Nursing Home Comparison and Oversight

by L. E. Green author of The Nursing Home Survival Guide

At least once a year nursing homes undergo an annual inspection called a “survey,” with certain nursing homes being surveyed more often - these nursing homes fall under the special focus facility program due to ongoing problems that require more frequent surveys. The agency that conducts the annual survey is the same one that investigates complaints.

During the survey, a team of healthcare workers review a sample of patient charts, employee personnel files, and patient billing records. They follow and observe staff members as they pass medications and provide patient care, and also ensure that the building is up to current codes. It’s common for the surveyors to time how long it takes for patient call-lights to be answered and to interview family members who are visiting. They also meet with the residents as a group and listen to their concerns. The survey process generally takes 3-5 days for each nursing home.

Once the nursing home has been surveyed, the state provides them with a document called a “2567 form” that specifically lists everything that was found. The nursing home will then submit a plan of corrections to address the findings. Additionally, the nursing home can either accept the findings, or appeal them. This can take several years to resolve; if the nursing home was found to be substandard there will be fines and the possibility of losing state and federal funding (Medicare/Medicaid) if the problems are bad enough.

Each nursing home is given a score of up to five stars on the Medicare “Nursing Home Compare” website - these findings are published at www.medicare.gov. The star system assigned by Medicare is confusing, because each nursing home is scored in comparison to the other nursing homes in the area. If they’re all below standard, they still might have a three or four-star overall rating. The best way to judge whether a nursing home is able to provide care for your family member is to view the actual survey results.

Every nursing home is required to post the most recent survey’s findings in a public area. However, some don’t make it easy to find the information or will require that a person ask before they’re allowed to see the results. Many states offer the survey findings online; at the very least, a copy of the actual survey can be obtained from the state agency (listed below).

Every state also offers an Ombudsman program, which is an impartial third party who helps to advocate for nursing home residents and to ensure that their rights are protected. Some states hire professionals to provide this service, while others hire volunteer coordinators who act as Ombudsmen to protect the rights of residents over the age of 60. Anyone can call an Ombudsman, whether it’s the patient, a relative or friend, or the nursing home itself. The facility is required to cooperate with an Ombudsman and can’t retaliate against an employee or resident who cooperates with that program. To obtain additional information about the Ombudsman program for your state, contact the agency below.

 

 

State

State Survey Agency

Long Term Care Ombudsman

Alabama

Alabama Department of Public Health

1-800-356-9596

1-800-243-5463

Alaska

DHSS of Alaska - DMA Health Facilities Licensing and Certification 1-888-387-9387

1-800-730-6393

Arizona

Department of Health Services of Arizona - Assurance and Licensure Division of Long Term Care 1-602-364-2690

1-800-432-4040

Arkansas

Department of Human Services of Arkansas - Office of Long Term Care 1-800-582-4887

1-501-682-2441

California

Department of Health Services of California - Licensing and Certification Program 1-800-236-9747

1-800-231-4024

Colorado

Colorado Department of Public Health and Environment 1-303-692-2800

1-800-288-1376

Connecticut

Department of Public Health of Connecticut - Division of Health Systems Regulation 1-860-509-7400

1-866-388-1888

Delaware

Health and Social Services of Delaware - Division of Long Term Care and Resident Protection 1-877-453-0012

1-800-223-9074

District of Columbia

Dept of Health of Washington, D.C. - Health Regulation Admin, Health Care Facilities Division 1-202-724-8800

1-202-434-2140

Georgia

Department of Human Resources of Georgia - Office of Regulatory Services 1-800-878-6442

1-888-454-5826

Florida

Agency for Health Care Administration of Florida 1-888-419-3456

1-888-831-0404

Hawaii

Hawaii Department of Health 1-808-692-7420

1-888-875-9229

Idaho

Idaho Department of Health and Welfare 1-208-334-6626

1-877-471-2777

Illinois

Illinois Department of Public Health 1-800-252-4343

1-800-252-8966

Indiana

Department of Health of Indiana - Long Term Care Division 1-800-246-8909

1-800-622-4484

Iowa

Department of Inspections and Appeals of Iowa - Health Facilities Division 1-877-686-0027

