Summary: A GAO review of the Nuclear Regulatory Commission's (NRC) oversight of nuclear power plants reveals that for some plants, NRC has not taken aggressive action to force plant operators to fix long-standing safety problems on a timely basis. As a result, conditions have worsened in these plants, making safety margins narrower. NRC allowed safety problems to persist because it was confident that redundant design features kept nuclear plants inherently safe and because it relied heavily on assurances from plant operators about their intentions to make changes. Moreover, NRC lacks a process for ensuring the plant operator uses competent managers. Finally, NRC was slow to place plants on its "watch list," which triggers more regulatory attention at an early stage. Although NRC is implementing various reforms, such as expanding its inspection program and revamping its process for identifying plants with long-standing safety problems, changing the agency's culture of tolerating problems will not be easy. Fundamental reform will require NRC to hold plant operators accountable for fixing problems more promptly and addressing management issues more directly.