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Study: A third of nursing homes may not meet basic care standards

"Once you're in a nursing home, if things don't go right, you're really a prisoner." That truth was recently pointed out by a woman with relatives in two nursing homes, prompted by a report just released by the Department of Health and Human Services' Office of Inspector General. The report looked at sample patient records from nursing homes in 42 states and estimates that Medicare pays billions of dollars a year for nursing homes that don't meet the federal standard for reasonable care.

The study involved patient records for people who stayed at least three weeks and used 2009 data, which was the latest available. According to DHHS, the sample size was large enough to represent probable outcomes in around 1.1 million patients.

On one out of every three occasions the patients studied were placed in a nursing home, the facility they were sent to failed to follow the standards of care required by Medicare. Since a large proportion of U.S. nursing homes serve both patients using Medicare and those with other insurance, Medicare's standards are applied to private-paying patients in many cases.

One of the main requirements Medicare sets out for nursing homes is that each patient must receive a personalized care plan, and that plan must kept up to date to ensure all of the health care professionals involved with that patient clearly understand the patient's current treatment and goals. When a patient needs to be transferred home or to another setting, the law requires a specific transition plan to be drawn up to ensure the patient is discharged safely.

Both the ordinary care plans and transfer plans turned out to be problematic in the study. In 20 percent of cases, the patient's health problems weren't addressed appropriately in the plans, or addressed at all. For example, in one case the facility had made no plan to monitor a patient's safety while prescribed three mental health medications even though the drugs could have serious side-effects.

When it came to transition plans, nearly a third of the time the nursing home did not provide enough information. Either the patient wasn't given enough information to care for him- or herself appropriately at home, or the new facility did not receive updated records.

The report also found a number of cases where patients received therapy or treatment they didn't need. The researchers pointed out that continuing physical or occupational therapy is in the facilities' interest, but in one example they found that a patient continued to receive therapy even though the care plan stated that all treatment goals had been met.

We've all heard stories about nursing home abuse or neglect, but we need to do more than listen; we need to act. Medical treatment that doesn't meet the basic standard of reasonable care is malpractice, and in nursing homes it can be deadly.

Source: The Huffington Post, "Medicare Paid $5.1 Billion In Taxpayer Dollars For Substandard Nursing Home Care, Report Finds," Garance Burke, Feb. 28, 2013

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