| HOME | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|---|
| ||||||||||||||||||||||||||||||||
a Health Services Management Centre, University of Birmingham, UK
b Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco
Correspondence: Charlene Harrington, PhD, Department of Social and Behavioral Sciences, School of Nursing, University of California San Francisco, 3333 California Street, Suite 455, San Francisco, CA 94188. E-mail: chas{at}itsa.ucsf.edu.
Decision Editor: Laurence G. Branch, PhD
Purpose: This study was undertaken to examine the resources, staffing, and performance of the state survey agencies that have primary responsibility for regulating nursing facilities—licensing them at a state level and certifying them for participation in Medicare and Medicaid on behalf of the Center for Medicare and Medicaid Services (CMS; formerly the Health Care Financing Administration). Design and Methods: A telephone and fax survey of survey agencies in all 50 states and the District of Columbia was used, supplemented by secondary data collected from CMS's On-Line Certification and Reporting (OSCAR) system. Results: Total state agency expenditures on nursing facility regulation in 2000 were $382.2 million, which is less than one half of 1% of the total expenditures on nursing facilities in the United States. About 3,000 full-time equivalent surveyors are employed to regulate more than 17,000 nursing facilities in the United States. Nursing facility licensing and certification dominates the work of state survey agencies, although they are responsible for regulating many other health care organizations. Spending has risen recently, but resource levels vary greatly across states, and most state agencies report significant funding shortfalls that impact on their ability to perform their regulatory function. On a range of indicators, the performance of state survey agencies varies fivefold. Some of that state variation is explained by differences in resource levels for regulation, but most is not. Implications: State survey agencies probably need more funding to fulfill their responsibilities properly, but other changes are also needed to improve their performance, including more support and oversight by CMS and more effective regulatory design.
Key Words: Nursing homes • Licensing and certification • HCFA • CMS • Long-term care
This article has been cited by other articles:
 |
|
 |
|
  N. G. Castle Nursing Home Evacuation Plans Am J Public Health, July 1, 2008; 98(7): 1235 - 1240. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. A. Miller and V. Mor Balancing Regulatory Controls and Incentives: Toward Smarter and More Transparent Oversight in Long-Term Care Journal of Health Politics Policy and Law, January 1, 2008; 33(2): 249 - 279. [Abstract] [PDF]
|
|
|
|
 |
|
 M. Putnam, Fengyan Tang, A. Brooks-Danso, J. Pickard, and N. Morrow-Howell Professionals' Beliefs About Nursing Home Regulations in Missouri Journal of Applied Gerontology, June 1, 2007; 26(3): 290 - 304. [Abstract] [PDF]
|
|
|
|
 |
|
 T. Tsoukalas, C. Rudder, R. J. Mollot, M. Shineman, H. Y. Lee, and C. Harrington The Collection and Use of Funds From Civil Money Penalties and Fines From Nursing Homes Gerontologist, December 1, 2006; 46(6): 759 - 771. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. A. Kash, N. G. Castle, G. S. Naufal, and C. Hawes Effect of staff turnover on staffing: a closer look at registered nurses, licensed vocational nurses, and certified nursing assistants. Gerontologist, October 1, 2006; 46(5): 609 - 619. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Harrington, J. T. Mullan, and H. Carrillo State Nursing Home Enforcement Systems Journal of Health Politics Policy and Law, February 1, 2004; 29(1): 43 - 74. [Abstract] [PDF]
|
|
|
|
|
|
X. Zhang and D. C. Grabowski Nursing Home Staffing and Quality Under the Nursing Home Reform Act Gerontologist, February 1, 2004; 44(1): 13 - 23. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. D. Allen, W. C. Klein, and C. Gruman Correlates of Complaints Made to the Connecticut Long-Term Care Ombudsman Program: The Role of Organizational and Structural Factors Research on Aging, November 1, 2003; 25(6): 631 - 654. [Abstract] [PDF]
|
|
|
|
|
|
L. Polivka, J. R. Salmon, K. Hyer, C. Johnson, and D. Hedgecock The Nursing Home Problem in Florida Gerontologist, April 1, 2003; 43(90002): 7 - 18. [Abstract] [Full Text] [PDF]
|
|
| HOME | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|---|
