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Nursing Homes: CMS Needs Milestones and Timelines to Ensure Goals for the Five-Star Quality Rating System Are Met

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Nursing Homes: CMS Needs Milestones and Timelines to Ensure Goals for the Five-Star Quality Rating System Are Met

4.85 86,281 ratings · 8,999 reviews
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Published September 4, 2013
ISBN 20771583
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U.S. Government Accountability Office
About the Author
U.S. Government Accountability Office
19,682 Followers

U.S. Government Accountability Office is a writer and avid reader based in the Pacific Northwest. Before pursuing writing full-time, they spent over a decade working in education. When not working on their next book, U.S. Government Accountability Office can usually be found hiking with their dog or trying out new coffee shops in their neighborhood.

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Ashley  Davis
Ashley Davis June 08, 2024
Absolutely brilliant. I became deeply invested in the protagonist's journey. A masterclass in storytelling. I am now a lifelong fan of this author.
Karen  Parker
Karen Parker January 03, 2025
I was completely blown away. The author orchestrated a breathtaking finale. Truly a work of art. Worth every moment spent reading.
Matthew Hall
Matthew Hall May 25, 2024
A profoundly satisfying read. The author orchestrated a breathtaking finale. Truly a work of art. I am now a lifelong fan of this author.
Gary Hernandez
Gary Hernandez September 26, 2024
I find myself somewhat conflicted. The prose was competent, yet the characters lacked the depth I usually seek. Perhaps more aligned with a different audience's tastes.
Deborah Roberts
Deborah Roberts November 01, 2024
Excellent, though slightly flawed. A brilliant concept executed with flair. Just a few pacing choices I would change. Quite impressive overall.
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Eric Sanchez September 15, 2025
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James Anderson February 05, 2024
Absolutely brilliant. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. I will undoubtedly revisit this masterpiece.
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Lisa Lewis September 29, 2025
Such a rich narrative. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. An effortless 5 stars.
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Elizabeth Roberts March 02, 2025
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Carol Nguyen November 18, 2024
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Nicholas Turner December 28, 2025
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Paul Lewis October 22, 2024
Exceeded all my expectations. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. A true literary gem.
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Richard Perez February 13, 2024
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Lisa Davis February 28, 2024
Took a moment to build, but the payoff was spectacular. The protagonist was compelling, though some subplots felt slightly overshadowed. A solid 4 stars from me.
Elizabeth Diaz
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Kevin Rivera June 10, 2025
Honestly one of the most premium reading experiences lately. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. Worth every moment spent reading.
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Charles Lee October 05, 2025
I thoroughly enjoyed the elegance of it. A brilliant concept executed with flair. Just a few pacing choices I would change. A wonderful companion for a quiet weekend.
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I thoroughly enjoyed the elegance of it. Beautiful writing, though I craved slightly more depth in the lore. Still, undeniably engaging. Quite impressive overall.
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Dorothy Thompson October 28, 2024
Exceeded all my expectations. The author orchestrated a breathtaking finale. Truly a work of art. Worth every moment spent reading.
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Sharon  Parker
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I thoroughly enjoyed the elegance of it. Beautiful writing, though I craved slightly more depth in the lore. Still, undeniably engaging. A wonderful companion for a quiet weekend.
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Cynthia Perez February 18, 2025
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Exceeded all my expectations. The prose is exquisite. It’s accessible yet undeniably sophisticated. A true literary gem.
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Joseph Rodriguez March 13, 2024
Masterpiece from start to finish. I became deeply invested in the protagonist's journey. A masterclass in storytelling. A true literary gem.
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Robert Parker August 12, 2025
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David Thompson
David Thompson March 11, 2024
Took a moment to build, but the payoff was spectacular. The middle had a deliberate pace, but the climax was phenomenal. Quite impressive overall.
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Sharon Baker August 08, 2025
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David Adams December 30, 2024
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Gary Hernandez
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Masterpiece from start to finish. I became deeply invested in the protagonist's journey. A masterclass in storytelling. An effortless 5 stars.
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Dorothy Hall November 21, 2024
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Such a rich narrative. The author orchestrated a breathtaking finale. Truly a work of art. An effortless 5 stars.
