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GAO Report Finds Faults with Current Nursing Home Compliance System, Recommends Changes

The GAO has released a study on the results of federal monitoring surveys of state inspections in nursing homes. The federal government often contracts with state employees to perform annual compliance surveys which are a prerequisite to Medicare and Medicaid funding. The GAO’s report unfortunately contains some very troubling reports of nursing home abuse and neglect.

The study found that a substantial proportion of state inspectors and surveys miss deficiencies in nursing homes regularly, including malnutrition, severe bedsores, overuse of prescription medications and nursing home abuse and neglect. Some of these deficiencies are at the most dangerous levels and could cause immediate harm to nursing home residents. However, less serious noncompliance was more frequent: approximately 70% of state surveys missed at least one instance of low-level noncompliance.

Click to view the full text of the study or the abstract.

What is most troubling is frequency with which state investigators fail to notice pressure sores and nutrition issues. According to the GAO, the most frequently missed type of deficiency was poor quality of nursing home care which includes ensuring proper nutrition and hydration and preventing pressure sores. The report cited two factors that may lead to nursing home deficiencies being underreported: state surveyors may lack investigative skills and may not have strong abilities to analyze the information they see to determine whether or not a home is compliant.

This study was commissioned by Senators Grassley and Kohl and coincides with their introduction of a bill to raise the bar on nursing home care and provide for increased penalties for noncompliance with federal standards. Though the nursing home industry lobby opposes the bill in its current form, legislators from both sides of the aisle have pledged their support.