1-800-532-3213

Kansas

Kansas Department on Aging 1-800-842-0078

1-877-662-8362

Kentucky

Office of Inspector General of Kentucky 1-502-564-7963

1-800-372-2991

Louisiana

Department of Health and Hospitals of Louisiana - Health Standards Section 1-888-810-1819

1-866-632-0922

Maine

Department of Health and Human Services of Maine 1-800-791-4080

1-800-499-0229

Maryland

Maryland Department of Health and Mental Hygiene 1-877-402-8219

1-800-243-3425

Massachusetts

Massachusetts Department of Public Health 1-800-462-5540

1-800-243-4636

Michigan

Michigan Department of Community Health 1-800-882-6006

1-866-485-9393

Minnesota

Health Facility Complaints and Provider Compliance Division of Minnesota 1-800-369-7994

1-800-657-3591

Mississippi

Mississippi Department of Health 1-866-458-4948

1-800-948-3090

Missouri

Elder Abuse and Neglect Hotline of Missouri 1-800-392-0210

1-800-309-3282

Montana

Department of Health and Human Services of Montana - Quality Assurance, Certification Bureau 1-406-444-2099

1-800-332-2272

Nebraska

Health and Human Services of Nebraska - Regulation and Licensure Credentialing Division 1-402-471-3324

1-800-942-7830

Nevada

State Health Division of Nevada 1-800-225-3414

1-702-486-3545

New Hampshire

Health Facility Administration of New Hampshire 1-800-852-3345

1-800-442-5640

New Jersey

State Health Insurance Assistance Program (SHIP) 1-800-792-9770

1-877-582-6995

New Mexico

Department of Health of New Mexico - Bureau of Health Facility Licensing and Certification 1-800-752-8649

1-800-432-2080

New York

New York State Department of Health 1-888-201-4563

1-800-342-9871

North Carolina

Division of Health Service Regulation-Nursing Home Licensure and Certification 1-800-624-3004

1-919-733-8395

North Dakota

North Dakota Department of Health 1-701-328-2352

1-800-451-8693

Ohio

Bureau of Long Term Care of Ohio - Quality Assurance 1-800-342-0553

1-800-282-1206

Oklahoma

Oklahoma State Department of Health 1-800-747-8419

1-800-211-2116

Oregon

Seniors and People with Disability 1-800-232-3020

1-800-522-2602

Pennsylvania

Pennsylvania Department of Health 1-800-254-5164

1-717-783-1550

Rhode Island

Rhode Island Department of Health 1-401-222-2566

1-401-785-3340

South Carolina

Department of Health and Environmental Control of South Carolina - Bureau of Certification 1-800-922-6735

1-800-868-9095

South Dakota

South Dakota Department of Health 1-605-773-3356

1-866-854-5465

Tennessee

Tennessee Department of Health 1-800-778-4504

1-877-236-0013

Texas

Department of Aging and Disability Services 1-800-458-9858

1-800-252-2412

Utah

Dept of Health of Utah - Bureau of Medicare/Medicaid Program-Certification and Resident Assessment 1-800-662-4157

1-877-424-4640

Vermont

Department of Aging and Independent living 1-800-564-1612

1-800-889-2047

Virginia

Department of Health of Virginia - Center for Quality Health Care Services and Consumer Protection 1-800-955-1819

1-800-938-8885

Washington

Dept of Social and Health Services of Washington-Aging and Adult Services Admin-Residential Care 1-800-562-6078

1-800-562-6028

West Virginia

Dept of Health and Human Resources of West Virginia-Office of Health Facility Licensure and Cert 1-800-442-2888

1-877-987-4463

Wisconsin

Dept of Health and Family Services of WI-Division of Supportive Living-Bureau of Quality Assurance 1-800-642-6552

1-800-815-0015

Wyoming

Office of Health Quality of Wyoming 1-800-548-1367

1-307-322-5553