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
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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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!
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