Nurse Corps Mortgage Reimbursement Program: Too Early to Decide Results of Permitting Recipients to Serve at For-Revenue Services

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What GAO Discovered

The Well being Assets and Providers Administration (HRSA), throughout the Division of Well being and Human Providers, manages the Nurse Corps Mortgage Reimbursement Program (LRP). This system offers academic mortgage repayments for registered nurses and different nursing professionals in change for his or her service in a vital scarcity facility (CSF)—a facility that’s situated in or designated as a well being skilled scarcity space. From October 2007 to March 2020, recipients of the Nurse Corps LRP couldn’t fulfill their required program service by working at for-profit CSFs. The CARES Act eradicated this restriction in March 2020, permitting recipients of the LRP to serve in both nonprofit or for-profit CSFs.

To handle this system, HRSA has processes in place to speak program info to candidates and to confirm info, reminiscent of an applicant’s eligibility, mortgage info, and proof of employment in an eligible CSF. HRSA additionally conducts annual evaluations to observe the consequences of this system and points an annual report back to Congress. These experiences describe this system’s outcomes, such because the variety of purposes, variety of recipients and mortgage repayments, quantity and placement places of the Nurse Corps LRP recipients, and recipients’ demographics.

It’s too early to find out the consequences of permitting mortgage recipients to meet their service dedication at a for-profit CSF. Funding choices for the primary group of candidates that will serve in for-profit CSFs won’t be accomplished till September 30, 2021. Chosen candidates will start their 2 years of service and begin working in designated CSFs in late 2021. In response to HRSA officers, they plan to look at the consequences of permitting service in for-profit amenities in future annual program evaluations, with the primary set of outcomes anticipated in fiscal yr 2022.

Officers related to for-profit and nonprofit CSFs had opposing views concerning the potential results of the elimination of the for-profit restriction. Officers from an affiliation representing for-profit CSFs acknowledged that eliminating the restriction might present an incentive for nurses to work in areas with the best want, no matter whether or not a CSF is for-profit or nonprofit. Officers from a nonprofit vital entry hospital and its related nonprofit rural well being clinic informed GAO they had been involved that for-profit CSFs could have monetary benefits over nonprofit CSFs. They acknowledged that these monetary benefits, reminiscent of a better wage fee, might make for-profit CSFs extra enticing to program members, leading to fewer nurses keen to work at nonprofit CSFs in rural or different underserved areas.

Why GAO Did This Examine

The availability and retention of registered nurses is uneven throughout the nation, with shortages in rural and different underserved areas. These shortages are exacerbated by different challenges, reminiscent of decrease numbers of nursing college students who need to work in rural or different underserved areas.

To assist tackle this downside, HRSA’s Nurse Corps LRP offers nursing faculty mortgage repayments for registered nurses and different nursing professionals who work in underserved areas. From fiscal yr 2016 by means of fiscal yr 2020, 4,156 Nurse Corps LRP awards had been distributed.

Congress included a provision within the CARES Act for GAO to evaluate the Nurse Corps LRP. This report describes (1) how HRSA manages this system, and (2) what is understood concerning the impact on CSFs of eliminating the for-profit restriction.

GAO reviewed the CARES Act and different associated statutory provisions, in addition to HRSA paperwork, together with software and steering info, info verification, annual experiences to Congress, and different program-related paperwork.

GAO additionally interviewed HRSA officers about their administration of this system, and officers from two nonprofit CSFs and one stakeholder group that represented for-profit hospitals which might be CSFs to acquire quite a lot of views on the elimination of the for-profit restriction.

The Division of Well being and Human Providers supplied technical feedback on a draft of this report, which GAO integrated as acceptable.

For extra info, contact Michelle B. Rosenberg at (202) 512-7114 or RosenbergM@gao.gov.

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