Does the government turn a blind eye to the large elderly and disabled population living in nursing homes? Why does the Centers for Medicare and Medicaid Services (CMS) specifically not reimburse hospitals for 10 ‘reasonably preventable’ conditions related to improper care when nursing homes continue to provide the same inadequate care without reprocussion?

Steve Gold, at the JF Activist blog raises these issues in his recent post, ‘Stop Paying Nursing Homes That Injure Elderly and Disabled People.’ Steve points out that as (CMS) has begun the crackdown on hospital safety, nursing homes continue to receive poor marks in national surveys. In 1998, 81% of nursing homes were cited for at least one deficiency during CMS inspections. By 2001, the number of nursing homes cited for deficiencies had risen to 89%. In the most recent CMS survey, in 2007, the percentage of nursing homes receiving violations has increased to 91%.

Even more outrageous is the increase in ‘immediate jeopardy’ and ‘actual harm’ violations–the most serious– handed to nursing homes by CMS. The percentages of ‘immediate jeopardy’ violations has risen from 1.4% in 1998, 2.3% in 2001, to 17% in 2007. To give people an idea of what these safety violations entail, Gold cites 2007 CMS OSCAR data:

19.1% of nursing facilities had residents with avoidable pressure sores, and the nursing facilities received deficiencies for failing to meet the federal standard. Up from 17.2% in 2001.
11.8% of nursing facilities imposed physical restraints on residents for purposes of discipline or convenience and not required by the residents’ medical symptoms, and they received deficiencies for this category. Up from 11.0% in 2001.
19.2% of nursing facilities had failed to prevent incontinence in residents and to restore bladder functioning as much as possible to residents, and the nursing facilities received deficiencies. Up from 12.0% in 2001.
7.0% of nursing facilities failed to provide residents with acceptable nutrition to maintain their body weight, and the nursing facilities received deficiencies. Down from 8.4% in 2001.
37.9% of nursing facilities failed to ensure residents with environments “free of accident hazards” to “prevent unexpected and unintended injury,” and the facilities received deficiency citations. Up from 22.1% in 2001.
6.6% of nursing facilities failed to provide residents with appropriate range of motion services to those people who required such services, and the nursing facilities received deficiencies. Down from 8.1% in 2001.
16.6% of nursing facilities failed to promote residents’ care in a manner and in an environment that maintains or enhances the residents’ dignity and respect for the individual resident, and the nursing facilities received deficiencies for violating the federal standard. Down from 17.3% in 2001.

Gold rightly feels that there is a double standard being applied to elderly and disabled nursing home residents. Most of the safety problems would never be tolerated in a hospital setting, yet we continue to allow them to occur nursing homes. Until our society puts a premium on helping the elderly, nursing home residents will not get the rights and safety they deserve. It is unfortunate that our culture turns their head from the elderly and their living conditions. If any of the above safety problems occurred in a nursery school people would be out in the streets in rage. Until then, let watch the annual safety violations escalate.

The JF Activist blog is published by The American Association of People with Disabilities (AAPD). AAPD is the largest national nonprofit cross-disability member organization in the United States, dedicated to ensuring economic self-sufficiency and political empowerment for the more than 50 million Americans with disabilities. AAPD works in coalition with other disability organizations for the full implementation and enforcement of disability nondiscrimination laws, particularly the Americans with Disabilities Act (ADA) of 1990 and the Rehabilitation Act of 1973.