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Honestly one of the most premium reading experiences lately. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. Worth every moment spent reading.
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Donald King November 10, 2024
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Honestly one of the most premium reading experiences lately. I adored how the story unfolded. It kept me captivated without sacrificing elegance. An effortless 5 stars.
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Edward Jackson March 02, 2024
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Jessica Gonzalez March 06, 2024
Exceeded all my expectations. I became deeply invested in the protagonist's journey. A masterclass in storytelling. An effortless 5 stars.
Donna Nguyen
Donna Nguyen April 15, 2024
Took a moment to build, but the payoff was spectacular. The protagonist was compelling, though some subplots felt slightly overshadowed. Quite impressive overall.
William Jackson
William Jackson July 08, 2024
Masterpiece from start to finish. I became deeply invested in the protagonist's journey. A masterclass in storytelling. I am now a lifelong fan of this author.
Gary Hernandez
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Exceeded all my expectations. I adored how the story unfolded. It kept me captivated without sacrificing elegance. An effortless 5 stars.
Deborah Scott
Deborah Scott July 24, 2025
Excellent, though slightly flawed. The protagonist was compelling, though some subplots felt slightly overshadowed. A wonderful companion for a quiet weekend.
Linda Moore
Linda Moore October 11, 2025
Honestly one of the most premium reading experiences lately. I became deeply invested in the protagonist's journey. A masterclass in storytelling. I will undoubtedly revisit this masterpiece.
Karen Hill
Karen Hill May 25, 2025
Such a rich narrative. The author orchestrated a breathtaking finale. Truly a work of art. An effortless 5 stars.
Kenneth Harris
Kenneth Harris August 19, 2025
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Joseph Reyes
Joseph Reyes August 12, 2024
A profoundly satisfying read. The author orchestrated a breathtaking finale. Truly a work of art. An effortless 5 stars.
Jacob  Parker
Jacob Parker November 14, 2024
Such a rich narrative. The author orchestrated a breathtaking finale. Truly a work of art. Worth every moment spent reading.
Carol Thompson
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Masterpiece from start to finish. The author orchestrated a breathtaking finale. Truly a work of art. An effortless 5 stars.
David King
David King February 08, 2025
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Edward Jones
Edward Jones December 22, 2025
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Sharon Allen September 10, 2024
Masterpiece from start to finish. I became deeply invested in the protagonist's journey. A masterclass in storytelling. I am now a lifelong fan of this author.
John Phillips
John Phillips July 31, 2025
Such a rich narrative. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. I will undoubtedly revisit this masterpiece.
Donald Diaz
Donald Diaz October 05, 2024
Such a rich narrative. I became deeply invested in the protagonist's journey. A masterclass in storytelling. A true literary gem.
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Donna White September 04, 2025
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Richard Martin September 14, 2025
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Sandra Rodriguez August 22, 2025
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David Thompson
David Thompson October 09, 2025
I was completely blown away. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. I will undoubtedly revisit this masterpiece.
Christopher Jackson
Christopher Jackson February 15, 2024
A profoundly satisfying read. I adored how the story unfolded. It kept me captivated without sacrificing elegance. An effortless 5 stars.
Susan White
Susan White November 23, 2025
Took a moment to build, but the payoff was spectacular. The protagonist was compelling, though some subplots felt slightly overshadowed. A wonderful companion for a quiet weekend.
Donald Cruz
Donald Cruz February 28, 2025
Honestly one of the most premium reading experiences lately. I adored how the story unfolded. It kept me captivated without sacrificing elegance. I will undoubtedly revisit this masterpiece.
Cynthia White
Cynthia White November 23, 2024
Excellent, though slightly flawed. A brilliant concept executed with flair. Just a few pacing choices I would change. A solid 4 stars from me.
Sharon Garcia
Sharon Garcia May 06, 2024
I thoroughly enjoyed the elegance of it. The middle had a deliberate pace, but the climax was phenomenal. A very distinguished novel.
Sarah Mitchell
Sarah Mitchell October 23, 2025
A very strong entry. A brilliant concept executed with flair. Just a few pacing choices I would change. A very distinguished novel.
Barbara Robinson
Barbara Robinson April 26, 2024
Absolutely brilliant. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. An effortless 5 stars.
