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GAO: Inspectors Downplay Nursing Home Problems

By Dave Reynolds, Inclusion Daily Express (subscribe)

WASHINGTON, DC--The federal government's data on the nation's nursing homes, collected for the Centers for Medicare & Medicaid Services, have shown improvements in quality and a reduction in problems over the past six years.

The quality of that data, however, was brought into question last week by the Government Accountability Office, which found that states were not consistent in how they conducted their nursing home surveys, and that overall, states tended to understate serious quality problems.

The GAO is Congress' investigative arm. It conducted the research at the request of Senators Charles E. Grassley, a Republican from Iowa, and Herb Kohl, a Democrat from Wisconsin.

In its 81-page report released last Tuesday, the GAO said that states varied widely in how they determined what problems were serious. During one two-year period, for instance, state surveyors in California cited just 6 percent of their nursing homes for serious deficiencies, while surveyors in Connecticut cited 54 percent of their nursing homes.

The report revealed that state surveyors often missed significant quality of care problems that federal surveyors discovered in the same settings. For example, in five large states where state surveyors had reported significant declines in problems, federal surveyors identified serious deficiencies "that cause actual harm or immediate jeopardy to patients" in between 8 and 33 percent of the surveys. Those deficiencies included fire safety violations -- primarily a lack of automatic sprinkler systems -- along with injuries and preventable pressure sores.

Additionally, the GAO found that states often take weeks or months to begin their investigations into reports of injuries from patients, relatives and nursing home employees, and that a federal Website on nursing home quality published inaccurate or unreliable data.

The report also indicated that nursing facilities often have time to hide problems because the timing of state inspections is very predictable.

Medicare and Medicaid, the joint federal-state health care program for people with low-incomes, spend more than $67 billion annually on nursing homes.

"Nursing Home Inspections Miss Violations, Report Says" (New York Times)

Report -- "Despite Increased Oversight, Challenges Remain in Ensuring High-Quality Care and Resident Safety" (PDF file) (Government Accountability Office)

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Problems are definitely underreported and the whistle blower law has no effect as administrators and personnel persons are able to make up other charges for terminating employment. I know because I was there. I was asked to fudge records to the state and I refused--I was fired.

I reported abuse when the administer of another facility wouldn't and once again I was fired--for other reasons, of course. Additionally, I have seen money pass hands to pass inspections, I have seen, the airs put on and exttra people come out of the woodwork when the state comes in to inspect, however as soon as tyhey are gone--it goes right back to usual, understaffing, uncertified persons on the night shift and the list goes on and on.

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