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Patient
Care Standards Still Lack at Nursing Homes By
Todd Zwillich Reuters
Health, July 18, 2003 WASHINGTON -
Government policing systems are failing to catch significant amounts of
patient neglect at thousands of U.S. nursing homes, a Senate committee
heard on Thursday. Substandard care remains rampant at nursing homes throughout
the country, according to the General Accounting Office, an investigative
arm of Congress. Twenty percent of homes evaluated during an 18-month
study ending January 2002, had "serious deficiencies that caused
residents actual harm or placed them in immediate jeopardy," the
report states. Investigators criticized state-run systems designed to police
nursing homes, saying that they suffer from a lack of consistent standards
that cause them to routinely understate the danger that inadequate care
poses to elderly nursing home residents. They said that they found cases where even homes with a
history of harming residents went uncited for deficiencies in patient care
that included bed sores, severe weight loss, and multiple falls. Another report conducted by the Health and Human Services (news
- web
sites) Inspector General found that 78% of nursing homes nationwide
received at least one deficiency in three areas related to patient care in
2001. "We're not talking about minor deficiencies like hanging
a sign wrong on a wall," said Dara Corrigan, the acting principal
deputy inspector general in testimony before the Senate Finance Committee.
Asked how she feels about patient care at nursing homes today
versus five years ago, Corrigan said, "The feeling that I'm left with
is mostly a feeling of disappointment." A representative of the nursing home industry acknowledged
that state-run systems for surveying care at facilities are not accurate
but also pointed out that the 20% rate of deficiencies is a significant
drop from a level of 29% in an 18-month period between 1999 and 2000. "I believe these results demonstrate actual quality
improvement," said Mary Ousley, chair Sun Bridge Health Care Center
in Albuquerque, N.M., who testified on behalf of the American Health Care
Association. But investigators maintained that actual rates of
deficiencies were not dropping significantly and that routine surveys
conducted by state and federal investigators were understating problems. "Quite honestly, I don't know which one of us is
correct," Ousley said. Many lawmakers remain concerned that nursing homes are poorly
paid by the Medicaid health system for low-income persons, forcing
facilities to make up shortfalls by charging Medicare, the program that
finances care for the elderly. Tom Scully, who heads the federal Centers for Medicare and
Medicaid Services (CMS) told lawmakers that federal regulators are
improving their oversight of nursing homes but that they still "have
a long way to go." The agency is considering regulatory changes that would allow
the government to divert nearly $7 billion over 10 years to nursing homes
that have been stung by recent payment cuts. Sen. Charles E. Grassley,
R-Iowa, said that he would consider taking action to guarantee that the
money is spent directly on improvements to patient care at homes. "We must ensure that the nursing home industry doesn't
line its pockets with this money. I expect the industry to use that money
for the direct care of residents," said Grassley, who chairs the
Finance Committee. Copyright
© 2002 Global Action on Aging
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