GAO was asked to assess the website and rating system as tools for consumers. To help consumers make informed choices about nursing homes, CMS developed the Nursing Home Compare website, and on the site made available the Five-Star System, which rates homes on quality components. As a result, CMS cannot ensure that the Five-Star System fully meets its primary goal.Įxample of Missing Information Affecting a Consumer's Nursing Home DecisionĪpproximately 15,600 nursing homes participating in the Medicare and Medicaid programs provide care to 1.4 million residents each year. In addition, the Five-Star System does not include consumer satisfaction survey information, leaving consumers to make nursing home decisions without this important information. For example, the ratings were not designed to compare nursing homes nationally, limiting the ability of the rating system to help consumers who live near state borders or have multistate options. GAO also found that several factors inhibit the ability of CMS's Five-Star Quality Rating System (Five-Star System) to help consumers understand nursing home quality and choose between high- and low- performing homes, which is CMS's primary goal for the system. Without having an established process to evaluate and prioritize implementation of improvements, CMS cannot ensure that it is fully meeting its goals for the website. Federal internal control standards require management to evaluate appropriate actions for improvement.
Rather, CMS officials described a fragmented approach to reviewing and implementing recommended website changes. However, GAO found that CMS does not have a systematic process for prioritizing and implementing these potential improvements.
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These mechanisms have helped identify potential improvements to the website, such as adding information explaining how to use the website. CMS uses three standard mechanisms for collecting website information-website analytics, website user surveys, and website usability tests. GAO found that the Centers for Medicare & Medicaid Services (CMS) collects information on the use of the Nursing Home Compare website, which was developed with the goal of assisting consumers in finding and comparing nursing home quality information.
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