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Majority of Nursing Homes Cited For Safety and Health Violations

Sep 30, 2008 | Parker Waichman LLP Nursing home abuse and neglect continues to be a serious problem in the U.S.  According to a new report conducted by the inspector general of the Department of Health and Human Services, a whopping 94 percent of all for-profit nursing homes were cited last year for violations of federal health and safety standards. In total, 90 percent of all nursing homes – including those owned by non-profit groups and government agencies - were cited last year for violations of health and safety standards.

The violations cited by the inspector general’s report included infected bedsores, medication mix-ups, poor nutrition, and abuse and neglect of patients.  The inspector general also said on Monday that some nursing homes “have systematically failed to provide staff in sufficient numbers and with appropriate clinical expertise to serve their residents.”  In other cases, nursing homes billed Medicare and Medicaid for services that “were not provided, or were so wholly deficient that they amounted to no care at all,” the inspector general said.

According to The New York Times, more than 1.5 million people live in the nation’s 15,000 nursing homes. To participate in Medicare and Medicaid, facilities must meet federal health and safety standards.  These programs cover more than two-thirds of nursing home residents, and cost taxpayers more than $75 billion per year.

About two-thirds of the nation’s nursing homes are owned and operated by for-profit companies. Non- profit organizations own 27 percent, while government entities own and operate 6 percent.

According to the inspector general’s report, in the past year, poor nursing home conditions were the subject of 37,150 complaints.  Of those, 39 percent were later substantiated by inspectors, and at least 20 percent involved the abuse and neglect of patients.   What’s more, 17 percent of nursing homes had deficiencies that caused “actual harm or immediate jeopardy” to patients, the report said.

While the report said privately-owned nursing homes were the most likely to have safety and health violations, others did not fare much better.  Of the facilities owned by non-profits, 88 percent were cited for violations, while 91 percent of government-run institutions received citations. According to the report for-profit nursing homes averaged 7.6 deficiencies per facility, while not-for-profit and government homes averaged 5.7 and 6.3, respectively.

It is not surprising that privately-run nursing homes have some of the highest rates of deficiencies.  Over the past several years, private equity firms have been actively working to acquire nursing homes, and have taken over large chains like of HCR Manor Car, Genesis Healthcare Corp. and Beverly Enterprises.  These firms buy facilities and then drastically reduce their costs – usually by cutting staff – with the goal of eventually selling the facilities at huge profits.

According to a New York Times investigation published last year, facilities owned by private investment firms score worse than national rates in 12 of 14 indicators regulators used to track ailments of nursing home residents. And the Centers for Medicare and Medicaid Services says that residents of such nursing homes suffer more from depression, loss of mobility and the loss of the ability to dress and bath themselves. And both federal and state regulators told the New York Times that citations for quality-of-care deficiencies, like moldy food and restraining residents for long periods of time, rose at every large nursing home chain that was acquired by a private investment group,

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