22% MORE Nursing Homes Cited for Serious Violations

  1. WASHINGTON-More nursing homes are being cited for serious violations as inspectors face increasing pressure to crack down on dangerous conditions, a USA TODAY analysis shows.
    From 2000 through 2006, the number of citations for putting patients in "immediate jeopardy" increased 22%, according to the records from the U.S. Centers for Medicare and Medicaid Services, which regulates nursing homes. Those citations are the most serious reprimand inspectors can issue and often follow cases in which patients were physically or sexually abused or left without medications.

    The increase came as many states stepped up nursing home inspections. Homes that put their patients in immediate jeopardy risk fines or being told they cannot accept new Medicaid patients, a major source of their income.

    Inspectors found nearly 2,000 violations last year that jeopardized patients at nearly 850 of the nation's 16,000 nursing homes, according to the records. They account for about 6% of the total violations uncovered in nursing homes.

    New York issued 131 immediate jeopardy citations last year, up from 41 in 2000. This year it cited one home for not stopping two elderly patients from hitting others, and another for not doing enough to check on patients who fell down, a common source of nursing home injuries.


    The Medicare and Medicaid services' records for 2007, still incomplete, already show more than 1,300 "immediate jeopardy" citations. New York inspectors issued eight of them to the Vivian-Teal Howard home in Syracuse, N.Y., after a January review found more than a dozen patients had not been given their medications over several days.

    "Did we have people that were at risk of losing their lives? I would say no," said the home's administrator, Joe Corradino. "There were problems there and we knew that, and we corrected all those issues."


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  3. by   NickiLaughs
    Should I pretend to be surprised? The nursing homes have such an insane ratio of nurse to patient that it is unsafe! The elderly often have more medications and more health concerns than any other age group yet they are the hospitals have ratio laws and the nursing homes don't!
  4. by   Simplepleasures
    I hope that these kinds of reports will bring about those desperatly needed nurse/patient ratios in LTC. It has been bad for years and looks like it is getting worse. The fines that the LTC corporations will have to pay will speak louder than the voices of the Nursing Home Reform Advocates or nurses who have to work in these conditions. Still it wont improve despite the fines, without a state/federal mandates for nurse/patient ratios.
  5. by   I love my cat!
    Quote from NickiLaughs
    Should I pretend to be surprised? The nursing homes have such an insane ratio of nurse to patient that it is unsafe! The elderly often have more medications and more health concerns than any other age group yet they are the hospitals have ratio laws and the nursing homes don't!
    No Kidding! Honestly. How these places get away with the things that they do is amazing.
    I could tell some horror stories.
    It is really, really depressing.
  6. by   happydays352
    GRRRRRR this makes me so mad. How can these companies make policies that leave our parents and grandparents many of the generation who fought in foreign wars and suffered the depression, in such conditions. How do these people sleep at night?
    What has happened to this country that we treat our elders like cash cows. Disgusting.
  7. by   Love_2_Learn
    This is so worrisome to me as my sister and I are beginning the process of finding a nursing home for our mother. It's ripping my heart out of my chest, and news information like this just makes me all the more fearful. I have found the medicare.gov website which has some very good information about specific nursing homes but I'm still so confused about it all. I'm praying for guidence from above because I'm not getting as much help as I feel I need from here on Earth. Big sigh.
  8. by   I love my cat!
    Quote from Love_2_Learn
    This is so worrisome to me as my sister and I are beginning the process of finding a nursing home for our mother. It's ripping my heart out of my chest, and news information like this just makes me all the more fearful. Big sigh.
    I am sorry that you are going through such a tough time.
    The best thing that you can do for your mom is for you, your sister and/or family friends to visit as often as possible and get to know the staff. From my experience, those patients whose family members stayed involved received better treatment. I understand that all patients should be treated equally no matter what the family dynamics are, but I am just stating what I have personally witnessed.
    I remember when we would have State Inspection. Management would be running around like crazy! Fixing and updating things that had been neglected for months. They would also add extra staff. How the State didn't see it when reviewing staff schedules was beyond me. I think they just chose to look the other way.
    I have never really understood 'scheduled' State Inspections. If the State really wanted to see what was going on, they should have popped in as a surprise, once during the day shift, once in the evening and once at night.
  9. by   Love_2_Learn
    Thank you for your comforting post along with your suggestions about visiting often. There are 3 different places near where I work (11-7) and I hope I would be able to drop by each morning after I get off work. I know so little about these things that I actually am wondering if they have visiting hours! Anyway, thank you so very much for your suggestions and your kindness.
    By the way, every hospital I've worked in goes a little crazy when Joint Commission is preparing for a visit. We were told 2 years ago that they could now drop in at any time without prior notice but of course, they didn't and our management found out about 3 months before they were coming and all ran around like chickens trying to be sure everything was just right. My first hospital did not go so nuts though because we simply did most everything the way it should be done all the time. Duh! I really miss that place sometimes!
  10. by   I love my cat!
    Also, please don't let the guilt get to you and burn yourself out. You are doing the best that you can!! If you can't stop in every morning, please don't worry! You can always give her a quick phone call. Also, talk with her and explain your work/family schedule and set up the best times to get together. She'll understand....she's a mom ;-).
    Your mom will start to get to know people within the facility, be involved with activities ans soon, be on her own schedule as well. Many places allow residents to bring in personal items from home to make their room feel more like home.


