Washington State Did Not Always Verify Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid

The Washington State Department of Social and Health Services, Aging and Long-Term Support Administration, Residential Care Services Division (State agency), did not always verify nursing homes' correction of deficiencies identified during surveys in calendar year (CY) 2012 in accordance with Federal requirements. For the 100 sampled deficiencies, the State agency verified the nursing homes' correction of 30 deficiencies but did not have documentation supporting that it had verified the nursing homes' correction of the remaining 70 deficiencies. On the basis of our sample results, we estimated that the State agency did not verify nursing homes' correction of deficiencies in accordance with Federal requirements for 1,164 (84 percent) of the 1,390 deficiencies identified during surveys in CY 2012.

The State agency did not provide adequate guidance and training to its surveyors or establish standardized practices for them to follow when verifying and documenting the correction of deficiencies. Further, the State agency did not have adequate internal controls over retaining documentation to support that it had verified the correction of deficiencies.

To ensure that the State agency complies with Federal requirements for verifying and documenting nursing homes' correction of deficiencies, we recommended that the State agency (1) provide guidance and training to its surveyors and establish standardized practices for them to follow and (2) improve internal controls over retaining documentation to support that it has verified the correction of deficiencies. We also recommended that the State agency follow all Federal requirements to appropriately verify and document nursing homes' correction of deficiencies before certifying their substantial compliance with Federal participation requirements. The State agency concurred with our findings and provided information on corrective actions taken.