Donald Flores
Donald Flores November 02, 2025
Masterpiece from start to finish. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. A true literary gem.
Barbara Brown
Barbara Brown January 28, 2025
Honestly one of the most premium reading experiences lately. The author orchestrated a breathtaking finale. Truly a work of art. I will undoubtedly revisit this masterpiece.
Nicholas Rodriguez
Nicholas Rodriguez November 24, 2025
I find myself somewhat conflicted. The tempo was somewhat languid, and I found my mind wandering. Not poor, simply average. A fair 3 stars.
Paul Johnson
Paul Johnson March 12, 2025
Honestly one of the most premium reading experiences lately. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. I will undoubtedly revisit this masterpiece.
Jacob  Parker
Jacob Parker March 14, 2025
I was completely blown away. The prose is exquisite. It’s accessible yet undeniably sophisticated. An absolute must-read for connoisseurs of the genre.
Joseph Reyes
Joseph Reyes November 04, 2025
A highly sophisticated read. The protagonist was compelling, though some subplots felt slightly overshadowed. I would highly recommend this to discerning readers.
Karen  Parker
Karen Parker November 14, 2025
I find myself somewhat conflicted. Certain acts were fascinating, while others felt like a slight endeavor to complete. Suitable if your reading queue is empty.
Sandra Reyes
Sandra Reyes December 24, 2025
I was completely blown away. The author orchestrated a breathtaking finale. Truly a work of art. An absolute must-read for connoisseurs of the genre.
Anthony Jones
Anthony Jones February 06, 2024
I was completely blown away. I became deeply invested in the protagonist's journey. A masterclass in storytelling. An effortless 5 stars.
Amanda Evans
Amanda Evans October 27, 2024
Masterpiece from start to finish. I adored how the story unfolded. It kept me captivated without sacrificing elegance. An effortless 5 stars.
Linda Flores
Linda Flores May 26, 2025
Honestly one of the most premium reading experiences lately. The author orchestrated a breathtaking finale. Truly a work of art. A true literary gem.
Cynthia Perez
Cynthia Perez September 15, 2024
Absolutely brilliant. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. An absolute must-read for connoisseurs of the genre.
George Reyes
George Reyes June 07, 2025
A very strong entry. Beautiful writing, though I craved slightly more depth in the lore. Still, undeniably engaging. Quite impressive overall.
John Evans
John Evans June 14, 2024
Masterpiece from start to finish. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. I will undoubtedly revisit this masterpiece.
Kenneth Miller
Kenneth Miller October 04, 2025
A profoundly satisfying read. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. An effortless 5 stars.
David Adams
David Adams July 30, 2024
Masterpiece from start to finish. I became deeply invested in the protagonist's journey. A masterclass in storytelling. I will undoubtedly revisit this masterpiece.
Margaret Jones
Margaret Jones November 12, 2025
A profoundly satisfying read. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. Worth every moment spent reading.
Donald King
Donald King September 11, 2024
A decent, if standard, experience. Certain acts were fascinating, while others felt like a slight endeavor to complete. Suitable if your reading queue is empty.
Daniel White
Daniel White September 01, 2025
I thoroughly enjoyed the elegance of it. The protagonist was compelling, though some subplots felt slightly overshadowed. A solid 4 stars from me.
George Allen
George Allen November 14, 2025
I thoroughly enjoyed the elegance of it. Beautiful writing, though I craved slightly more depth in the lore. Still, undeniably engaging. Quite impressive overall.
Richard Lopez
Richard Lopez December 03, 2025
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Robert Rodriguez
Robert Rodriguez January 18, 2024
It was adequate. Certain acts were fascinating, while others felt like a slight endeavor to complete. Perfectly average.
Sarah Torres
Sarah Torres July 02, 2025
Masterpiece from start to finish. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. Worth every moment spent reading.
Stephanie Robinson
Stephanie Robinson February 27, 2025
Excellent, though slightly flawed. The protagonist was compelling, though some subplots felt slightly overshadowed. A solid 4 stars from me.
Karen Wilson
Karen Wilson December 30, 2025
Exceeded all my expectations. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. I am now a lifelong fan of this author.
