of other sanctions. In 10 of the 14 homes reviewed, officials used the sanction successfully in returning the home to compliance in the short term. However, some homes had compliance problems in the longer term after the conclusion of temporary management. Officials from states and CMS regional offices identified several obstacles to using temporary management: time constraints; lack of qualified temporary managers; and inadequate funding to pay for a temporary manager.

The GAO report recommends improving the usefulness of the federal temporary management sanction through the following actions: 1) creation and maintaining lists of qualified temporary managers; 2) developing information that identifies best practices such as when and how to use the sanction; and 3) developing guidance for states to help ensure the longer-term compliance of homes that have undergone temporary management. The GAO also suggested that CMS work with states to develop a list of temporary managers who are qualified to step in on short notice and mitigate crises of care at nursing homes.

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