The Government Accountability Office (GAO) has issued a report entitled "Nursing Homes: More Reliable Data and Consistent Guidance Would Improve CMS Oversight of State Complaint Investigations." According to the GAO, state survey agencies received 53,313 complaints about nursing homes in 2009; the number and types of complaints varied among states. State survey agencies investigated all but 102 complaints that required an investigation; 19% of investigated complaints were substantiated and resulted in the citation of at least one federal deficiency. The GAO also reports that: many state survey agencies had difficulty meeting some of CMS’s nursing home complaint standards; CMS’s oversight of state complaint investigation processes is hampered by data reliability issues; and state corrective action plans do not necessarily address the underlying causes of performance issues. The GAO recommends that CMS take steps to strengthen oversight of complaint investigations, such as improving the reliability of its complaints database and clarifying state performance standards guidance to assure more consistent interpretation.  HHS generally agreed with the GAO’s recommendations. Separately, the OIG has issued a report on "Medicare Atypical Antipsychotic Drug Claims for Elderly Nursing Home Residents." Based on a limited medical record review of claims for the period January 1 through June 30, 2007, the OIG concluded that: 51% of Medicare claims for atypical antipsychotic drugs for elderly nursing home residents were erroneous, amounting to $116 million; 14% of elderly nursing home residents had Medicare claims for atypical antipsychotic drugs; 83% of Medicare claims for such drugs for elderly nursing home residents were associated with off-label conditions and 88% were associated with dementia, the subject of an FDA boxed warning; and 22% of the atypical antipsychotic drugs claimed were not administered in accordance with CMS standards regarding unnecessary drug use in nursing homes. The OIG recommends that that CMS: (1) facilitate access to information necessary to ensure accurate coverage and reimbursement determinations, (2) assess whether survey and certification processes offer adequate safeguards against unnecessary antipsychotic drug use in nursing homes; (3) explore alternative methods to promote compliance with federal standards regarding unnecessary drug use in nursing homes; and (4) take appropriate action regarding the claims associated with identified erroneous payments. CMS generally agreed with all except the first recommendation.