Report: 90% of nursing homes faulted
Posted on Sunday, October 5, 2008
WASHINGTON — More than 90 percent of nursing homes were cited for violations of federal health and safety standards last year, and for-profit homes were more likely to have problems than other types of nursing homes, federal investigators said in a report issued Monday.
In Arkansas, more than 95 percent of nursing homes had deficiencies or complaints in each of the past three years, according to the report, “Trends in Nursing Home Deficiencies and Complaints.” The average number of deficiencies per Arkansas nursing home exceeded eight for each year from 2005 to 2007, said the report, which is produced annually by the government.
Deficiencies fall into 17 categories, including physician, rehabilitative, dental, nursing, dietary or pharmacy services; quality of life; quality of care; and admission, transfer and discharge rights.
“Obviously, that is a high rate of deficiencies,” said Julie Munsell, a representative for the Arkansas Office of Long Term Care. “But it is difficult to make a wholesale implication based on the raw numbers. You have to look a little deeper and see what are the issues.”
The deficiencies could be more serious issues such as bedsores, restraint, abuse or neglect, or less serious problems such as failure to fill out a time card correctly or clean a floor properly, Munsell said.
About 17 percent of nursing homes nationally had deficiencies that caused “actual harm or immediate jeopardy” to patients, said the report, by Daniel R. Levinson, the inspector general of the U. S. Department of Health and Human Services.
Problems included infected bedsores, medication mix-ups, poor nutrition, and abuse and neglect of patients.
The most common violations, cited in the case of 28 percent to 36 percent of nursing homes, related to improper storage and distribution of food, accident hazards, and care services necessary for residents ’ mental and physical well-being, the report said.
Deficiency rates varied widely among states. The proportion of nursing homes cited for deficiencies ranged from 76 percent in Rhode Island to 100 percent in Alaska, Idaho, Wyoming and the District of Columbia.
The average number of deficiencies also varied, from 2. 5 deficiencies per nursing home in Rhode Island to 13. 3 per home in Delaware.
The survey process is too subjective to determine how well nursing homes are performing, said Susan Feeney, a spokesman for the American Health Care Association, a Washington advocacy group for 9, 000 nursing homes.
Inspectors received 37, 150 complaints about conditions in nursing homes last year, and they substantiated 39 percent of them, the report said. About one-fifth of the complaints verified by federal and state authorities involved the abuse or neglect of patients.
About two-thirds of nursing homes are owned by for-profit companies, while 27 percent are owned by nonprofit organizations and 6 percent by government entities, the report said.
The inspector general said 94 percent of for-profit nursing homes were cited for deficiencies last year, compared with 88 percent of nonprofit homes and 91 percent of government homes.
“For-profit nursing homes had a higher average number of deficiencies than the other types of nursing homes,” Levinson said. “In 2007, for-profit nursing homes averaged 7. 6 deficiencies per home, while not-for-profit and government homes averaged 5. 7 and 6. 3, respectively.”
On Monday, Levinson issued a compliance guide that says some nursing homes “have systematically failed to provide staff in sufficient numbers and with appropriate clinical expertise to serve their residents.”
Researchers have found that people receive better care at homes with a higher ratio of nursing staff to patients.
The inspector general said he had found some cases in which nursing homes billed Medicare and Medicaid for services that “were not provided, or were so wholly deficient that they amounted to no care at all.”
More than 1. 5 million people live in the nation’s 15, 000 nursing homes. The homes are typically inspected once a year and must meet federal standards as a condition of participating in Medicaid and Medicare, which cover more than two-thirds of their residents, at a cost of more than $ 75 billion a year. Information for this article was contributed by David Smith of the Arkansas Democrat-Gazette and Aliza Marcus of Bloomberg News.
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