Few states post online reviews of nursing homes

Scripps Howard News Service

Must credit Salt Lake Tribune

By MATT CANHAM

Salt Lake Tribune

Nursing homes harbor some of the nation's most vulnerable Americans. Yet only a handful of states offer online reviews of the facilities' inspections, giving people an easy, timely way to compare conditions for an ailing loved one.

"Too many Americans receive poor care, often in a subset of nursing homes," said Sen. Chuck Grassley, R-Iowa. "Unfortunately, this subset of chronic offenders stays in business, in many ways keeping their poor track record hidden from the public at large."

Grassley is sponsoring a bill with Sen. Herb Kohl, D-Wis., introduced in February, that would load a federal Web site with more information to give consumers a chance to differentiate the good homes from the poor performers.

The Nursing Home Transparency and Improvement Act of 2008 would provide online access to the inspections nationwide, replacing a system where the surveys are summarized in general categories. The legislation would:

- Place ownership information, a standardized complaint form and links to inspection reports on the federal Nursing Home Compare site, accessible through www.medicare.gov.

- Require improved reporting of staffing information so people could compare with other homes.

- Boost fines from the current cap of $10,000 to up to $100,000 for a deficiency resulting in a death.

- Call for independent audits of nursing home chains, focusing on companies that own homes in multiple states. It would allow the government to go after nursing home chains that have poor compliance histories.

The Nursing Home Compare site should not only have links to the reports but also should put the information into context, allowing people to compare homes over multiple years, said Lewis Morris, chief counsel to the inspector general at the U.S. Department of Health and Human Services.

Morris said this new level of information would help families identify what he calls "yo-yo" facilities that bounce in and out of compliance.

Grassley said the online information is needed because many families must make a rush decision on a nursing home after a relative has an unexpected medical problem.

In at least six states -- including Arizona, Illinois, Iowa, Minnesota, New Mexico and Pennsylvania -- people can review inspections online.

In other states like Utah, people who want to see reports must take a trip to each nursing home and flip through a hard copy. Even then, it is only one year's worth of data.

Marc Babitz directs Utah's Division of Health Systems Improvements. While he likes the idea of posting nursing home inspection reviews, he said Utah doesn't follow the example of Arizona and other states because it can't afford to.

"It is a matter of money," Babitz said. "Many of the states that do this are much better funded."

Looking at inspection reports over time can show which homes have problems with nutrition, restraints or even abuse.

"I think it is just extremely important that people should be able to read these reports," said Janet Wells, public policy director for the National Citizens' Coalition for Nursing Home Reform, based in Washington, D.C.

But those representing the nursing home industry warn that inspection reports are only a snapshot in time and should not be the only tool used to determine quality. Some criticize the inspections all together.

"It is a punitive system based on a gotcha mentality," said Dirk Anjewierden IV, the executive director of the Utah Health Care Association, which is the industry group for nursing homes. "It really doesn't measure the quality of care a facility provides on an ongoing basis."

He said even a good nursing home can have a bad inspection report, and he worries that the public will have a hard time understanding the bureaucratic and medical language. He says people should only worry if they see a pattern of deficiencies.

(E-mail Matt Canham of the Salt Lake Tribune at mcanham(at)sltrib.com.)

(Distributed by Scripps Howard News Service, www.scrippsnews.com.)