Old woman taking her pills

The average nursing home in the U.S. had at least one deficiency in each of the last three years, with for-profit homes getting more citations than homes operated by non-profits and local governments, according to a report of the Department of Health and Human Services (DHHS) inspector general.

For-profit nursing homes — which comprise 67% of all 15,000 nursing homes nationwide — showed an average of 7.6 deficiencies per home and 94% of them received citations in 2007.

In contrast, non-profit nursing homes and government homes — which account for 27% and 6%, respectively — generated averages of 5.7 deficiencies per non-profit home and 6.3 deficiencies per government home. Only 88% of non-profit nursing homes and 91% of government homes were cited for violations last year.

* The most common citations involved quality of care deficiencies. This category includes deficiencies in the care and treatment administered on pressure sores and urinary tract infections. This also refers to lack of facilities to promote the mental and physical well-being of residents.

* Quality of life deficiencies were also noted. This category covers housekeeping and maintenance deficiencies, substandard quality of meals served, and improper food storage. About 43% of all homes were found deficient in dietary services.

* Nearly 20% of homes received citations for immediate jeopardy, abuse, neglect, or actual harm caused to residents. When such incidents occurred, the event was usually isolated.

However, the inspector general did warn that some homes “systematically failed to provide staff in sufficient numbers and with appropriate clinical expertise to serve their residents.”

The report also revealed there are nursing homes that would overstate the severity of patient’s illness in order to make larger claims to Medicare.

Medicaid and Medicare spend over $75 billion yearly to cover over two-thirds of more than 1.5 million Americans staying in nursing homes across the country.

The American Health Care Association president said their industry has been improving its quality-of-care services. The association instead criticized the DHHS inspection system, saying it is flawed, does not evaluate quality of services in a reliable way, and fails to set up positive incentives to improvement.

The number of citations in 2007 last year increased over 2005, as inspectors acted on 37,150 complaints. But only 39% of the complaints were substantiated last year, a lower rate than in 2005.

There were wide differences in the deficiency rates among states. Only 76% of nursing homes in Rhode Island were cited for deficiencies, while the rate was 100% in Alaska, Idaho, Wyoming and the District of Columbia.

Safety Tip:

* Compare carefully the facilities and services of nursing homes in your area. Non-profit homes may be more likely to provide better care.