Consumer Reports Says Nursing Homes Stay on Watch List

Yonkers, New York, October 31, 2001— Consumer Reports updated its State-by-State Nursing Home “Watch List” and found that one-third of 1,708 homes remain on this List because of previous or new violations cited in state inspection surveys. Consumer Reports believes that these 536 “repeat” facilities nationwide may not be correcting violations, some quite serious, identified in state inspection surveys.

In some cases, these “repeat” facilities may have corrected the specific violations that placed them on the first Watch List, which was released by Consumer Reports earlier this year. Subsequently, they may have been cited for new violations the second time around.

Posted in the free consumer advice area at ConsumerReports.org, which is easily accessible from the Home Page, the Watch List update is a valuable tool for families searching for a quality nursing home. Trudy Lieberman, Director of the Center for Consumer Health Choices at Consumers Union, which compiled the Watch List, says, “Families who have loved ones in nursing homes on our Watch List or find they must place someone in one of those homes because they have no alternative must be extra vigilant about the care that’s given.” Monitoring care at any nursing home requires making frequent visits and working with the facility’s staff and family councils to oversee services. Additional advice for finding a nursing home is included in this special online feature.

Of states with large numbers of facilities, the following have the largest percentage of “repeat” facilities on the current Watch List: California: 45 percent; Iowa: 43 percent; Nebraska, Arizona, Georgia, and Minnesota: approximately 40 percent. Inspectors in these states are not hesitant to cite nursing homes for problems.

According to an analysis of the data used for the Watch List, from the Centers for Medicare and Medicaid Services, the federal agency responsible for administering Medicare payments to nursing facilities, the five most common deficiencies cited by state inspectors are:

1. Storing, preparing, and serving food under unsanitary conditions.

2. Quality of care — for example, failure to give adequate fluids to someone who is dying.

3. Failure to keep the facility free from hazards that cause accidents.

4. Fostering conditions that cause pressure sores.

5. Failure to prepare comprehensive care plans. This is a serious violation. Without this plan, there is little guidance for the staff on how to care for a resident.

The Watch List update includes homes with the most questionable patterns of deficiencies on state inspection surveys, approximately 10 percent of all facilities in each state. It is based on facilities that had state inspection surveys conducted primarily between January 1996 and April 2001 that Consumer Reports has judged to raise questions about the quality of care delivered to residents.

This information is particularly relevant now because in September the U.S. Department of Health and Human Services had considered reducing government regulation of nursing homes as a cost-cutting measure. Watch List findings suggest that reducing regulations would further endanger one of the nation’s most vulnerable populations. “Our study shows that too many nursing homes are failing to keep their residents safe,” Trudy Lieberman says. “These facilities make it difficult for residents to reach the highest level they can function at. This certainly indicates that any move to cut the number of inspections at the nation’s nursing homes would be a serious mistake.”

The Watch List identifies facilities by name, address, city and state. It is based on five criteria selected by the Center for Consumer Health Choices:

High-severity deficiencies: This indicates that nursing home residents may be in immediate jeopardy.
Substandard quality-of-care deficiencies: Such deficiencies could potentially affect resident safety.
High numbers of repeat deficiencies: May indicate failure to address problems identified by state inspectors.
High numbers of total deficiencies: Indicates potential failure to correct deficiencies.
Citations for failing to provide adequate access to the survey report: Many nursing homes hide their surveys if they contain information they don’t want the public to see.

Consumers shopping for a nursing home should talk to the local ombudsman, who can be located by calling the Eldercare Locator at 1-800-677-1116, and by contacting local watchdog groups.

Research for the Watch List was underwritten with funding provided by The Commonwealth Fund, a New York-based philanthropic organization interested in health care.