Update: We have updated Nursing Home Inspect with new data from the government, so the exact search result numbers cited here may no longer be accurate.
We’ve
designed Nursing Home Inspect to make it fast and easy to search thousands
of recent government inspection reports from around the country, most since the
beginning of 2011. Following are some tips to help you get the best results.
First, a little background.
The reports
come from the U.S. Centers for Medicare and Medicaid Services (CMS), which put them online in July. Unlike the CMS site, however, Nursing Home Inspect
allows searches by keyword and city, as well as a home’s name. Also unlike CMS,
our app allows you to search across all the reports at once.
As of today,
the underlying database covers nearly 118,000 deficiencies at 14,565 homes.
There are more than 15,000 nursing homes in the U.S., and as CMS releases newer
inspection reports in the future, we plan to add them.
Our search
engine looks through the narrative portion of the inspection reports —
the part where inspectors describe conditions in the home and any deficiencies
they discovered. This is where the details are.
It’s best to
keep two things in mind while searching. First, the results are a snapshot and
not necessarily comprehensive for homes nationwide. Second, because inspectors
may write up their reports differently, it is wise to try several different
search terms to be sure you’re getting the most complete results.
For example,
take a common problem like bed sores, which can develop if a resident is confined
to bed and staff do not turn the person often enough.
Searching
for the phrase pressure sore returns 2,121 results. Searching
for the phrase bed sore returns 1,946 results, some of them
duplicates. But other words that also can return deficiencies related to bed
sores include: decubitus, purulent and pus, as well as stage iii and stage iv (phrases that describe the most
serious and dangerous sores, but can also describe cancer progression).
Another
example: sexual assaults. Though uncommon in nursing homes, 88 reports include rape and 120 include sexual assault (there is some overlap). A broader
search for the word sexual yields far more results, 787.
Some other searches
that piqued our interest were: cigarette and burn (found patients who were burned
when allowed to smoke without supervision); conviction (found nursing home staff with criminal
records); ignore, mistreat and rude (found residents who believed they had
been mistreated).
A search for
the words terminate and suspend often produces results involving
nursing home staff who were disciplined for alleged misconduct.
Here are more tips, cautions and
limitations:
- Nursing homes are inspected periodically as a matter of routine, and
when the government receives a complaint about the home. Almost all nursing
homes have been cited for some deficiencies, so they are not necessarily an
indication that a home is subpar. - Nursing Home Inspect relies on narrative reports from a home’s most recent
periodic review (known as standard surveys), as well as complaint
investigations from the past 12 months.
Although the majority of deficiencies in Nursing Home Inspect are from January 2011 and later, about 2,700 are from
2009 and 2010. Those are primarily from homes that haven’t had standard
inspections since then. Earlier reports can be requested under the Freedom of
Information Act
(FOIA). - To count total deficiencies for a
home, you can search by the home’s name in Nursing Home Inspect. Please
note that this total may be different from the total listed on the “Inspections
and Complaints” tab at Nursing Home Compare, the CMS web site. That is because the CMS site counts reports
that go back 15 months, and because CMS sometimes finds new deficiencies during
follow-up visits after a standard survey (those follow-ups are not included as
yet in the narratives posted online). - Be careful when counting
“deficiencies.” When searching for a keyword, our app only returns the number
of deficiencies that contain the search term, not the overall number of
deficiencies cited against the home on that visit or other visits. - ProPublica has not inspected the nursing homes and did not assign the severity scores for deficiencies, which range from A to L, with L being the most severe. Those scores are assigned by government inspectors.
- If you want to search for all homes
in a given state or all deficiencies by a given severity, leave the keyword box
blank. That said, our app is optimized for keyword searches. If you look up a city or nursing home name, results for the same home may be spread over several pages. You can improve the way your results are returned by selecting a state and then sorting the data by city. - Inspection reports only focus on
problems, not accomplishments or excellent care, so they should be used in
conjunction with other information when assessing a home’s overall performance. - The government isn’t aware of all
problems in nursing homes, so don’t assume if there is no report that a home
doesn’t have problems. A complete list of nursing homes is
available on Medicare’s website. - The reports contain a lot of jargon
and sometimes don’t make clear who exactly is at fault for a problem. Don’t
make assumptions. You should verify information with the nursing home’s
administrator. - Some reports mention the words you’re
searching in the text but they don’t describe a problem at the home. The word
could be in a home’s policy statement or may describe past behavior. For
example, a patient who has wandered off may be mentioned in a report that uses
the word elope but does not refer to a deficiency.
To be sure, read the report by clicking on the nursing home name. - Our search engine in most cases will
only return results with the precise word you entered. In a few cases, we have designed
our program to return related matches. For instance, if you search the term
“elope,” you will also see results for “elopes,” “eloped” and “elopement.”
(There still may be other variations or misspellings.) It is best to search by
the singular and the plural, as well as past and present tense. (The search
engine will sometimes return a related match without highlighting the word in
the text blurb, so again make sure to click through to the report to see
exactly how it appears.) - As noted above, nursing home
inspectors in different parts of the country have different styles and
techniques for writing up deficiencies. Use a variety of search terms if you
are trying to determine the scope of a particular problem. - The government has redacted certain
information, including medication names, diseases and certain dates. That means
you can’t search for a drug like Seroquel or Zyprexa
(common antipsychotic medications). But you can use the term antipsychotic to find mentions of the drug
category. Similarly, searches for antidepressants and opioids (narcotic
analgesics) yield reports mentioning those drug categories. - Although the government is reporting
nursing home deficiencies online, it does not report how homes plan to fix the
problems. These “Plans of Correction” can be viewed at the nursing home or by
submitting a FOIA request to the government.
