The CMS is charged with conducting quality assessments of nursing homes that participate in Medicare and Medicaid. But in recent years, the GAO found the periodic inspections of those homes, which provide care to roughly 1.5 million people, to be inadequate, according to the report. In response, the CMS developed the Quality Indicator Survey. The program was pilot-tested in five states and is now being implemented nationwide.
The revamped electronic inspection process will let surveyors compare a home's performance with national standards of care and will allow them to record their observations electronically, according to the GAO's report. Use of an electronic system also will help surveyors review the right residents in order to assess a home's quality, the report noted.
"Using the traditional approach, surveyors select residents for the review using various sources of information combined with professional judgment," according to the report. "Using the QIS software, surveyors select a random sample of residents that is representative of the home's population."
The process of training surveyors could take as long as three years in each state, and the last phase of instruction is set to begin in 2014 or 2015—meaning training may not be fully complete until 2018, according to the report.