South Carolina Nursing Home Blog : South Carolina Nursing Home Lawyer & Attorney : Poliakoff & Associates Law Firm : Elderly Care, Senior Care

USA Today had a great article on the excessive number of nursing homes that receive taxpayer money but refuse to meet the minimum requirements for quality of care.  The requirements are basic and necessary services, and fundamental safety and food standards. Personal hygiene, responding to call bells, fresh foods, hot water, taking vital signs, etc----basic stuff but because of greed and short-staffing one in five of the nation's 15,700 nursing homes have consistently received poor ratings for overall quality.

More than a quarter-million patients live in homes given another set of low scores within the past year, according to data released today by Medicare, which first released the star ratings of the nation's nursing homes in late 2008. The ratings are derived from inspections, complaint investigations and other data collected mostly in 2008 and 2009.

USA TODAY found that all 50 states and the District of Columbia have homes with poor ratings from one year to the next.  And dozens of those facilities are the only nursing homes for miles.

Late in the Bush administration, the Centers for Medicare & Medicaid Services began assigning nursing homes one to five stars for quality, staffing and health inspections, as well as an overall score. Nearly all homes that repeatedly received few overall stars — one or two stars — were owned by for-profit corporations, the data show.

"The issue is the owners have to take responsibility for the consequences" of poorly performing homes, says Larry Minnix, CEO of American Association of Homes and Services for the Aging.

The newspaper's analysis found the lowest-rated homes had an average of 14 deficiencies per facility, which can include quality-of-life measures and safety violations.

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WCCO out of Minnesota had an article about how most violations in nursing homes are under reported.  This seems like common sense since most employees do not want to risk their jobs admitting mistakes, and there is not enough personnel to enforce the regulations or conduct proper investigations. Many complaints are ignored because the nursing home claims the resident was demented.

The system designed to help Minnesotans choose a nursing home for loved ones is under fire. Serious flaws in the system have been uncovered by a nursing home watchdog group.  You might not know about physical and sexual abuse happening inside the nursing home.

Wes Bledsoe, the founder of a nursing home watchdog group, says he can prove that the rating system on Medicare.gov does not show what is really going on in nursing homes.  For example, after all of the well known abuse at Good Samaritan Society in Albert Lea, a report from the Minnesota Department of Health says no deficiencies were noted at the nursing home.

At a different facility in the state, someone saw an employee pick up a nightgown soaked with urine and that worker "shoved it in the resident's mouth and told her to shut up." Again, the Department of Health didn't note any deficiencies.

A spokesperson from the Minnesota Department of Health said "If a facility has taken appropriate steps to correct problems, they may not be cited with deficiencies."  However, when deficiencies aren't noted, they don't show up on the Medicare site, so there's no way you could know if you've only checked that Web site.

Bledsoe said it's happening all the time. He found that 80 percent of confirmed abuse cases in Minnesota in the last four years didn't get reported to the feds.

"I think it's bureaucratic mumbo-jumbo that's deceiving the consumers and the American public about what's really going on in our long-term care facilities," said Bledsoe.

Bledsoe said another big problem is the star system on the Medicare Web site. On a lot of the nursing home Web sites, a lot of the information is not available, so he's wondering how they can give a place four or five stars when there's no information.

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Here is a link to the recent GAO Report that shows a lack of investigation into nursing home neglect and abuse.  The NY Times ran a great article on this report.  Below are some excerpts from that article.

Nursing home inspectors routinely overlook or minimize problems that pose a serious, immediate threat to patients, Congressional investigators say in a new report.   In the report, the investigators from the Government Accountability Office, say they have found widespread “understatement of deficiencies,” including malnutrition, severe bedsores, overuse of prescription medications and abuse of nursing home residents.

The accountability office found that state employees had missed at least one serious deficiency in 15 percent of the inspections checked by federal officials. In nine states, inspectors missed serious problems in more than 25 percent of the surveys analyzed from 2002 to 2007.

The nine states most likely to miss serious deficiencies were Alabama, Arizona, Missouri, New Mexico, Oklahoma, South Carolina, South Dakota, Tennessee and Wyoming, the report said.

“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,” the report said.   Nursing homes must meet federal standards as a condition of participating in Medicaid and Medicare.

Lewis Morris, chief counsel to the inspector general of the Department of Health and Human Services, said he had often been frustrated in trying to identify the owners of nursing homes that provided substandard care.  “We have found nursing home residents who were grossly dehydrated or malnourished,” Mr. Morris said. “We’ve found patients with maggot infestations in wounds and dead flesh. We’ve found residents with broken bones that went unmended.”

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