GAO rips nursing-home fire safety; inspections to quintuple

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Congress' investigative arm has found that nursing home fire safety standards not only are extremely weak in many places, but they also often aren't enforced. Nearly 3 in 5 (59%) of the country's nursing homes were cited for shortcomings in their most recent fire-safety inspections, according to the Government Accountability Office, which presented its findings to Congress on Thursday.

The cost of installing new or improved sprinkler systems and smoke detectors has led many providers to hold off on upgrading systems, investigators found. Provider advocates say they are in favor of tougher, uniform standards, but they want government assistance to help make it happen.

Deadly fires last year in Connecticut and Tennessee, which killed 16 and 15 nursing home residents, respectively, led to a surge of interest in nursing home fire-safety issues.

"The substantial loss of life in the Hartford and Nashville fires could have been reduced or eliminated by the presence of properly functioning automatic sprinkler systems,'' the report said, but the federal government has not required sprinklers at some older homes, "in part because of the cost of retrofitting such structures.''

The report also found that less than 5% of the 871 nursing homes federal inspectors checked last year were checked for fire safety – instead of the mandated 100%. Further, no federal fire-safety checks took place at all in 27 states, investigators found.

In accepting the report's criticisms and suggestions, Mark McClellan, administrator of the Centers for Medicare and Medicaid Services, said there would be five times as many inspections in the future.  Further, CMS will propose a rule that would mandate smoke detectors, he said. CMS also will examine the "feasibility" of mandating sprinkler systems, which are lacking in at least 20% of facilities, McClellan said.