State Inspection System for Nursing Homes, Assisted Living Facilities ‘Corrupted,’ Senator Says
State inspectors of nursing homes and assisted living centers are "sometimes pressured to overlook or downplay problems," and CMS needs to increase its oversight of the "broken" process, according to a letter from Sen. Chuck Grassley (R-Iowa) to CMS Administrator Mark McClellan, USA Today reports. Inspectors go to nursing homes and assisted living centers to assess whether the facilities meet state and federal guidelines and to follow up on patient complaints. "The survey process upon which we rely for accurate, objective and independent data ... has been corrupted ... and we need to restore the integrity of the system," the letter, sent Friday, stated. According to a review of states' inspection programs by Grassley's staff, inspectors are "routinely instructed" to downgrade or ignore violations; sometimes rewrite their reports in the facilities' favor; and rarely "thoroughly" review complaints from patients or families, USA Today reports. Grassley recommended in his letter that CMS allow inspectors to anonymously report superiors' efforts to manipulate the process, and that the agency review sudden improvements in reports from facilities with a history of violations to determine if the changes are legitimate.
In a statement Friday, CMS said that it has already enacted some changes such as focusing inspections on specific problems, including bed sores, malnutrition, dehydration and personnel levels. The agency added it "will take appropriate further action to improve the quality of nursing home care." Industry representatives said they had not yet read Grassley's letter, but they are working with facilities and regulators to improve the inspections process. The American Health Care Association, which represents long-term care facilities, said the inspections system is convoluted and "focuses on a facility's compliance with regulations, rather than whether it is ensuring successful outcomes for patients" (Appleby, USA Today, 7/12).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.