Patient Safety Events Underreported In Nursing Homes

January 5, 2023

Imagine taking the difficult step to place your loved one, or yourself, into a nursing home. While nursing homes have their benefits such as assistance with daily tasks, regular meal times, a social environment, and healthcare, it is still an unfamiliar environment unlike your home, which you have spent years cultivating to be your perfect haven. There is a certain level of trust that must be placed into nursing homes and their staff. However, certain nursing homes are violating that confidence. 

“Nursing homes are vastly underreporting patient safety events, like the occurrence of moderate pressure ulcers, to the Centers for Medicare and Medicaid Services, a practice that could impact the reliability of publicly reported Nursing Home Care Compare ratings intended to guide consumer care access decisions,” reports Sara Heath for Patient Engagement HIT. According to a study done by the University of Chicago, nursing homes only reported 22.4 percent “of the pressure ulcers that resulted in hospitalization in which pressure ulcer was the primary diagnosis”. When investigators looked at this concerning development further, they discovered that 45 percent of secondary diagnoses of pressure ulcers resulting from hospitalization went unreported. This investigation delved even deeper and uncovered that nursing homes went so far as to underreport the number and severity of falls to CMS as well. The nursing homes’ focus has shifted from resident care to profit margins. 

Sara Heath writes, “More severe pressure ulcers were more common among Black residents than White ones. Among short-stay residents, 40.8 percent of White residents, 50.4 percent of Black residents, and 46.1 percent of Hispanic residents suffered stage 4 ulcers. Among long-stay residents, those figures were 45.6 percent, 54.2 percent, and 48.9 percent, respectively.” Researchers did take note that nursing homes were more likely to report severe pressure ulcers, which could have skewed their findings regarding racial disparity. The researchers did denote in their discussion section of their report that, “Black and Hispanic populations had more severe pressure ulcers, but more severe pressure ulcers were much more likely to be reported, perhaps because they are more visibly apparent.”

This study has proven that relying on the data provided by the CMS data on the Care Compare website is not at all useful. The underreporting of patient safety events does not help potential residents to make decisions regarding their health. In order to highlight other inaccurate data provided by nursing homes, the same research team will be taking a look into urinary tract infection and pneumonia patient safety events. Their goal is to provide a deeper look into the nursing homes’ true quality of care.  

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