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Office of the Inspector General: Raise the Quality of Care in Our Nursing Homes

In its most recent “Compendium of Priority Recommendations,” the Department of Health and Human Services’ Office of the Inspector General has strongly emphasized that more steps are necessary to ensure a higher quality of care in nursing homes. The Compendium is released periodically with the goal of protecting the integrity of the department’s programs, and this edition makes twenty-five suggestions for the improvement of HHS programs. Among these twenty-five, the improvement of nursing home care figured prominently.

Under the topic of “Medicare Quality of Care and Safety Issues,” the Office of the Inspector General suggested the following: (1) improving care planning and discharge planning for beneficiaries in nursing home settings; (2) addressing harm to patients, questionable resident hospitalizations, and inappropriate drug use; (3) improving emergency preparedness and response. Further, under for the improvement of hospice care, the Compendium recommends ensuring better compliance with Medicare conditions of participation.

While these suggestions are generally taken from older editions of the OIG reports, the renewed focus on nursing homes is new territory for the Compendium. In the previous edition, released in December of 2012, nursing homes were not mentioned in any of the recommendations concerning quality of care and safety.

The renewed focus may have been inspired by a congressional report released last summer which reported that 30 percent of nursing homes in the United States, which totals some 5,283 locations, were cited for instances of abuse over the two year span of January 1999 to January 2001.

Among the near 9,000 instances of abuse in that period were problems such as untreated bedsores, insufficient medical treatment, malnutrition, dehydration, negligent accidents, and unsanitary conditions. In about 1,600 of the cases, the abuses were so serious as to put residents at risk for serious injury or death. In a few of the cases, nursing home staff members were accused of physical and even sexual abuse, while in others, staff members were merely cited for failing to protect residents from one another. In these incidents, residents sustained significant injuries such as bone fractures and lacerations. In one particularly shocking account, two staff members offered a brain-damaged resident cigarettes to attack another resident in order to see a fight between the two of them.

As shocking as some of the findings are, a bit of sobriety is warranted, at least according to some. Authorities in the field have said that the strict reporting regulations regarding incidents in nursing homes somewhat artificially inflate abuse statistics, being that some of the incidents that must be reported as abuse may be as innocuous as one resident slapping another.

Regardless of whether the abuse statistics are inflated, instances of abuse seem to be rising. The report found that the percentage of facilities that have been cited for abuse violations has increased each year since 1996. The abuse of our vulnerable elderly is a serious matter, particularly when it occurs in the places designed to treat and protect them. If you believe that you or a loved one has been abuse while in the care of a nursing home or other elderly care facility, you may have a claim.

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