Reports of serious, physical, sexual and verbal abuse are "numerous" among the nation's nursing homes, according to a congressional report released today.
The study, prepared by the minority (Democratic and Independent) staff of the Special Investigations Division of the House Government Reform Committee, finds that 30 percent of nursing homes in the United States — 5,283 facilities — were cited for almost 9,000 instances of abuse over a recent two-year period, from January 1999 to January 2001.
Common problems included untreated bedsores, inadequate medical care, malnutrition, dehydration, preventable accidents, and inadequate sanitation and hygiene, the report said.
Many of the abuse violations caused harm to the residents, the report said.
In 1,601 cases, the abuse violations were serious enough "to cause actual harm to residents or to place the residents in immediate jeopardy of death or serious injury," it said.
"What we have found is shocking," says Rep. Henry Waxman, D-Calif., the committee's minority leader, who instructed the staff to do the study.
Kelley Queale, director of communications for the California Association of Health Facilities, however, says reports such as the one released today can be misleading, since stringent regulations require reporting even the most minor of incidents, such as one resident slapping another.
"That inflates the figures and makes it sound a lot worse than the reality is," she says. "We believe that nursing homes are providing the best care they can in a difficult environment."
In some reported cases, a member of the nursing home's staff was accused of committing physical or sexual abuse. In others, staff were cited for failing to protect people from abuse by other residents.
The report documents instances of residents being punched, slapped, choked or kicked by staff members or other residents, causing injuries such as fractured bones or lacerations.
Some of the violations uncovered are particularly disturbing. In one case, according to the report, an attendant walked into a resident's room, said "I'm tired of your ass," and hit her in the face, breaking her nose.
In another case, attendants bribed a brain-damaged patient with cigarettes to attack another resident, then watched the two fight. The report also described a case in which a male attendant molested an elderly female resident while bathing her.
Instances of abuse appear to be on the rise. The percentage of nursing homes cited for violations has increased every year since 1996, according to the report.
Many for Profit, Taking Federal Money
The homes cited by the study for instances of abuse accommodate some 550,000 residents. Nationwide, some 1.6 million people reside in 17,000 nursing homes and 11,000 of them are for-profit businesses.
The federal government is the biggest contributor of nursing home care, mostly through Medicaid, a joint federal-state health care program for the poor, and Medicare, the federal program for elderly and disabled people. Federal heath and safety standards are designed to protect nursing home residents from abuse.
To enforce the standards, the U.S. Department of Health and Human Services contracts with the states to conduct annual inspections of nursing homes. The states also are required to investigate individual abuse complaints. The report's statistics were derived from these state inspections.
Industry Says Money a Factor