GAO: Nursing homes are 'repeatedly harming' residents

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Health officials are not punishing nursing homes with serious deficiencies severely enough, resulting in poor care for residents, according to a report from the Government Accountability Office.

Facilities cited for harmful conditions often correct their bad situations, but only temporarily, according to researchers for the GAO. Between fiscal years 2000 and 2005, nearly half the nursing homes reviewed by the GAO "cycled in and out of compliance more than once, harming residents, even after sanction had been implemented," the agency's report states.

The findings are in a report for the Senate Committee on Finance. They are expected to spark legislative proposals to crack down on bad nursing home operators.

Other problems addressed in the report include insufficient fines amounting to a "slap on the wrist" for nursing homes; an appeals process and deferred sanctions that allow violations to continue and potentially further harm residents; and fragmented data systems among officials, which hamper monitoring of the worst offenders.

Overall care provided by the nation's nursing homes - which was not the focus of the GAO report - has improved over the past 10 years, said Bruce Yarwood, president and CEO of the American Health Care Association.

Added Larry Minnix, president and CEO of the American Association of Homes and Services for the Aging: "We want to see substandard owners and managers displaced, not nursing home residents and employees. Within the current enforcement system, however, providers who take over (poorly performing) facilities are required to assume the previous operator's deficiencies. This policy discourages good providers who have the skills and expertise to turn around these poor-quality homes."

Minnix said "early warning systems" and interventions should be developed to prevent nursing home residents from receiving "deteriorating care." He also urged the Centers for Medicare & Medicaid Services "to revise the cost reports system and gather the staffing information needed to help them identify poor performers before further problems occur."