The Centers for Medicare and Medicaid Services needs to improve the accessibility and reliability of expenditure data collected from skilled nursing facilities, according to the Government Accountability Office.
While SNFs are required to self-report their expenditures in annual financial cost reports and CMS posts the raw data on its website, GAO contends that the agency has not provided the data in a readily accessible format and has not posted the data in a place that is easy to find on its website.
Specifically, auditors note that the “data’s format volume, and organization can make it difficult for public stakeholders to use the data” and the “data files are so large that some users have been unable to download them.”
And, although the public stakeholders could benefit from using the cost report data to compare SNFs’ costs for resident care, the government watchdog group finds that CMS does little to ensure the accuracy and completeness of the data. In fact, GAO criticizes the agency for performing minimal quality control of the SNF expenditure data in the Medicare cost reports to ensure data reliability, and instead relying on SNFs to validate and self-certify the accuracy and completeness of their cost report data.
Part of the problem, according to auditors, is that because the data do not affect the amount of Medicare payments each SNF receives, the SNFs have no incentive to ensure the accuracy and completeness of their data.
“Until CMS takes steps to make reliable SNF expenditure data easier to use and locate, public stakeholders will have difficulty accessing and placing confidence in the only publicly available source of financial data for many SNFs,” concludes GAO’s report.
As a result, GAO recommended that CMS improve public stakeholders’ ability to locate and use SNF expenditure data, as well as ensure the accuracy and completeness of the data.
In response to the report, the Department of Health and Human Services agreed with the first recommendation but not the second one, citing resource considerations.
“HHS said that it has made a reasonable effort to ensure the accuracy of the expenditure data, that the data are used for general purposes, and that the amount of time and resources that may be required to verify the accuracy and completeness of the data could be substantial and might not create significant benefit to the agency or the public,” states the report.
However, GAO said that it continues to believe that CMS should provide reliable SNF expenditure data.
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