Amanda Walker
Amanda Walker December 13, 2025
A highly sophisticated read. The protagonist was compelling, though some subplots felt slightly overshadowed. Quite impressive overall.
Paul Lewis
Paul Lewis March 16, 2025
Such a rich narrative. I adored how the story unfolded. It kept me captivated without sacrificing elegance. A true literary gem.
Mary Hall
Mary Hall July 31, 2024
Not entirely to my refined tastes. Certain acts were fascinating, while others felt like a slight endeavor to complete. A fair 3 stars.
Deborah Allen
Deborah Allen March 26, 2025
A very strong entry. The protagonist was compelling, though some subplots felt slightly overshadowed. A very distinguished novel.
Melissa  Parker
Melissa Parker November 14, 2025
Such a rich narrative. I adored how the story unfolded. It kept me captivated without sacrificing elegance. I am now a lifelong fan of this author.
Dorothy Hernandez
Dorothy Hernandez March 15, 2024
I was completely blown away. I became deeply invested in the protagonist's journey. A masterclass in storytelling. I will undoubtedly revisit this masterpiece.
George Martinez
George Martinez October 05, 2024
I was completely blown away. The prose is exquisite. It’s accessible yet undeniably sophisticated. I will undoubtedly revisit this masterpiece.
Sharon Allen
Sharon Allen December 06, 2024
Masterpiece from start to finish. The author orchestrated a breathtaking finale. Truly a work of art. Worth every moment spent reading.
Gary Jackson
Gary Jackson June 14, 2024
Exceeded all my expectations. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. I will undoubtedly revisit this masterpiece.
Amanda Evans
Amanda Evans April 22, 2025
I find myself somewhat conflicted. It possessed moments of brilliance, but the narrative felt slightly disjointed ultimately. Perfectly average.
Daniel Hall
Daniel Hall January 30, 2025
Masterpiece from start to finish. The prose is exquisite. It’s accessible yet undeniably sophisticated. An effortless 5 stars.
Gary Reyes
Gary Reyes November 24, 2024
Such a rich narrative. I became deeply invested in the protagonist's journey. A masterclass in storytelling. Worth every moment spent reading.
Laura Gonzalez
Laura Gonzalez October 14, 2024
Not entirely to my refined tastes. It verged on repetitive in the second act. A more concise edit would have served it well. Suitable if your reading queue is empty.
Brian Hernandez
Brian Hernandez March 27, 2024
A very strong entry. The protagonist was compelling, though some subplots felt slightly overshadowed. A wonderful companion for a quiet weekend.
Matthew Taylor
Matthew Taylor July 24, 2025
I find myself somewhat conflicted. The tempo was somewhat languid, and I found my mind wandering. Not poor, simply average. Perfectly average.
Gary Young
Gary Young November 30, 2025
Masterpiece from start to finish. The prose is exquisite. It’s accessible yet undeniably sophisticated. A true literary gem.
Mary  Davis
Mary Davis August 14, 2025
Took a moment to build, but the payoff was spectacular. It held my rapt attention, even when certain twists were telegraphed. I would highly recommend this to discerning readers.
Linda Moore
Linda Moore August 05, 2024
Exceeded all my expectations. I became deeply invested in the protagonist's journey. A masterclass in storytelling. I will undoubtedly revisit this masterpiece.
Mary Torres
Mary Torres September 19, 2025
Honestly one of the most premium reading experiences lately. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. I am now a lifelong fan of this author.
Cynthia White
Cynthia White February 09, 2025
Not entirely to my refined tastes. Certain acts were fascinating, while others felt like a slight endeavor to complete. A fair 3 stars.
Deborah Baker
Deborah Baker August 15, 2025
A highly sophisticated read. It held my rapt attention, even when certain twists were telegraphed. A wonderful companion for a quiet weekend.
Ryan Wilson
Ryan Wilson February 12, 2025
Excellent, though slightly flawed. It held my rapt attention, even when certain twists were telegraphed. I would highly recommend this to discerning readers.
David Thompson
David Thompson May 16, 2025
I was completely blown away. I adored how the story unfolded. It kept me captivated without sacrificing elegance. An effortless 5 stars.
