CONTINUING VIOLATIONS AND QUALITY PROBLEMS WITH U.S. NURSING HOMES UNCOVERED
BY THREE YEAR "WATCH LIST"

CONSUMERS UNION REPORT FINDS MANY STATE GOVERNMENTS ARE NOT USING THEIR AUTHORITY
TO ASSESS FINES AGAINST NURSING FACILITIES

-"Watch List" Update and Consumer Advice Posted at www.ConsumerReports.org/health -

Yonkers, New York, June 18, 2003 - Quality of care issues continue to plague the U.S. nursing home industry, with many nursing homes being cited repeatedly for violations that may put residents at serious risk, according to a report released today by the Center for Consumer Health Choices at Consumers Union. The report, "How Good are Your State's Nursing Homes?" is based on a comprehensive national analysis of state inspection surveys of nursing home facilities and enforcement actions.

Beginning in 2000, the Center for Consumer Health Choices published an annual Nursing Home Watch List, which identifies approximately 10 percent of nursing homes in each state whose inspection reports Consumers Union judged to raise concerns about the quality of resident care. The list was published again in 2001 and 2002, providing the opportunity to examine trends in the quality of nursing home care.

In the latest Nursing Home Watch List published in 2002, almost 17 percent of 1,709 nursing homes remain on the watch list. Nearly seven percent of those facilities were cited for an "immediate jeopardy" deficiency that places residents at immediate risk for being seriously harmed. Two hundred ninety (290) facilities have been on all three watch lists, raising concerns that state and federal oversight is failing to improve the quality of care that residents receive throughout the country.

"How Good Are Your State's Nursing Homes" also examines whether states are imposing fines on facilities. Over half (58 percent) of the states that have authority to issue fines have actually assessed them against the facilities on those lists, although nearly 42 percent had not. And in those states with authority to assess fines, only half of the facilities on our list (55 percent) received monetary penalties; 45 percent did not. Eleven states have no authority to issue their own fines.

The Center also reports that the federal Centers for Medicare and Medicaid Services has not produced a list of fines levied against facilities cited for violations. Six months ago the Center made a Freedom of Information Act request for release of the fines assessed against nursing homes by the federal government. To date, the Center has not received them.

"This three-year study raises very alarming findings and serious concerns about nursing homes in America and about the care our most vulnerable citizens are getting," says Trudy Lieberman, Director of the Center for Consumer Health Choices at Consumers Union. "Many states are not levying fines against those facilities which fail to improve the quality of care given to their residents."

Families searching for a quality nursing home can access the full report in the Health Care area at consumersunion.org. The "Watch List" for each state is available in the health area of www.consumerreports.org/health under "Finding a Nursing Home".

Nearly every state has experienced problems with nursing home violations. Seventy-eight of these facilities, which are currently listed, were on Consumers Unions' first Watch List published in 2000 in the Consumer Reports Complete Guide to Health Services for Seniors. These "repeat" facilities may have corrected the specific violations that placed them on the first Watch List, but subsequently they may have been cited for new or the same violations indicating a "yo-yo" pattern of compliance with health and safety regulations.

Of states with large numbers of facilities, the following have the largest percentage of facilities on the current Watch List that are "repeat" facilities, meaning they have also appeared on both prior Watch Lists: Georgia, 30 percent; Nebraska, 29 percent; California, 28 percent; Minnesota, 25 percent; Pennsylvania, 22 percent; Ohio, 22 percent; Iowa, 21 percent.

Key findings from the Survey:

• From 2001 to 2002, there was a 41 percent increase in the proportion of facilities with more than 15 percent of their facilities receiving a citation for giving substandard care to residents. Twenty-four states fell into this category in 2002; 17 states did in 2001.
  
  
• The number of states in which 10 percent or more facilities were cited for immediate jeopardy violations nearly doubled from 2001 to 2002.
  
  
• Only about 2 percent of the facilities received a fine of $100,000 or more.
  
  
• Connecticut levied the lowest fine of $1.
  
  
• The willingness to assess fines varies by geographic region. The Northeast region has the highest percentage of states with the ability to levy penalties, though only a third of the facilities on the Watch List from the Northeast were fined. By contrast, the states in the West fined 82 percent of the facilities on the lists.

Consumers shopping for a nursing home should talk to their local long-term care ombudsman, who can be located by calling the Eldercare Locator at 1-800-677-1116, and by contacting local watchdog groups.

Research for the Watch List was underwritten with funding provided by The Commonwealth Fund, a New York-based philanthropic organization interested in health care.

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The material above is intended for use by legitimate news entities only. It may not be used for commercial or promotional purposes. ConsumerReports.org is the Web site of Consumers Union, an independent, nonprofit testing and information-gathering organization, serving only the consumer. We are a comprehensive source of unbiased advice about products and services, personal finance, health, nutrition, and other consumer concerns. Since 1936, our mission has been to test products, inform the public, and protect consumers.

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