Tag Archives: nursing home compare

600-plus Ill. patients drugged without consent

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

After a review of 40,000+ inspection reports for Illinois nursing homes, the Chicago Tribune‘s Sam Roe reports that the paper found 1,200 violations (affecting 2,900 patients) involving psychotropic drugs since 2001. More than 600 patients were drugged without their consent. According to Roe, “The actual numbers are likely far higher because regulators inspect some facilities just once every 15 months, and even then they usually check only a small sample of residents for harm.”

The violations, many of which were caused by a desire to make patients easier to deal with, were “for ‘chemical restraint’ and ‘unnecessary drugs’ as well as cases involving dosages that exceeded safety standards or falls in which psychotropics possibly played a role.”

While some nursing home residents suffer from major mental illnesses, such as schizophrenia, the inspection reports show that many patients harmed by antipsychotic drugs had not been diagnosed with psychosis. They were disabled by Alzheimer’s disease, cancer or Parkinson’s disease. Some were blind or so frail that they could not breathe without the aid of an oxygen tank.

In a follow-up story, Roe reveals that doctors responsible for these dubious prescriptions are not held accountable, even when cited by government entities.

The Chicago Tribune‘s full series on nursing home safety can be found here.

AHCJ resources

Recent workshop

AHCJ’s Aging in the 21st Century workshop, held Oct. 16 and 17 in Miami, addressed many topics raised by the Tribune‘s reports, as well as the changing picture of aging Americans and key research and issues related to this growing population. Tip sheets and presentations from that workshop are available to AHCJ members.

Related tip sheets
Aging Nation: Troublesome Health Care Issues
Headlines an advocate for seniors would like to see
The impact of aging upon health care
Covering nursing homes and other issues of aging
How will retiring boomers affect the national health agenda?
You Can Run, but You Can’t Hide: Policy and Problems in Long-Term Care
Biology of Aging: Sources and Resources

Trib looks into dangerous nursing home residents

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

The Chicago Tribune‘s Gary Marx and David Jackson examined the effectiveness of Illinois regulations implemented in 2006 to protect nursing home residents from potentially dangerous peers. They’ve pulled together some alarming anecdotes and data that show the law is not as effective as hoped.

For example, the reporters focus on the man with a criminal record who attacked by another resident with an ice pick. Just a year after the attack, he ended up in the same facility as his victim again. This time, he slashed him with a box cutter. Obviously, there was a hole somewhere in the new system. Marx and Jackson lay out the facts:

With growing numbers of mentally ill felons entering Illinois nursing homes, the state in 2006 became the first to require criminal background checks as part of an overall risk assessment of new residents. The screenings by state contractors are used to identify high-risk individuals who should live in private rooms and be closely monitored.

But a review of confidential reports in 45 recent cases shows that in many instances the assessments were incomplete, leaving out some criminal convictions and other crucial details.

The project includes a searchable database of safety reports on nursing homes in Illinois, including information not searchable on government sites. Readers can use the database to find out the number of residents at a facility who are convicted felons and sex offenders, crimes reported at Chicago nursing homes and fines levied because of deficiencies in care. Head over to the investigation’s homepage to follow the story and its results.

GAO: Four percent of nursing homes are troubled

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

A new report from the Government Accountability Office report estimates that 580, or 4 percent, of America’s approximately 16,000 nursing homes are troubled enough to qualify for Centers for Medicare and Medicaid Services “Special Focus Facility” designation. Because of CMS’ limited resources, only 136 are.

Special Focus Facilities, which are evaluated based on deficiencies and revisited to ensure compliance, are chosen from a list of the 15 worst homes in each state. Using more objective criteria based on CMS recommendations, the GAO report found that, in reality, the nation’s worst homes don’t follow such a neat distribution “with 8 states having no such homes and 10 others having from 21 to 52 such homes.”

Legislators, including influential voices like Sen. Herb Kohl, D-Wis. and Sen. Chuck Grassley, R-Iowa, are saying the report shows that the “Special Focus Facility” program should be expanded to include more low-quality homes, Freking reported.

The GAO also released a profile of the most common sort of under-performing nursing home:

The worst-performing ones tend to be for-profit facilities affiliated with a chain of nursing homes. They are more likely to be a larger facility, averaging 102 residents, while other nursing homes not identified as among the worst had 89 residents on average.

Find the full 57-page report here.

Related article

Reporter discovers data missing from federal Nursing Home Compare
Member Duane Schrag of the Salina (Kan.) Journal tells AHCJ how he discovered that certain data was missing from the Nursing Home Compare database and chronicles his efforts to break through the CMS bureaucracy and figure out what was missing and why.

Glitch kept data out of Nursing Home Compare

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

Duane Schrag of the Salina (Kan.) Journal reports on problems he found in the data behind Nursing Home Compare, the federal government’s online tool to help guide consumers in judging the quality of nursing homes.

Schrag says that an area nursing home announced it was shutting down because it couldn’t comply with a state fire marshal’s requirement to replace its sprinkler system. But a check of the Nursing Home Compare data found no fire safety violations for the facility for 2007 or 2008, despite the fact that it had been cited for several fire code violations in both years.

nursing-home-compareWhen the Salina Journal pushed officials to explain why the deficiencies were not showing up, the Centers for Medicare & Medicaid Services discovered a software problem:

But a glitch in the software used by the federal government kept the reports from showing up in Nursing Home Compare. The software blocked more than 1,000 fire code violation reports involving Kansas nursing homes in 2006, a similar number in 2007 and almost 800 in the first six months of 2008.

Nationally, about 21,600 reports were blocked during that same period.

Officials at CMS say the software was fixed on July 23.

Schrag talked to nursing home administrators and found that most of them dispute the rankings that Nursing Home Compare assigns to them; the exception was a nursing home that had a five-star rating.