Typical nursing home generates 7 deficiencies

[September 30, 2008]  WASHINGTON (AP) -- The typical nursing home was cited for seven health and safety deficiencies last year, with for-profit homes more likely to have problems than facilities run by local governments or non-profits, federal investigators said Monday.

More than 90 percent of nursing homes surveyed were cited for at least one deficiency last year -- a rate that has changed little over the past three years. About 94 percent of the for-profit homes surveyed generated a citation, compared to 91 percent for government nursing homes and 88 percent for non-profits, said the inspector general for the Department of Health and Human Services.

The most common deficiencies centered on quality of care. That category includes such things as the appropriate treatment to prevent and treat pressure sores and urinary tract infections. The most common quality-of-life deficiencies involved housekeeping and maintenance problems. Another common problem involved meals, with 43 percent of homes cited for problems with dietary services.

The inspector general's findings were included Monday in a memorandum to Kerry Weems, acting administrator for the Centers for Medicare and Medicaid Services.

CMS officials said an increase in the number of deficiencies occurred as a result of more vigorous enforcement and inspections. As a result, an uptick in the number of deficiencies found can occur even in homes where care is improving, said CMS spokesman Jeff Nelligan.

About one in five homes surveyed last year were cited for the immediate jeopardy of patients or actual harm. Usually, the problem was isolated rather than a pattern or widespread, the inspector general said.

The percentage of nursing homes surveyed with deficiencies ranged from 76 percent in Rhode Island to 100 percent in Alaska, the District of Columbia, Idaho and Wyoming.

Even though inspections generated more citations last year, the number of substantiated complaints decreased slightly compared to 2005. About four in 10 complaints were substantiated.

States that participate in Medicare and Medicaid must meet certain federal requirements. States conduct unannounced surveys at least every 15 months to determine whether those requirements are being met. Inspectors conduct reviews of patient medical records and plans of care. They also observe facility operations and interview residents and their family.

The inspector general did not make any recommendations in the report.

[Associated Press; By KEVIN FREKING]

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