As part of its evaluation, GAO made a series of recommendations to the Health Care Financing Administration (HCFA) for improvements to its nursing home survey process and for stronger enforcement in instances when nursing homes repeatedly violate regulations and do not correct deficiencies.
The HCFA has been given recommendations as to how to enforce regulations on nursing homes.
Details of the numerous requests we have received are covered in the third and fourth section, with included description of agencies' systems design and modifications, and our views on the effectiveness of the designed internal control in the proposed changes.