The number of nursing homes punished for federal standards violations fell by more than 18% when comparing 2000 and 2003 levels, according to a new report. In addition, the number of civil monetary fines levied against nursing homes fell by nearly 12% during the same time frame.

According to the paper “Barriers to Effective Enforcement,” many nursing homes displayed a “yo-yo pattern,” in which standards violations are corrected but then neglected, leading to further violations later on. The report was written by Centers for Medicare & Medicaid Services official Jerry Sandlin and Georgia Department of Human Resources official David Dunbar.

The authors said they found an insufficient number of inspectors, and inconsistent application of increasingly complex rules, as some of the reasons for the findings.

The Bush administration credited providers for the apparent better care at some facilities. This better care has been spurred on by the government’s posting of quality information on its Web site beginning in late 2002, said Health and Human Services Secretary Tommy Thompson.

The actual number of violations cited in 2003 was down to 2,146, while the number of monetary penalties was fell to 1,979. In addition, denials of Medicare or Medicaid reimbursement for new admissions as a penalty were cut nearly in half (47%), to 698, over the studied span.