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| | Report: 'Vast majority' of Arkansas nursing homes fall short
Tuesday, Nov 11, 2003 By Doug Thompson A third of Arkansas nursing homes either had a resident harmed or were at risk of having a patient seriously injured or killed, according to a federal study completed last week. Actual harm came to at least one resident in 17 percent of Arkansas nursing homes, the study says. Another 16 percent had problems that created a risk of serious injury or death to residents. "We unequivocally deny that," Randy Wyatt, executive director of the Arkansas Healthcare Association, said Monday. Wyatt said the study is based on federal Department of Health and Human Services guidelines. The study implies that nursing homes placed their patients at risk by not following those guidelines, which far exceed the legal minimums for nursing home staff, he said. Those guidelines are not legal minimums because meeting them would be cost-prohibitive, he said. Wyatt said the report by the U.S. House of Representatives Committee on Government Reform gives the impression that those guidelines are regulations. At the request of U.S. Rep. Vic Snyder, D-Little Rock, the committee reviewed the records of 245 nursing homes in Arkansas that accept Medicaid or Medicare payments. Records of 15 months ending in August were reviewed. "If this is an accurate report, we all have a lot of work to do," Snyder said in a telephone interview. Snyder said he wants to meet with nursing home owners and hear their responses before commenting on the report in detail. One-third of Arkansas nursing homes had serious violations of federal regulations, compared to a national average of about a fourth, the report says. Wyatt, citing federal figures, said the average number of deficiencies reported in the 15-month period is 6.04 and Arkansas nursing homes average 6.77. The "vast majority" of Arkansas nursing homes - 92 percent - do not have enough staff hired to operate safely, the report concludes. Wyatt said all but 30 of 236 nursing homes checked by his group on Oct. 1 had as many employees as the law requires. The law requires enough staff to give each patient 2.6 hours of personal treatment a day, and 146 Arkansas nursing homes had enough staff to provide at least 3 hours of that care daily, Wyatt said. The 4.1 hours recommended in the study is a figure that has been proposed by specialists but is cost-prohibitive, he said. About 18,000 Arkansans live in nursing homes. Of those, 554 are in nursing homes that were cited for few or slight deficiencies, the report says. "Representatives of the nursing home industry argue that the 'overwhelming majority' of nursing homes meet government standards and that many violations are actually trivial in nature," the report says. "However, state inspectors who visited nursing homes in Arkansas uncovered many serious violations that could impact the health and safety of residents." Failure to properly administer medications or treat pressure sores, to give residents enough food or water, and to "prevent abuse, mistreatment and neglect of residents" were among the problems cited in the study. Inspectors "consider a facility to be in 'substantial compliance' with federal standards" if the violations found are not significant, if those violations "do not have the potential to cause more than minimal harm," the report says. "Of the 245 nursing homes in Arkansas, only 13 facilities were found to be in full or substantial compliance with the federal standards. In contrast, 232 nursing homes had at least one violation with the potential to cause more than minimal harm to residents or worse. On average, each of the 232 nursing homes had 10.3 violations of federal quality of care requirements during recent annual inspections and complaint investigations." The committee staff reviewed state nursing home inspection reports and federal records. More than "90 percent of the 245 nursing homes in Arkansas violated federal health standards during recent state inspections," the report says. "One-third of the nursing homes had violations that caused actual harm to residents or placed them at risk of death or serious injury." "A total of 40 nursing homes were cited for 15 or more violations, including 15 nursing homes that were cited for 25 or more violations," the report says. |
