Investigators overlook problems in nursing homes

Investigators from the Government Accountability Office have found that state inspectors often overlook serious violations in the nation’s nursing homes, according to a report in The New York Times.

State employees who inspect the homes, working under contract to the federal government, pervasively understated “serious deficiencies that cause actual harm or immediate jeopardy to patients,” according to the GAO. The harm includes severe weight loss, multiple falls resulting in broken bones and other injuries and pressure soars. The deficiencies also include fire safety violations, with concerns about cost delaying the installation of automatic sprinkler systems that leave more than 20 percent of homes without adequate fire protection.

Nursing homes must meet federal standards to receive Medicaid and Medicare. They spend $67 billion per year on nursing home care, but Medicare plans to begin linking payment to the quality of care nursing homes provide and will test a “pay for performance” system this year, according to Dr. Mark B. McClellan, a Medicare official.

Federal employees visit about five percent of the nation’s 17,000 nursing homes each year to validate findings of state inspectors. Serious problems not detected by the state inspectors were found in 28 percent of the visits from 2002 to 2004, up from 22 percent in 2000 to 2001.