90% of Nursing Homes Cited for Health, Safety Violations Last Year

More than 90% of U.S. nursing homes were cited for federal health and safety violations in 2007, according to an HHS Office of Inspector General report released on Monday, the New York Times reports.

Findings

The report found that deficiencies were cited for 94% of for-profit nursing homes, 88% of not-for-profit homes and 91% of government-run homes.

HHS Inspector General Daniel 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."

For-profit homes account for approximately 66% of U.S. nursing homes, not-for-profit homes account for 27% and government-run homes account for 6% (Pear, New York Times, 9/30).

According to the report, the most common deficiencies centered on quality of care measures, including treatment and prevention of bedsores and urinary tract infections. The most common quality of life issues involved housekeeping, maintenance and nutrition, with 43% of homes cited for problems with dietary services (Freking, AP/Boston Globe, 9/29).

The report found that about 17% of nursing homes had deficiencies that caused "actual harm or immediate jeopardy" to residents. Of the 37,150 complaints inspectors received in 2007 about the condition of nursing homes, 39% were substantiated and about 20% of those verified complaints involved patient abuse or neglect.

The proportion of nursing homes cited varied among states, ranging from 76% of homes in Rhode Island to 100% of homes in Alaska, Idaho, Wyoming and Washington, D.C. The average number of deficiencies per home ranged from 2.5 in Rhode Island to 13.3 in Delaware (New York Times, 9/30).

Context

The report's findings were included in a memorandum sent to CMS acting Administrator Kerry Weems (AP/Boston Globe, 9/29).

Levinson issued a compliance guide for nursing homes on Monday stating that some facilities "have systematically failed to provide staff in sufficient numbers and with appropriate clinical expertise to serve their residents." He also said that he found 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."

In December, President Bush plans to institute a five-star system to be published on a federal Web site that will rank the overall quality of care at all U.S. nursing homes (New York Times, 9/30).

Response

CMS spokesperson Jeff Nelligan said, "The addition of stronger inspections and enforcement of quality-of-life requirements means that more of the serious deficiencies are being identified, even though many nursing homes also made improvements in their care" (Marcus, Bloomberg/Pittsburgh-Post Gazette, 9/30).

Bruce Yarwood, president of nursing home trade group American Health Care Association, said, "We know we have to do a better job" but the inspection system "does not reliably measure quality" and "does not create any positive incentives" (New York Times, 9/30).