Steve Gold, The Disability Odyssey continues

CMS' 2007 Nursing Home Data Compendium was recently released. In the previous Information Bulletin #238, we looked at the distribution of people in these institutions by Activity of Daily Living and Cognitive Impairments. In this Information Bulletin, we will break down some of the findings. To review how your State measures up, scroll down to the Download section to the Nursing Home Data Compendium 2007 - Parts 1 & 2 .

Are People Receiving Medically Care in Nursing Facilities?

Many of the following are life endangering conditions, and many of them are actually caused by improper medical care and treatment in the nursing facilities.

They all demonstrate that people are at significant risk to their health and safety when they are in a nursing facility.

1. Pressure Ulcers

   CMS counted these only if the pressure sore was at stage 2 or greater.

   1. Nationally, half of ALL nursing facilities had more than 7.9% of its residents with pressure ulcers at stage 2 or greater. (Table 3.7).
   2. The following States, in descending order, had the highest percentages of nursing facilities whose residents who had these pressure ulcers:
      
      DC
      New Jersey
      Maryland
      California
      Virginia
      Nevada
      New York
      S. Carolina
      
      
2. Use of Physical Restraints

   CMS writes that it "conservatively considered only" people whom the nursing homes reported were in a trunk restraint, limb restraint, or some sort of restraining chair and in such restraint at least once in the 7 days prior to the assessment. CMS noted that it did not report use of bed rails.

   1. Nationally, half of ALL nursing facilities had more than 3 % of its residents who were in these physical restraints. (Table 3.11)
   2. The following States, in descending order, had the highest percentages of nursing facilities whose residents were in physical restraint, and all of these States were at least twice the national average: Arkansas
      Louisiana
      Oklahoma
      California
      Mississippi
      North Carolina
      
      
3. Weight Loss

   CMS identified people who had a weight loss of more than 5 percent in the 30 days prior to the assessment or more than 10% weight loss in last 180 days. CMS excluded residents with end-stage disease or receiving hospice care.

   1. Nationally, half of ALL nursing facilities had more than 8.0% of its residents who had such weight loss. (Table 3.17).
   2. The following States, in descending order, had the highest percentages of nursing facilities whose residents who had such weight loss:
      
      Wyoming
      Vermont
      Washington
      Oregon
      Kentucky
      
      
4. Severe Bladder or Bowel Incontinence

   CMS identified and counted only persons who were incontinent of bladder or of bowel on almost all occasions. This is a measure of severe incontinence.

   1. Nationally, half of ALL nursing facilities had 32.9% of its residents who had severe bladder or bowel incontinence. (Table 3.19).
   2. The following States, in descending order, had the highest percentages of nursing facilities whose residents who had severe bladder or bowel incontinence on almost all occasions:
      
      South Carolina
      Hawaii
      DC
      California
      Georgia
      North Carolina
      Virginia
      Mississippi
      
      

What are Older American and Disability Advocates doing to correct these four situations? Even if your State was not listed, go to the above CMS website and find out how your State compares.

Each of the above - pressure sores, physical restraints, weight loss, and severe bladder or bowel incontinence - is very dangerous!

Pressure sores, weight loss, and the sequelae of incontinence are all treatable conditions that if not properly treated can be life threatening.

Older American and disability advocates should be meeting with and pressuring your State Medicaid officials and your State Health Departments for letting these conditions go on, and to find out why they are occurring in such numbers and in many cases year after year.