Nursing Homes: Stronger Complaint and Enforcement Practices Needed to Better Ensure Adequate Care : Statement of William J. Scanlon, Director, Health Financing and Public Health Issues, Health, Education, and Human Services Division, Before the Senate Special Committee on Aging

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The Office, 1999 - Nursing home care - 11 pages
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Page 1 - California Nursing Homes: Care Problems Persist Despite Federal and State Oversight (GAO/HEHS-98-202, July 27, 1998).
Page 10 - HCFA reporting systems for nursing homes' compliance history and complaint investigations do not collect timely, consistent, and complete information. Having full and accurate information on a nursing home's compliance and enforcement history, including the results of complaint investigations, would improve HCFA'S ability to identify nursing homes in need of further enforcement sanctions. Further information system weaknesses pertain to the inability to centrally track enforcement actions or to identify...
Page 6 - Deficiencies Surveys conducted since the July 1995 implementation of stronger enforcement tools showed that, each year, more than 4,700 homes had deficiencies that caused actual harm to residents or placed them at risk of death or serious injury. The most frequent violations causing actual harm included inadequate prevention of pressure sores, failure to prevent accidents, and failure to assess residents' needs and provide appropriate care. Although most homes were found to have corrected the identified...
Page 8 - HCFA had no formal requirements for the prompt investigation of serious 7When a home is terminated, it loses any income from Medicare and Medicaid payments, which for many homes represents a substantial part of operating revenues. Residents who receive support from Medicare or Medicaid must be moved to other facilities.
Page 7 - HCFA for sanctions, and subsequently cited for serious deficiencies again. 15Although civil monetary penalties show a similar pattern of having far fewer fines take effect than were imposed by HCFA, the relatively small number of penalties that have taken effect is a reflection of the large number of fines under appeal. As appeals are settled, a higher number of the 115 fines imposed may take effect Table 6: Examples of Nursing Homes With Patterns of Repeat Deficiencies and Repeat Referrals for Sanctions...
Page 1 - They are frequently dependent on extensive assistance in basic activities of daily living like dressing, grooming, feeding, and using the bathroom, and many require skilled nursing or rehabilitative care. The...
Page 8 - Texas surveyors cited one nursing home for placing residents in immediate jeopardy and actual harm twice in 1995 — including failure to prevent choking hazards, provide proper incontinent care, and prevent or heal pressure sores. On the next...
Page 3 - ... Michigan encourage callers to submit their complaints in writing. In contrast, Washington readily accepts and acts on phone complaints without encouraging a written follow-up. This practice would appear to contribute to Washington's much higher volume of complaints than in either Maryland or Michigan. When a complaint is received, the state agency ascertains its potential seriousness. HCFA requires states to investigate complaints that may immediately jeopardize a resident's health, safety, or...
Page 11 - HCFA to integrate the results of complaint investigations, track the status and history of deficiencies, and monitor enforcement actions.
Page 2 - ... accidents, and failure to assess residents' needs and provide appropriate care, often go uninvestigated and uncorrected. Our work in selected states reveals that, for serious complaints alleging harm to residents, the combination of inadequate state practices and limited HCFA guidance and oversight have resulted in policies or practices that may limit the number of complaints filed; serious complaints alleging harmful situations not being investigated promptly; and incomplete reporting on nursing...

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