C. Harrington, September 06

Nursing Facilities, Staffing, Residents, and Facility Deficiencies,
1999 Through 2005

This book, by Charlene Harrington, Helen Carillo, and Courtney LaCava, was published in September 2006.  The entire book including its text, tables and graphs, appears here in sections.  It shows trends in U.S. nursing homes by state from 1999 through 2005.  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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Highlights from this year's report, with author comments, can be found in the press release. Some findings follow below:

• The number of nursing homes certified to take both Medicare and Medicaid residents increased by 6 percent (from 87.5 to 93.9 percent).
• The number of nursing homes operated by hospitals declined by 36 percent (from 13.2 to 8.8 percent) of total homes.
• Residents whose care was paid by Medicare increased by 52 percent (from 8.6 to 13.1 percent of all residents), residents whose care was paid by Medicaid declined by 3 percent.
• The average number of registered nurse (RNs) hours per resident day declined by 25 percent (from 0.8 hours to 0.6 hours) between 1999 and 2005.  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 10 percent (from 41.4 to 45.4 percent of residents) and the percent with other psychiatric diagnoses increased by 43 percent (from 13.8 to 19.7 percent of residents).
• Quality of care is the second most common violation of federal regulations. Almost one-third of all nursing homes have quality of care problems.

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.