Who's watching Grandma?Certain nursing homes in California are so poorly monitored that residents' safety cannot be guaranteed, a report by the U.S. General Accounting Office (GAO) found. The report, delivered to the U.S. Senate Special Committee on Aging, concluded that state investigators who evaluate the performance of individual nursing homes miss problems affecting the safety and health of residents. "Even when such problems are identified, enforcement actions do not ensure that they are corrected and do not recur," the report said. The Special Committee on Aging asked the GAO to review federal and state monitoring and enforcement efforts after it learned that 3,113 residents died in 971 California nursing homes in 1993 due to malnutrition malnutrition, insufficiency of one or more nutritional elements necessary for health and well-being. Primary malnutrition is caused by the lack of essential foodstuffs—usually vitamins, minerals, or proteins—in the diet. , dehydration dehydration Method of food preservation in which moisture (primarily water) is removed. Dehydration inhibits the growth of microorganisms and often reduces the bulk of food. , and other serious conditions involving lax care. The GAO report focused only on California, but a new study by the investigative arm of the U.S. Congress will address nursing home enforcement nationwide. It is scheduled for release early next year. The California study was based on data from federal surveys and state complaint investigations conducted by the California Department of Health Services Department of Health Services may refer to:
The GAO looked at 62 cases of "avoidable deaths" and found residents in more than half (34) of these cases "received care that was unacceptable and that sometimes endangered en·dan·ger tr.v. en·dan·gered, en·dan·ger·ing, en·dan·gers 1. To expose to harm or danger; imperil. 2. To threaten with extinction. their health and safety." Care problems included dramatic, unplanned weight loss; failure to properly treat bedsores Bedsores Definition Bedsores are also called decubitus ulcers, pressure ulcers, or pressure sores. These tender or inflamed patches develop when skin covering a weight-bearing part of the body is squeezed between bone and another body part, or a bed, ; and failure to manage pain. Nearly 1 in 3 (407) of the 1,370 homes studied was cited by surveyors for having "serious or potentially life-threatening care problems." These homes were cited for violations that "caused death, seriously jeopardized residents' health and safety, or were considered by state surveyors to have constituted substandard substandard, adj below an acceptable level of performance. care." The report noted that the extent of care problems portrayed in the data on which the study was based was likely understated. "We found that homes could generally predict when their annual on-site reviews would occur and, if inclined, could take steps to mask problems otherwise observable ob·serv·a·ble adj. 1. Possible to observe: observable phenomena; an observable change in demeanor. See Synonyms at noticeable. 2. during normal operations Generally and collectively, the broad functions that a combatant commander undertakes when assigned responsibility for a given geographic or functional area. Except as otherwise qualified in certain unified command plan paragraphs that relate to particular commands, "normal operations" of ." The GAO report also noted instances of irregularities in the homes' documentation of care: "These types of irregularities could shield from surveyor scrutiny such problems as inadequate staffing or avoidable injuries." An example of irregularities included missing pages of clinical notes that would explain residents' injuries later identified in physicians' examinations. "Although our report focuses on nursing homes in California, the problems we identified are indicative of systemic survey and enforcement weaknesses," the report said. "Our recommendations, therefore, target federal guidance in general so that improvements are available to any state experiencing problems with seriously noncompliant homes." The GAO emphasized that through the leadership of the Health Care Financing Administration Health Care Financing Administration, n.pr department in the U.S. agency of Health and Human Services responsible for the oversight of the Medicaid and Medicare benefit programs, including guidelines, payment, and coverage policies. , which oversees nursing homes that participate in the Medicare and Medicaid Medicare and Medicaid U.S. government programs in effect since 1966. Medicare covers most people 65 or older and those with long-term disabilities. Part A, a hospital insurance plan, also pays for home health visits and hospice care. programs, "federal and state oversight of nursing homes can be strengthened nationally and residents nationwide can enjoy increased protection." To obtain a copy of the report, California Nursing Homes: Care Problems Persist Despite Federal and State Oversight (GAO/HEHS-98-202, July 27, 1998), call the GAO Document Distribution Center at (202) 512-6000. The first copy is free. |
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