Health Facilities

In response to a congressional request, GAO provided information on the adequacy of the New York State Department of Health's nursing home and hospital inspections to ensure that these facilities met the conditions for participation in the Medicare and Medicaid programs. GAO specifically addressed allegations about defects in the inspection process that could result in: (1) the certification of substandard facilities for participation in the programs; and (2) beneficiaries receiving substandard care.

GAO found that: (1) there was no evidence that nursing homes received advance notice of inspection times; (2) changes to inspection reports were mainly editorial and did not suppress findings of deficiencies; (3) the state investigated patient complaints within the time periods established by state policy; (4) the state began sharing patient complaint information with GAO in June 1985; (5) although the state increased its emphasis on enforcement actions against nursing homes in 1983 and against hospitals in 1985, it failed to consistently take action against hospitals and negligent physicians; and (6) although there was no evidence of bias in favor of certain facilities regarding inspection and enforcement actions, the state lacked adequate internal controls to prevent conflicts of interest.