Despite what most people believe, poor treatment and care of nursing home residents is common throughout the country. An analysis of state inspections for some 16,000 homes nationwide found that not-for-profit nursing homes generally provide better care than those operated for profit. Also, independent nursing homes, according to the study, tend to provide better care than those managed by companies that run numerous nursing homes. Consumer Reports, which is published by Consumers Union, says that those conclusions are based on its evaluation of recent state inspection reports for the nursing homes. A grant from the Commonwealth Fund was used to compile a list of the facilities in each state that rank in the best or worst 10% on at least two indicators of quality. Researchers reviewed the three most recent inspection reports for each home.

Only a fraction of nursing homes, regardless of whether they were a for-profit or non-profit, met Consumer Reports’ standards for a quality nursing home. With for-profits, only about 2% were classified as likely to provide good care. The non-profits fared a little better at 7.3%. One reason the independently owned facilities might do better than those run by a chain is that they tend to have more staff. The magazine found they also are more likely to use registered nurses. Consumer Reports issued several recommendations for family members who want to improve their prospects for finding a good nursing home. Those recommendations include:

• Get a list of local facilities from your nearest agency on aging, as well as contact information for the local ombudsman, a government official whose job is to investigate nursing home complaints and advocate for residents.

• Check the ownership. A resident’s chances of getting good care are better at an independent, not-for-profit home.

• Don’t depend on the federal website at the Centers for Medicare and Medicaid Services. “Our comparison of the information on that site and the state inspection reports on which it is based show that you’ll probably get an incomplete and possibly misleading picture.”

• Visit the homes under consideration unannounced. Drop in between 9:30 and 10 a.m., for example, to see how many people are still in bed. Homes with too few staff members don’t get people out of bed until later in the day, if at all. Also visit at dinner time. If 75% of the residents are eating in their rooms, that’s not a good sign.

Our experience in nursing home litigation has been that the worst nursing homes are in fact those run by large chain operations. Those facilities are generally understaffed and often lack real good quality control systems. The advent of binding arbitration in nursing home admission forms has resulted in even worse care of residents in Alabama. When there is no fear of being held accountable in court for wrongdoing, the level of care and attention to residents drops significantly.

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