Nursing Home Deficiency Trends 2005-2007:
National and Washington State Data

In September 2008, a report by the Inspector General of the Department of Health and Human Services reviewed the most recent data on nursing home deficiencies and complaints.  The report found that in 2005, 2006 and 2007, more than 91 percent of the nursing homes surveyed were cited for deficiencies.  This represents a gradual increase from the 81 percent citation rate in 1998.

Federal law mandates that nursing homes which participate in Medicare or Medicaid be surveyed regularly.  Surveys assess the quality of medical and nursing care, as well as nutrition services, social activities, sanitation and the physical environment.  The deficiencies most commonly cited between 2005 and 2007 included quality of care, resident assessment and quality of life.  When deficiencies are found, surveyors may take one of several forms of corrective action, including termination of participation in Medicare and Medicaid, money penalties, monitoring, transfer of residents and closing of the facility.  Surveyors also review all complaints made against nursing homes and investigate allegations.  In 2007, there was an average of 7 deficiencies per home.

Between 2005 and 2007, for-profit nursing homes were cited at a higher rate than not-for-profit and government nursing homes.  Multi-facility homes were also cited at a higher rate than single-facility homes.

Deficiencies are given a severity rating based on the number of residents affected by the deficiency and the extent of the risk posed.  The rating uses a scale of increasing severity based on the letters A through L, where A represents isolated situations posing minimal harm while L represents widespread, immediate jeopardy.  In 2007, 15 percent of nursing homes surveyed were cited for actual harm deficiencies (severity G,H or I), and nearly 3 percent were cited for immediate jeopardy deficiencies (J, K, or L-level deficiencies).  A higher percentage of for-profit nursing homes were cited for immediate jeopardy or actual harm deficiencies compared to not-for-profit homes (17 percent compared to 15 percent).  The most common deficiency ratings were at the D and E levels, meaning that there was no actual harm, but that the potential existed for more than minimal harm. 

The percentage of Washington nursing homes surveyed which were cited for deficiencies was roughly equal to national levels, with a deficiency rate of 90.9 percent in 2005, 91.5 percent in 2006, and 90.9 percent again in 2007.  The average number of deficiencies per home was 6.3 in 2005 and 2006, and 6.6 in 2007.

Source:

Department of Health and Human Services Memorandum Report
OEI-02-08-00140 Trends in Nursing Home Deficiencies and Complaints
http://www.oig.hhs.gov/oei/reports/oei-02-08-00140.pdf