One-in-five nursing homes delivers care that is directly harmful to patients, a government official told federal lawmakers, and the problem is likely even worse than that. Lewis Morris, chief counsel to HHS inspector general, told members of the Energy and Commerces oversight and investigations subcommittee that more needs to be done at the federal level to stem egregious instances of poor care that occur in nursing homes across the country.
The procedural inefficiencies, communication breakdowns, inconsistent citing of deficiencies and application of remedies mean that consumers have no guarantee that the nursing home in which they place a family member provides good care or that it thoroughly screens its staff, Morris said.
Connecticut Attorney General Richard Blumenthal described his battle with Haven Healthcare, a nursing home operator whose poor quality-of-care record, byzantine ownership structure and financial troubles made investigations and compliance near impossible, a house of horrors.
Haven Healthcare is really a poster child for the perils of corporate owners who are too far removed from quality-of-care issues, Blumenthal said.
Congress hasnt weighed in on the issue of broad nursing home regulations in more than 20 years, but likely will act this year because of a number of government and investigative news reports that show a trail of poor elderly care, dilapidated and rodent-infested facilities and other qualities woes.
Acting CMS Administrator Kerry Weems outlined to the House panel a number of initiatives that the agency is taking, including an ongoing campaign to reduce the use of restraints and incidence of pressure sores, a new emphasis for quality-improvement organizations to work on care improvement with nursing homes, and a soon-to-come pilot program on value-based purchasing in the nursing home setting as a means to test payment incentives on quality.
Regardless of setting or ownership, quality health and long-term care for Medicare and Medicaid beneficiaries is of the utmost importance to CMS, Weems said.
Meanwhile, the Government Accountability Office released a comprehensive report showing that state nursing home inspectors routinely miss critical, life-threatening problems. For instance, the GAO said that state surveyors would often miss quality-of-care problems such as ensuring proper nutrition and hydration and preventing pressure sores. The CMS spends about $75 billion per year on nursing home care. -- by Matthew DoBias