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The Good, the Bad, and the Ugly on Nursing Homes

According to Consumer Reports' "Nursing Home Quality Monitor" not all nursing homes are created equal. Here is what you should know before checking yourself or a loved one into one.

The report showed that the quality of care has not improved much in the past 6 years, despite laws passed nearly 20 years ago by Congress to improve the quality of care that nursing home residents receive.

The report looks at approximately 16,000 nursing homes around the country, and focused on three areas of quality: deficiencies that were noted in reports, the staff of the nursing home, and five indicators of the residents of poor quality. It listed the top and bottom ten percent in performance nursing homes in each state.

Unfortunately, there is no tried and true way to rate all nursing homes, so the report just gives you a look at the generalities of nursing home care. Many non-profit homes scored better than their for-profit counterparts, and independently run homes scored better than chains. This worked out to about two percent of for-profit homes earning passing scores, and seven percent of the non-profit ones. At the flipside of the report, only about one and a half percent of non-profit were likely to provide poor care, while three and half percent of those that were for-profit were.

Non-profits also provided more care for their patients, with almost an hour more of nursing on average each day, and about twice as many nurses per resident.

The list provided in the report also included 12 homes that had been at the bottom of the list five times, and another 181 that were also repeat bad performers. This further demonstrates how the care at many nursing homes if failing to improve. Some of these homes show signs of neglect, such as failure to properly sanitize dishes or follow doctor's orders, while others have even been sued for abuse. However, enforcement on a state level seems to be lax.

In fact, state enforcement seems to be declining. The average fine in 1999 was about $4800, in 2004, just $3000. Some of the homes on the poor performers list have not received any fines at all, and only two percent had received fines for more than $100,000. State inspectors are writing fewer deficiencies even for severe violation, and the number of homes being shut down for poor performance has dropped.

One bit of information that you can glean from the report is the importance of researching the nursing home you or a loved one is considering. Read the "Nursing Home Quality Monitor" to find well performing homes in your area. However, nursing home owners change frequently, so you will still want to visit the home itself to make sure it is still a top performer. Look for independent, nonprofit homes as your first choice, and read the information given on the state's inspection survey. Make several surprise visits to the nursing home to see how care is on a consistent basis even when they are not expecting you.