C. Harrington, August 05

Nursing Facilities, Staffing, Residents, and Facility Deficiencies,
1998 Through 2004

This book, by Charlene Harrington, Helen Carillo, and Cynthia Mercado-Scott, was published in August 2005.  The entire book including its text, tables and graphs, appears here in sections.  It shows trends in U.S. nursing homes by state from 1998 through 2004.  The data are from the federal On-Line Survey and Certification System (OSCAR) reports that are completed at the time of the annual nursing home surveys by state Licensing and Certification programs for the U.S. Centers for Medicare and Medicaid Services. You may retrieve and print the book by clicking on each link below.  The documents are in pdf format and may take a moment to download.  You will need Acrobat Reader to open the documents. 

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Some findings in this year's report include:

• The number of nursing homes certified to take both Medicare and Medicaid residents increased by 6 percent (from 87.5 to 93.1 percent).
• The number of nursing homes operated by hospitals declined by 34 percent (from 14 to 9.2 percent) of total homes
• The average number of registered nurse (RNs) hours per resident day declined by 25 percent (from 0.8 hours to 0.6 hours). The number of nursing assistants (NAs) hours increased to make up for the reduction in registered nurse hours.
• The percent of residents with dementia increased by 8 percent (from 41.6 to 45 percent of residents) and the percent with other psychiatric diagnoses increased by 45 percent (from 13.2 to 19.1 percent of residents).
• The average number of deficiencies increased by 43 percent (from 5.2 to 9.2 per facility). At the same time, the percent of facilities that were issued serious deficiencies for causing harm or jeopardy declined by almost half (from 30 percent in 1998 to 15.5 percent in 2004).
• Quality of care is the second most common violation of federal regulations, increasing from17 percent to 26 percent of all US nursing homes.

The author notes that these trends in nursing homes should be of concern to policy makers, nursing home providers, and consumer advocates because they do not show major improvements over the past seven years.   Moreover, they show wide variations in staffing, residents, quality of care and enforcement across states that have not improved.