How nursing homes keep track of their most dangerous residents

A N.Y. Times investigation released today found that most nursing homes nationwide don’t track the riskiest residents. Senior living facilities want to keep those residents to care for the long-term residents who are most…

How nursing homes keep track of their most dangerous residents

A N.Y. Times investigation released today found that most nursing homes nationwide don’t track the riskiest residents.

Senior living facilities want to keep those residents to care for the long-term residents who are most expensive to care for, but they don’t want the public and lawmakers to know which patients are at most risk.

In 2015, the Centers for Medicare and Medicaid Services required nursing homes to track how many residents suffered a fall or an attack that resulted in hospitalization. But they were given no deadline to report this information and no penalties for failing to report the information to government regulators.

Nursing homes are also not required to report how many patients die each year.

Part of the issue is that nursing homes collect plenty of data — sometimes all the data they have — and often do an inadequate job of identifying and reporting bad actors. The Times found some examples:

a nursing home in New York that cut corners to keep its Medicaid reimbursement checks coming in and reported only the number of residents who moved out of the facility after their financial assistance ran out;

a Florida nursing home that reported its residents’ deaths were caused by “treatable infections,” but its CEO said he did not include in that death report the fact that at least 47 residents were hit by a car, sometimes so many times it caused multiple brain bleeds;

a nursing home in New Jersey that categorized its resident’s use of psychotropic drugs as “managing behavioral problems,” even though the resident was a violent, frequently suicidal patient on suicide watch who was placed back in a unit in which there were only three trained staffers;

“If those metrics were being reported, it might go someplace,” Medicare and Medicaid Administrator Seema Verma told the Times. “But who’s actually getting the penalties, I’m not sure.”

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