In a new report released by Congress’s investigative branch, the Government Accountability Office (GAO) the U.S. government is criticized for its oversight of nursing homes across the nation.

According to the report published in The New York Times, nursing homes and long-term care facilities that are continuously cited for mistreating patients often only face minimal penalties.

Because the penalties are so weak, some nursing homes fail to consistently meet strict federal standards, posing a serious threat to the health and safety of patients, said the GAO.

The report said the U.S. Health and Human Services Department fails to hold homes with a long history of harming residents accountable for the poor care provided, and added that some of these homes repeatedly harmed residents over an extended period and yet remain in the Medicare and Medicaid program.

In 1987, a strict set of standards and guidelines were established by Congress to decrease the incidence of nursing home malpractice and abuse. Unfortunately, the enforcement of these standards are insufficient and the report said that homes can repeatedly harm residents without facing sanctions.