Editor’s note: Nursing Home Inspect was updated on May 6, 2020, and we’ve published a guide outlining the changes.
Today we’re updating our Nursing Home Inspect tool to include more information about federal sanctions against nursing homes across the country, including fines and payment suspensions.
This is our first major update since we introduced the tool in August as a way to search through tens of thousands of nursing home inspection reports to find problems and trends.
Today’s update allows users to easily compare the nursing homes in each state in a variety of areas: the number of deficiencies cited by regulators in the past three inspection cycles (roughly three years); the number of serious deficiencies per home (that is, deficiencies in which patients were put at immediate jeopardy of harm); the amount of fines imposed; and how often the government has suspended payments to the home for new patients, another type of penalty.
A new mapping feature visually shows how states differ in average fines, serious deficiencies per home and payment suspensions.
Our data are from the U.S. Centers of Medicare and Medicaid Services (CMS), which has its own website called Nursing Home Compare. We’ve taken the information and organized it into a user-friendly format for consumers, researchers and other journalists.
Our new site includes:
• State pages: Every state now has its own section that allows you to compare all of the homes in a state on a variety of indicators.
• Individual nursing home pages: Every home now has a section listing all of the deficiencies identified within the past three survey cycles (roughly three years). Full-text of these deficiency reports, if available, can be accessed via links from this page to CMS. Each home’s page also has ownership status — whether for-profit, government-run or nonprofit — and whether the home has been labeled by the government as a Special Focus Facility, meaning that it has many more problems than other homes.
• State-by-state maps: We’ve revamped the main page of the app to show how states compare on issuing the most serious deficiencies per home, the average fine and the number of times homes were denied payments for new admissions.
• Top-20 Lists: We’ve added a list of homes that have paid the most in fines in the nation, and a list of homes with the highest number of serious deficiencies.
According to CMS’ website: “Fines may be imposed once per deficiency or each day until the nursing home corrects the deficiency. During a payment denial [suspension], the government stops Medicare/Medicaid payments to the nursing home for new residents until the nursing home corrects the deficiency.
“If the nursing home doesn't correct these problems, Medicare ends its agreement with the nursing home. This means the nursing home is no longer certified to provide and be paid for care to people with Medicare and Medicaid. Residents with Medicare or Medicaid who are living in the home at the time of the termination are moved to certified nursing homes.”
Nursing Home Inspect continues to allow users to search through more than 260,000 inspection reports by keywords – such as “choke” or “maggots” – to look for issues you care about. These search results can be sorted by date, city, state or by severity of the deficiency.
Nursing homes are inspected on both a regular schedule and when there is a complaint. Inspectors typically work for state agencies paid by Medicare. If they find problems, known as deficiencies, they rank them on a scale of A to L, the most severe. The vast majority are either labeled D or E.
What you won’t find on these pages are self-reported quality measures for each home. Those can be found on Nursing Home Compare. We also don’t list the state sanctions imposed against homes because those are not centrally collected. For information on penalties within a given state, you should consult the state agency that regulates nursing homes. The federal government has a list of contacts available here.
When reading through inspection reports, it is a good idea to keep in mind the caveats we’ve outlined previously on this site.
How We Combined Data Sources
To compile our app, we used three different data sets: a listing of all Medicare-certified nursing homes, a database with inspection violations and penalties, and a database containing the deficiency report narratives.
We merged spreadsheets containing findings from routine inspections and those identified during complaint visits and kept only health violations, not fire safety violations.
We used each home’s unique identification code to match penalties imposed to the dates of their corresponding inspections so we could display that data together for each home. (We also noted some cases in which a penalty date did not have a corresponding inspection in the database.)
You can find the data we used on these sites:
• For a list of nursing homes: https://data.medicare.gov/dataset/Nursing-Home-Compare-General-Information/dg6a-rxvx
• For inspection reports and penalties: http://www.medicare.gov/download/downloaddb.asp (Click on the Nursing Home Compare-About the Nursing Home Inspection Results option.)
• For deficiency report narratives (updated in November): http://downloads.cms.gov/files/Full-Statement-of-Deficiencies-November-2012.zip