Saturday, October 03, 2009

Illinois ranks high on bad nursing home report

Illinois has the nation’s second-highest number of nursing homes that have been flagged as having poor quality, according to a new federal report.

Forty-seven Illinois nursing homes are among facilities that perform “most poorly” on quality-of-care measures, according to a study released by the General Accounting Office. It’s second only to Indiana’s 52 facilities.

The report rated homes on staffing levels, procedures to prevent bed sores, measures to prevent abuse and neglect and other factors. Ones that were included among the poorly performing facilities averaged a 46% greater number of serious deficiencies that harmed residents when compared to other homes.

The study recommends vastly expanding a federal program that closely monitors U.S. nursing homes with the worst quality ratings, to 580 facilities from the current 136. The GAO did not list the facilities by name.

It also highlights a shortcoming in the way that program, run by the Centers for Medicare and Medicaid Services, is administered. The 136 homes that now undergo more-frequent inspections are the worst performers in their respective states. But some states, like Illinois, perform worse than others, which means many homes that deserve closer scrutiny slip through the cracks.

The study urges CMS to consider a facility’s performance relative to other homes nationally, which likely would label many more Illinois facilities as poor performing.

CMS officials told the GAO they disagreed with relying solely on a national comparison. The agency said it would consider an approach that allows for a national comparison to have more weight.

Officials from the state’s largest nursing home trade group, the Health Care Council of Illinois, which represents for-profit facilities, said they hadn’t had a chance to review the report and would not be able to comment.

Homes rated as poorly performing tend to be larger, with an average of 102 residents; for-profit and part of a chain, and have an average of nearly 24% fewer registered-nurses hours relative to the number of patients.

Several large states had far fewer poor quality homes than Illinois, including Ohio (three), Pennsylvania (six); New York (18) and California (40).

Nationally, there are about 16,000 nursing homes. So the 580 homes that the GAO’s report describes as the worst-performing represents almost 4% of the nation's nursing homes.

Separately, the Chicago Tribune reported in a front-page story Tuesday that 15% of Illinois’ nursing home residents are mentally ill and more than 3% have been convicted of serious felonies. Illinois houses mentally ill patients in nursing homes at a rate greater than any other state, placing residents at greater risk of being harmed by other patients, the story says

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