Nursing Home Data Suggests Lax Enforcement of Harm to Residents


A recent report shares that federal data from nursing homes across the country has agencies mostly concerned about the use of antipsychotic drugs, failure to control infection, failure to prevent and properly care for pressure ulcers, and issues with insufficient staffing.

The Long-Term Community Care Coalition recently released a report analyzing federal data concerning the oversight of nursing home facilities across the country. The report draws high-level conclusions about nursing home surveys and enforcement actions taken by state, regional, and federal regulatory authorities. Specific enforcement areas concerned include antipsychotic drug use, infection control, pressure ulcer care, staffing issues, and resident rights.

One section of the report details an analysis of overall citations issued by state enforcement agencies. As the report notes, state and regional health authorities are empowered to cite facilities over various deficiencies; they rate these deficiencies according to their “scope and severity.” According to the lCC, “The accurate identification and rating of harm or immediate jeopardy is crucial because, in the absence of such a finding, it is highly unlikely that the facility will be penalized for the substandard care, abuse, or neglect.” If a deficiency is identified but not classified as causing harm or posing a threat of harm to residents, “a facility will generally face no negative repercussions.”

It may therefore be concerning that, according to the LTCCC’s analysis, the vast majority of nursing home citations are classified as posing no harm or jeopardy to the residents in the facilities they concern. During the three year period beginning in 2018 and ending in 2020, the data showed, there were 290,289 citations. Of these, 95% were classified as causing no harm or jeopardy. Breaking the data down by category, the LTCCC found that 7.8% of citations concerned infection control deficiencies; 2% concerned antipsychotic use, pressure ulcers, and resident rights; only one percent concerned insufficient staffing, even though “most US nursing homes persistently fail to meet CMS’s threshold for safe staffing”; and merely 0.1% concern quality of life issues.

Breaking the data down geographically, the LTCCC found that New York boasted a concerning distinction: “the lowest citation rate in the country.” Over the period in question, surveyors issued an average of one citation per 50 residents. The state with the highest citation rate was Alaska, with an average of one citation per four residents.

The Long-Term Community Care Coalition’s full report analyzing nursing home enforcement data is available here.

The attorneys at the Law Offices of Thomas L. Gallivan, PLLC work diligently to protect the rights of nursing home residents.  Please contact us to discuss in the event you have a potential case involving neglect or abuse.

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