Better care for nursing homes

Critical report: Federal auditors cite Maryland, others for delay in complaint investigation and action.

April 10, 1999

NURSING HOMES are not improving their health and safety conditions, despite increased government scrutiny and penalties, congressional auditors say.

Long delays in investigation and downgrading by state regulators of complaints about abuse is too frequent, raising the potential for harm to the 1.6 million elderly Americans in some 17,000 nursing homes.

Maryland, with 30,000 nursing home residents, was among a dozen states cited in a scathing recent report by Congress' General Accounting Office on failure to enforce nursing home standards.

That criticism of the state's nursing home oversight contributed in large part to the ouster of Martin P. Wasserman as state health secretary Thursday.

The GAO study found more than a quarter of U.S. nursing homes had serious health and safety violations. And 40 percent of them had a history of repeat violations, in what a congressman calls "a yo-yo pattern of compliance."

Washington recently told states to react more quickly to complaints and authorized immediate fines of up to $10,000 for violations, eliminating the grace period often used by homes to avoid penalties. Because Medicare pays $39 billion a year to nursing homes, the federal government sets standards and states monitor and enforce them.

Insufficient staff and money, plus mounting federal requirements, are excuses offered by the states. Washington also demanded action against repeat violators, diverting state staff from investigating general complaints.

The GAO report said Maryland's nursing home agency failed to investigate complaints promptly and discouraged filing of telephoned complaints. GAO cited a backlog of 101 complaints, one 9 months old, without even an assigned investigator.

Carol Benner, head of the state's licensing agency, denied that backlog of unaddressed complaints, saying GAO did not understand Maryland's system. Maryland closed two nursing homes last year and handled 70 percent of complaints within 45 days, she said.

Inspections are finding more violations; the Maryland agency is asking for more staff. Nursing home operators complain that state inspectors are pressured to find technical deficiencies.

Nursing homes may be better than decades ago, but the bar has been raised. Tighter inspections, prompt complaint investigation and better understanding between the regulators and the regulated will help to improve the conditions of nursing homes and their vulnerable residents.

Pub Date: 4/10/99

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