NURSING HOMES: One-Fourth Jeopardize Patient Safety
The day after the Clinton administration announced a crackdown on nursing home abuse, a report released yesterday by the Government Accounting Office shows that more than one quarter of the nation's nursing homes have been cited for "violations that threaten the safety of residents." Despite 1995 reforms, 40% of those cited are repeat offenders. The lack of compliance has been attributed to rules that void penalties if violations are corrected within a certain amount of time and allow homes that have been kicked out of Medicare or Medicaid to participate again within one or two months with a "clean slate" (Wolfe, Minneapolis Star Tribune, 3/19). The report noted that another problem is the appeals process, now backlogged with 700 cases, which has allowed offenders to avoid paying fines.
The report has prompted widespread calls for reform, even from the nursing home industry. David Seckman, acting president of the American Health Care Association, which represents 12,000 nursing homes, said the report "underscores the pressing need for reform of the federal government's system for inspecting and certifying nursing homes." He said one problem was that federal inspectors are barred from working with nursing homes to improve care. Sen. Chuck Grassley (R-IA), chair of the Senate Special Committee on Aging, said, "Patients suffer. Bad homes profit. The taxpayers are suckered" (MacPherson, Pittsburgh Post-Gazette, 3/19). Grassley has pledged to hold hearings on the report this year. HCFA called the findings "disturbing" and said it will crack down on substandard nursing homes (Star Tribune, 3/19).
The report recommended that HCFA shorten the appeals process, "do a better job of withholding Medicare and Medicaid funding from homes that are unacceptable, better communicate with states about problems at particular homes and track repeat offenders better" (Towle, Ft. Worth Star-Telegram, 3/19). Mark Shade, spokesperson for Pennsylvania Auditor General Robert Casey, said the report highlights the "need for nursing home 'report cards' that help consumers make informed choices" (Post- Gazette, 3/19). Maryland Sen. Michael Collins (D) has introduced a bill in that state that would require "notification of the families or legal representatives of patients found to be getting substandard care" (Roche, Baltimore Sun, 3/19).