Rebecca Reyes
Rebecca Reyes April 04, 2025
I was completely blown away. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. I will undoubtedly revisit this masterpiece.
Jacob Nelson
Jacob Nelson February 27, 2024
Exceeded all my expectations. I became deeply invested in the protagonist's journey. A masterclass in storytelling. I am now a lifelong fan of this author.
Ryan Taylor
Ryan Taylor May 14, 2025
Absolutely brilliant. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. An absolute must-read for connoisseurs of the genre.
Thomas Flores
Thomas Flores October 15, 2025
Honestly one of the most premium reading experiences lately. The author orchestrated a breathtaking finale. Truly a work of art. I am now a lifelong fan of this author.
Rebecca Johnson
Rebecca Johnson November 17, 2025
Honestly one of the most premium reading experiences lately. The prose is exquisite. It’s accessible yet undeniably sophisticated. I will undoubtedly revisit this masterpiece.
Nicholas Turner
Nicholas Turner October 15, 2025
I was completely blown away. I became deeply invested in the protagonist's journey. A masterclass in storytelling. I will undoubtedly revisit this masterpiece.
Susan Young
Susan Young October 23, 2025
Took a moment to build, but the payoff was spectacular. The protagonist was compelling, though some subplots felt slightly overshadowed. I would highly recommend this to discerning readers.
Thomas Baker
Thomas Baker June 24, 2025
I was completely blown away. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. I will undoubtedly revisit this masterpiece.
Edward Adams
Edward Adams December 14, 2025
I was completely blown away. I adored how the story unfolded. It kept me captivated without sacrificing elegance. An effortless 5 stars.
Matthew Taylor
Matthew Taylor August 30, 2025
I find myself somewhat conflicted. The tempo was somewhat languid, and I found my mind wandering. Not poor, simply average. Unlikely to reread, but a reasonable expenditure of time.
Charles Torres
Charles Torres May 01, 2024
Took a moment to build, but the payoff was spectacular. Beautiful writing, though I craved slightly more depth in the lore. Still, undeniably engaging. A wonderful companion for a quiet weekend.
Christopher Green
Christopher Green May 10, 2025
Exceeded all my expectations. I adored how the story unfolded. It kept me captivated without sacrificing elegance. An absolute must-read for connoisseurs of the genre.
Mark Phillips
Mark Phillips November 14, 2024
I was completely blown away. I became deeply invested in the protagonist's journey. A masterclass in storytelling. A true literary gem.
Ryan Perez
Ryan Perez June 23, 2024
I was completely blown away. I became deeply invested in the protagonist's journey. A masterclass in storytelling. Worth every moment spent reading.
Donald Diaz
Donald Diaz May 26, 2025
Such a rich narrative. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. An effortless 5 stars.
Jacob Diaz
Jacob Diaz June 04, 2025
Excellent, though slightly flawed. A brilliant concept executed with flair. Just a few pacing choices I would change. A wonderful companion for a quiet weekend.
Donna Hall
Donna Hall April 07, 2025
Masterpiece from start to finish. The author orchestrated a breathtaking finale. Truly a work of art. An effortless 5 stars.
Robert Clark
Robert Clark September 19, 2024
Not entirely to my refined tastes. Certain acts were fascinating, while others felt like a slight endeavor to complete. A fair 3 stars.
Michelle Moore
Michelle Moore September 10, 2025
Not entirely to my refined tastes. The tempo was somewhat languid, and I found my mind wandering. Not poor, simply average. Perfectly average.
Stephanie Allen
Stephanie Allen June 15, 2025
Took a moment to build, but the payoff was spectacular. It held my rapt attention, even when certain twists were telegraphed. Quite impressive overall.
Christopher White
Christopher White July 16, 2025
I was completely blown away. I became deeply invested in the protagonist's journey. A masterclass in storytelling. An effortless 5 stars.
Michelle Green
Michelle Green March 08, 2025
Excellent, though slightly flawed. The middle had a deliberate pace, but the climax was phenomenal. A solid 4 stars from me.
Deborah Thompson
Deborah Thompson November 24, 2024
A profoundly satisfying read. The author orchestrated a breathtaking finale. Truly a work of art. A true literary gem.
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