Tennessee and Georgia are falling behind in investigating nursing home complaints. Learn what you need to look for when choosing a home.
Anyone can file a complaint about the treatment of a resident in a nursing home — you don’t have to be the person in charge. You’ll file the complaint with the state where the resident lives (check here to find a state’s agency).
Your complaint might be about neglect. More than 47 percent of long-term nursing home residents lose control of their bladder or bowels, and staff should be available to help them clean up. Letting a resident sit in soiled pants for hours is unacceptable.
The most common nursing home complaints have to do with the quality of medical care: for example, if residents are admitted to a hospital for preventable infections. You might see a patient become much worse if she is overmedicated.
Complaints to state agencies about nursing homes rose in the first half of this decade, up from nearly 33 for every 1,000 nursing home residents to 45 in 2015. State employees decide which might need quick follow-up. Nearly 60 percent of the complaints met that standard. Among those, state investigations confirmed the complaint in about a third.
The figures come from a report by the federal agency that checks how well states are monitoring nursing homes. The increase in nursing home complaints may not mean care has declined, the report noted, since people might be more willing to complain or tracking may have improved.
Depending on the complaint, states must investigate them onsite on a timetable — some within two days and some within 10. A report of a fall with broken bones would trigger the two-day deadline, for example.
If the state investigator finds evidence of an immediate danger to patients, the home must remove the threat within 23 days from the last day of the investigation. The state could also fine the home or ask it to report on a plan for preventing more incidents.
Less than one percent of these cases over the five years of 2011 through 2015 were never investigated. But in some states, the staff fall behind their deadlines. In 2015, Tennessee took 15 or more days to look into 467 cases that had been classified as urgent requiring a response within two days. In another 187 urgent cases, the state took up to two weeks. Tennessee explained that it was short of staff and had lost expertise because of turnover. Georgia fell behind the two-day deadline by two weeks or less in 104 cases and by 15 or more days in six cases.
Across the five years of 2011 through 2015, Arizona, Maryland, New York, and Tennessee were most likely to miss the 10-day deadline for those cases.
When you choose a nursing home, you can work with an ombudsman for the state. You can look up any home’s record at Medicare’s Nursing Home Compare site. You’ll see the home’s statistics on important questions based on third-party inspections, with state and national figures for comparison.
For example, on average, 3.4 percent of long-stay nursing home residents across the nation experience a fall with a major injury. If you see a much higher number for a particular nursing home, ask why.
More than 16 percent of long-stay nursing home residents are given antipsychotics, often to control the symptoms of dementia. But the Centers for Medicare and Medicaid Services (CMS) has been urging homes to cut the use of anti-psychotics and the Food and Drug Administration (FDA) has found that they increase death rates in older residents with dementia. So you’d want to see a lower than average number. You can check what percentage of long-stay residents take antipsychotics and the percentage of short-stay residents are given an antipsychotic for a short time.
When you look at a home’s score card at the Medicare site, the last tab is labeled “Penalties.” That’s where you’ll see if the home has been fined.
December 20, 2017
Janet O’Dell, RN