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GAO Issues Report Calling for Additional Reporting on Key Staffing Information and Stronger Payment Incentives for Skilled Nursing Facilities

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  • GAO Issues Report Calling for Additional Reporting on Key Staffing Information and Stronger Payment Incentives for Skilled Nursing Facilities
August 12, 2021

The Government Accountability Office (GAO) this week issued a report examining skilled nursing facility (SNF) performance on staffing measures, CMS reporting of staffing information on Care Compare, and Medicare payments for critical incidents. Based on its analysis, GAO recommended that Congress should consider directing the Secretary of the Department of Health and Human Services to implement appropriate payment reductions for SNFs that generate Medicare spending on potentially preventable critical incidents, primarily hospital readmissions occurring within 30 days of the SNF admission. GAO’s 3 specific recommendation to CMS are:

  • The Administrator of CMS should report weekend decreases in RN and total nurse staffing levels on the Care Compare website. (Recommendation 1)
  • The Administrator of CMS should report minimum RN and total nurse staffing thresholds below which SNF residents are at increased risk of quality problems—such as thresholds that are similar to those identified in the CMS staffing study—on the Care Compare website. (Recommendation 2)
  • The Administrator of CMS should assess the feasibility of incorporating into the Five-Star System staffing ratings information on weekend decreases in RN and total nurse staffing levels, and minimum RN and total nurse staffing thresholds below which SNF residents are at increased risk of quality problems—such as those that were identified in

    the CMS staffing study. (Recommendation 3)

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