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May 2008
 Federal Monitoring Surveys Demonstrate Continued Understatement of
Serious Care Problems & CMS Oversight Weaknesses
The Government Accountability Office (GAO)
evaluated the effectiveness of nursing home surveys conducted by the
Centers for Medicare and Medicaid Services (CMS). GAO was also asked to
evaluate CMS oversight of the survey program.
GAO reviewed the results of federal monitoring surveys over a five-year
period from 2002 to 2007, reviewed CMS guidance for the survey program,
and interviewed officials. GAO found that the surveys generally
understated serious care problems and deficiencies. The most frequently
missed deficiency was poor quality of care, which includes ensuring
proper nutrition and hydration and preventing pressure sores.
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