    You'll do fine and remember, there are a lot of us on this board for support!
  11. by   VivaLasViejas
    OK, here is a slightly different perspective from a nursing management angle:

    Surveyors come in LOOKING for violations to cite. They are not there to help us get better staffing, improve the quality of care we give, or anything else---they are there to find things wrong. More often than not, they cite facilities for minor things that have little or nothing to do with resident care and safety---a shelf in the janitor closet that hasn't been dusted, paperwork (dear God, don't ever let 'em catch you documenting vital signs in only three places instead of four if that's what the rules call for), or failing to fully investigate each and every single 1 mm skin tear, fall, bump, cough, burp, or sneeze. (Ever "investigate" an unwitnessed incident on a Coumadin-enhanced resident who can't remember what she said to you two seconds ago, let alone how she came by a 0.5 cm bruise on her elbow?)

    This isn't to say that surveyors don't perform a great service when they close down a facility that's putting its profits ahead of its residents and failing to give them the care they are paying for. There are far too many substandard LTCs of all types in this nation, and the fact that so many elders are paying thousand of dollars a month to live in these places just infuriates me!! The way I see it, these people worked hard and paid into the system for decades, and now the services aren't there for them because government, the insurance and pharmaceutical industries, and corporations have combined to make decent, affordable long-term care facilities rarer than hens' teeth.

    BUT---I still say that overall, state surveyors "major in the minors"; in other words, when they can't find any big problems in a facility, they will nitpick until they can find something to cite, and the resulting flurry of corrections does very little to assure quality resident care.........in fact, it only makes a hard job even harder. I've never yet found any evidence that more time spent on paperwork equals better care. We in LTC are sadly understaffed and overworked. Who's going to make it better for US so that we can give better care?

    Climbing down off my soapbox now.......
  12. by   pickledpepperRN
    Safe staffing and adequate supplies must become a priority.
    Is there an organization working on this now?
  13. by   PMHNP10
    the problem is that we (i.e., Americans as a society) don't care about our elders, therefore the odds of addressing the staffing in LTC facilities is slim to none; however, what will happen is DONs will create more paperwork for the already overworked/understaffed nurses/CNAs to have to deal with, creating further deficiencies (e.g., as mentioned, documenting VS in 4 spots--quadruple charting--which many of us were taught in school to never double chart, much less quadruple chart). Sadly, LTC nursing is an enter at your own risk occupation. If I'm not mistaken, LTC nurses are most frequently brought before the BON (or sued, or something). It's really sad.

    On a side thought...If the time comes when I'm no longer able to take care of myself, I plan on getting a gun (not loaded), walking into a Bank and holding them up and walking (or wheeling myself) out the door and wait to be arrested. As horrible as that sounds, I believe prison where all of my medical, dental, optometry, psych, etc. needs as well as a private room, 3 hots and a cot, TV, etc. is a better option than a nursing home.
  14. by   grandolecat
    I have visited many nursing homes to possibly obtain employment. When I observe nurses aides sitting around a desk while patients are crying, wet with urine and covered in BM, sitting in a wheel chair in the hall then I wonder WHO is to blame. No way would I ever tolerate anyone sitting in chairs when work is to be completed. I have visited many homes with the intent of observing before hire. They are all the same. RN running around like a chicken, aides sitting, patients neglected. MDS coordinators, Directors of Nursing sitting behind their desk and the Administrator apparently absent. No Thanks. I am too much in love with patients to witness such neglect/abuse.