Inspectors Are Missing Many Nursing Home Violations, Report Finds

State nursing home inspectors are missing "serious deficiencies that cause actual harm or immediate jeopardy to patients," according to a new report released by the Government Accountability Office (GAO).

Its findings, the report concludes, undercut the Bush administration's claims of "significant improvements" in safety in the nation's 17,000 nursing homes.

Nursing homes that participate in Medicare and Medicaid must meet federal standards. State employees under contract with the federal government inspect the facilities to ensure these standards are being met.

According to the administration, the proportion of nursing homes cited by state inspectors for serious deficiencies declined from 29 percent in 1999 to 16 percent in 2005.

But the GAO found such wide variations from state to state that the reported gains are largely baseless. For example, California cited 6 percent of its nursing homes for serious violations from 2003 to 2005, while Connecticut cited more than half of its homes. The GAO also said the same conditions can be viewed as a violation of federal rules in one state but not in others.

The report, concludes that most of the alleged quality improvements in nursing homes cited by Bush administration have resulted from inadequate inspections, rather than improved conditions.

The report, requested by Sens. Chuck Grassley (R-IA) and Herb Kohl (D-WI), also found that states often take weeks or months to start investigating reports of harm to nursing home residents, such as multiple falls, preventable bed sores and severe weight loss. In addition, more than 20 percent of nursing homes lack sprinkler systems in the event of fires.

While saying he is "concerned about possible understatement or omission of serious deficiencies," Centers for Medicare and Medicaid Administrator Mark McClellan maintained that the quality of nursing homes has improved under the Bush administration.

To read the GAO report '“ "Nursing Homes: Despite Increased Oversight, Challenges Remain in Ensuring High-Quality Care and Resident Safety," GAO-06-117 '“ click on:
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For an article on the report in the Jan. 16, 2006, New York Times, go to: (Free registration required and article is available free of charge for only one week.)