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<em>Consumer Reports</em> Scores Best, Worst U.S. Nursing Homes

By Sarah Abruzzese, CQ Staff

August 7, 2006 -- A good nursing home is hard to find, but the best place for consumers to start looking is an independent, not-for-profit establishment, according to a new report by the nonprofit advocacy group Consumers Union.

The report, "Nursing Homes: Business as Usual," says life inside America's nursing homes hasn't changed for the better since the group's publication, Consumer Reports, started researching the issue and since Congress passed legislation aimed at protecting seniors in nursing homes.

"We have seen little evidence that the quality of care has improved much since the first list came out in 2000," Consumers Union Programs Director Charles W.F. Bell said at a news conference Monday.

In fact, a total of 186 homes found to be providing poor care have been cited by Consumer Reports in previous years. The authors of the report also listed 12 five-time repeaters. Labeled the "deficient dozen," the group includes facilities around the country, including three from California, two from Minnesota, and two from Ohio.

The report also says enforcement of penalties for poor care has been tempered in recent years. Of the "deficient dozen," only four had received fines between 1999 and 2004. In 1999, the median fine for a deficient nursing home was $4,800, a number that dropped to $3,000 in 2004. According to the report, far fewer homes are being denied funding from the Centers for Medicare and Medicaid Services. In 1998, 51 facilities were terminated for poor care, and in 2005, only eight.

Consumer Reports looked at staffing levels, quality indicators, and recent state inspection reports for about 16,000 nursing homes across the country. The report broke the results down by state, identifying the top and bottom 10 percent, which consisted of 7 percent of the nation's nursing homes. To be listed in the top or bottom 10-percent tier, the home had to rank at the bottom or top in at least two of the three categories.

Staffing is a crucial piece of providing good care, said Trudy Lieberman, director of the Center for Consumer Health Choices at Consumers Union. The researchers found that not-for-profit nursing home patients received more attention from staff—an average of an hour more a day and two hours more a day of time with registered nurses.

"Nursing homes can choose how they spend money," Lieberman said, adding that it is possible independent homes put more money back into patient care and staffing numbers.

Lieberman recommended that families searching for a nursing home look at the home's owner and read reports on the home by CMS and ombudsman complaints. She also suggested paying unannounced visits with careful attention paid to meals and services.

"Consumer reports are a good thing, helping people get the data they need and make their own choice," said Bruce Yarwood, president and chief executive officer of the American Healthcare Association. But he cautioned that it is important to have the correct data and that some of the institutions that Consumer Reports examined aren't long-term care nursing homes for the elderly.

The report, the group's fifth examining nursing homes, will be in the September issue of Consumer Reports. It was paid for by a grant from The Commonwealth Fund.

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