At Least 59% of U.S. Nursing Homes Have Received Fire Safety Citations, Report Finds
Recent inspections at nursing homes nationwide found that at least 59% have been cited for fire safety violations, but many facilities have not installed sprinklers and smoke detectors because of cost issues, according to a Government Accountability Office report released Thursday, the New York Times reports. The GAO report was conducted at the request of Sen. Chuck Grassley (R-Iowa) and Senate Majority Leader Bill Frist (R-Tenn.) after fires at nursing homes in Connecticut and Tennessee resulted in the deaths of 31 people. CMS investigators annually inspect about 5% of the 17,000 nursing homes in the United States, but investigators assessed fire safety at only 40 of the 871 homes they inspected last year. Federal law requires inspectors to assess fire safety at all of the homes they inspect. According to the GAO report, "State and federal oversight of nursing home compliance with fire safety is inadequate," and inspectors in some cases ignored violations that were found by "whiting-out deficiencies on the survey forms." The report recommended that nursing homes conduct more fire drills and install more safeguards, such as fire alarms; federal regulators no longer exempt some older nursing homes from certain safety standards; and a government Web site should provide list for consumers the basic fire safety information at nursing homes. The report also recommended that health officials install sprinkler systems in all nursing homes; 20% to 30% of homes currently lack such systems.
Grassley said the inspection system is "broken" and federal safety enforcement at nursing homes "in all likelihood, has been seriously corrupted" by political pressure from high-ranking officials. CMS Administrator Mark McClellan said he plans a fivefold increase in federal inspections. In addition, McClellan said he will propose a rule requiring smoke detectors in all nursing homes and will "explore the feasibility" of requiring sprinkler systems in all facilities. McClellan said CMS also will begin posting fire safety information on the Internet. Rep. John Larson (D-Conn.) plans to introduce a bill next week that would require all nursing homes receiving Medicare or Medicaid funding to be equipped with sprinklers. Under the proposed legislation, the federal government would reimburse the cost of all sprinkler systems installed since September 2003 (Pear, New York Times, 7/16).
In related news, nursing home industry officials on Thursday testified before Congress that a "dramatically" increasing number of "frivolous lawsuits" are impeding nursing homes' ability to provide adequate care, CongressDaily reports. At a hearing of the Senate Special Committee on Aging, witnesses compared lawsuits against nursing homes to those against physicians and hospitals, citing an industry analysis that found a significant increase in the number of claims and the amount of awards in recent years. Theresa Boudon of Aon Risk Consultants said long-term care homes must save $6.27 daily per patient "just to cover the cost of litigation." However, Marshall Kapp of the Southern Illinois University Law School said the lawsuits have had a "deterrent impact" and improved the quality of care. Kapp added that nursing homes also have responded to the lawsuits by becoming more reluctant "to openly identify, disclose, discuss and remedy errors." The National Citizens' Coalition for Nursing Home Reform, which was not asked to testify, said witnesses at the hearing sought to "blame the victims who seek redress in civil courts for the rising cost of liability insurance, rather than the providers who neglected and abused them" (Rovner, CongressDaily, 7/16).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.