Friday, November 21, 2014

Nursing Home Care Levels May Be Much Lower Than Families Think


This story was published by The Center for Public Integrity, a nonprofit, nonpartisan investigative news organization in Washington, D.C.
 
Many U.S. nursing home patients may not be receiving the level of care their loved ones believe they're getting, a Center for Public Integrity probe has found. 

Staffing levels reported by thousands of nursing homes on a widely-used government website were higher than the staff levels calculated by the Center for Public Integrity through an analysis of annual financial reports submitted by the homes, suggesting that consumers in those facilities may not be getting as many hours of skilled care as they expect. Experts have shown that the amount of care provided by nursing homes is linked to the quality of care. 

The discrepancies raise profound questions about the accuracy of the information in the so-called Nursing Home Compare website that many consumers use to pick a nursing home for family members. The reporting discrepancies occurred for all types of positions, but were particularly high for registered nurses, the most skilled and highest paid workers. 

More than 80 percent of the facilities reported higher registered nurse staffing levels on the public website than those the Center calculated through its analysis of the cost reports. In more than 25 percent of nursing homes nationwide, the amount of staff listed on the public website was at least double the level in the cost reports. 

 
Close to 100 peer-reviewed, academic studies have shown that the amount of care, particularly that provided by registered nurses, is most strongly connected with residents’ quality of care. Lower levels of care are associated with a higher likelihood of injury and even death. 

Eight of the 10 states with the largest levels of discrepancies in the reporting of registered nurse staffing levels were southern. Among them: Louisiana and Arkansas, where the average self-reported levels were at least twice the amount calculated through the cost reports analysis. 


Jon Lowenstein / NOOR
Edna Irvin lies in her bed at the Arkansas Health Center in Benton, Ark. A Center for Public Integrity analysis of more than 10,000 nursing homes across the country found that Arkansas was one of two states where the daily level of registered nurse care listed on public website Nursing Home Compare was at least twice the level the Center calculated from an analysis of annual financial cost reports. The Arkansas Health Center was not included in the analysis.

A systematic problem
Data on the publicly available Nursing Home Compare website, which is promoted by the government for comparison shopping, reflects staffing levels self-reported by nursing homes during a two-week period before annual inspections. Advocates say many homes work hard to prepare for these visits. As a result, critics say, those staffing levels may be artificially inflated. 

In 2005, the Centers for Medicare and Medicaid Services (CMS), the federal agency responsible for overseeing nursing homes, said cost reports to the Medicaid program, which are harder for the public to locate and understand, are a more accurate source of information than Nursing Home Compare. 

The Center analyzed staffing levels in Medicare cost reports that contain largely the same information as the Medicaid documents, and compared them to those reported by Nursing Home Compare. 

CMS declined to comment on this issue since it had not seen the Center’s analysis. Dr. David Gifford, senior vice president of quality and regulatory affairs for the American Health Care Association, the nursing home industry’s largest professional organization, said he is “not surprised by these findings since the way the cost reports collect information on staffing is different than [Compare].” He added in a statement that daily direct care nursing hours have increased for residents at all levels of nursing staff from 2008 to 2013. 

But Robyn Grant, director of public policy for the Washington, D.C.-based advocacy group the National Consumer Voice, said the Center’s analysis was shocking. 

“We all recognize the data is flawed, but I am truly stunned by [the] findings and appalled that you’re finding this level of over-reporting” Grant said. 

Rep. Jan Schakowsky (D-Ill.), said the self-reported data included on the Nursing Home Compare website shows an “extreme overestimation.” 

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1 comment:

StandUp said...

I think the figures are manipulated but at the same time, I think families know care is overall not good in facilities. Those who find a good facility feel like they've won the lottery!