And we developed a management contingency plan spelling out responsibilities of State and federal governments so we can respond quickly and effectively if a facility s financial situation places resident health or safety at risk. To improve consistency in how these efforts are implemented across the country, we have established a workgroup that includes key central and regional office staff. This workgroup is promoting clear and consistent communication among all involved staff. And it is specifically addressing areas where inconsistencies have been identified. We agree with the GAO that comparative surveys, in which federal surveyors conduct a completely separate review and compare results to those of a State survey of a given facility, have an important role in our oversight efforts.
Comparative surveys do find more deficiencies missed by State surveyors.
Observational surveys, on the other hand, in which federal surveyors accompany State surveys to review their performance, also have an important role. They enable us to directly evaluate State surveyors work and assess how and why they may have failed to identify problems. We believe that the most prudent approach at this time is one that includes both comparative and observational surveys. We are reviewing this issue to determine the appropriate balance between the two and the budget implications of any changes. In the meantime, we are shortening the time between State surveys and comparative surveys.