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
