The Government Accountability Office is issuing a report this week that shows nursing homes with numerous citations for mistreatment of patients receive only minimal penalties, according to the New York Times. Under federal law, the government has the ability to deny Medicaid and Medicare payments to homes that are not in compliance with increasingly stringent standards. Fines of up to $10,000 a day may also be imposed. The report highlights the aggressive reform efforts that have been undertaken in recent years, but concludes that highly punitive sanctions are rarely used for fear of putting facilities out of business.