Inspectors Often Overlook Serious Deficiencies At U.S. Nursing Homes, GAO Report Finds

Main Category: Seniors / Aging
Also Included In: Caregivers / Homecare;  Medicare / Medicaid / SCHIP;  Public Health
Article Date: 16 May 2008 - 9:00 PDT

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State nursing home inspectors miss or minimize deficiencies -- such as malnutrition, severe bedsores, overuse of medications and abuse -- that pose a serious, immediate threat to patients, according to a report scheduled for release on Thursday by the Government Accountability Office, the New York Times reports.

State inspectors visit most nursing homes once annually under contract with the federal government, which imposes standards on the facilities. Nursing homes must meet federal standards to participate in Medicare and Medicaid. Federal officials in some cases accompany state inspectors to nursing homes or make subsequent visits to the facilities within a few weeks to check the results of the inspections.

According to the report, from 2002 to 2007, federal officials found that state inspectors had missed at least one serious deficiency at nursing homes in 15% of the inspections they checked. In nine states -- Alabama, Arizona, Missouri, New Mexico, Oklahoma, South Carolina, South Dakota, Tennessee and Wyoming -- federal officials found that state inspectors had missed at least one serious deficiency at nursing homes in 25% of the inspections they checked, the report found.

"Poor quality of care -- worsening pressure sores or untreated weight loss -- in a small but unacceptably high number of nursing homes continues to harm residents or place them in immediate jeopardy, that is, at risk of death or serious injury," according to the report.

Vincent Ventimiglia, an assistant secretary of HHS, said in written comments on the report, "We fully endorse and will implement all the GAO recommendations."

Bill
GAO compiled the report at the request of Sens. Chuck Grassley (R-Iowa) and Herb Kohl (D-Wis.), who have introduced a bill that seeks to improve nursing home care. The legislation, which the senators hope to attach to a Medicare bill, would increase fines for violations of federal standards at nursing homes. Under the bill, nursing homes would have to pay $25,000 for serious deficiencies, compared with $10,000 currently, and $100,000 for serious deficiencies that result in the deaths of patients. In addition, the legislation would require nursing homes to provide consumers and the government with more information about ownership and "affiliated or related parties."

A number of consumer groups support the bill. David Sloane, senior vice president of AARP, called the legislation "one of the most significant nursing home reform initiatives" in two decades.

However, Bruce Yarwood, president of the American Health Care Association, said, "We should not be increasing fines, adding auditors and encouraging a 'gotcha' mentality. We should be testing new, less punitive ways to measure and improve the quality of care" (Pear, New York Times, 5/15).

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