Problems Often Underreported On Federal “Nursing Home Compare” Website: Study

A government website widely used to help families research the quality of care provided at nursing homes nationwide appears to be severely under-reporting the number of falls residents suffer, according to the findings of a new study.

Data reported by the “Nursing Home Compare” website includes less than 60% of all nursing home falls actually suffered by residents, according to researchers from the University of Chicago, who published a study last week in the medical journal Health Services Research.

Nursing Home Compare is a website sponsored by the U.S Centers for Medicare & Medicaid Services, and is a resource for families researching nursing home options. Families often look at the data to determine the quality of care provided by looking facility ratings and citations. The number of falls experienced by residents that lead to an injury can determine if the nursing home will be safe for their loved one, yet this study suggests that metric is often under-reported.

Researchers wanted to determine how accurately nursing homes self-report problems involving major injury falls, as tallied by the Nursing Home Compare website. They compared the self reporting data to MDS assessments and Medicare claims from 2011 to 2015.

The team identified 150,828 major injury falls which occurred at nursing homes using data from more than 88.7 million Medicare admission claims.

Nursing Home Compare reported only 57% of the falls submitted to Medicare as fall claims. In addition, they found that most of the underreported falls involved nonwhite residents and short-term residents.

The study indicted that reporting rates were higher for white residents, with about 59% of falls reported, compared to non-white residents, where only 46% of falls were reported. Similarly, reporting was also higher for long stay residents compared to short stay residents. The reporting rate for falls for long-stay residents was 63%, compared to 47% for short stay residents.

Falls are a leading cause of death among individuals over 65 and can lead to other serious injuries. Deaths from elderly falls increased 31% in recent years.

Often, once a patient has fallen once they can become fearful of walking again because of re-injury. Gauging the safety of residents based on fall data can mean the difference between a nursing home resident thriving or deteriorating, especially since falls are a preventable injury.

Safety precautions like bed alarms, fewer antipsychotic medications, and better staffing can all help prevent nursing home falls. Other measures, like installing padded flooring and implementing patient checks can also lead to fewer fall injuries.

Researchers were especially concerned to see significant underreporting by the Nursing Home Compare Website. They warned that without a good measurement of injury data, it can be hard to identify nursing homes that may be less safe and need improvement, or which may be a better choice for families researching nursing homes. Fall data also reflects how well a nursing home prevents patient injury overall.

Last year, Medicare issued a warning indicating it would include a special icon on the Nursing Home Compare website indicating what facilities are associated with abusive behavior or substandard care.

The move came after many long-term facilities were cited for abuse and neglect after the Inspector General issued a report indicating many skilled nursing homes are not reporting injuries sustained by residents.