Nursing Home Inspection Report

Under federal and state law, nursing homes are held to specific standards of care and undergo regular and random inspections to meet the minimum requirements.

You can access these reports to help you make an informed decision about a care facility or pursue legal action if you believe they violate the law. Here’s everything you need to know about nursing home inspection reports. 

What is a Nursing Home Inspection Report?

The state’s public health department conducts a nursing home inspection report. It provides an overview of the nursing home, including:

• Impressions: The report will detail whether the facility is well-maintained, note the cleanliness standards, and indicate whether there are any hazards or other issues with the nursing home.
• Safety: The report will examine overall facility safety and whether safety equipment is present. It will also determine whether medication is secure, disposed of properly, and within date.
• Staff: Inspection reports examine the staff, including their qualifications, education, and background checks. They assess the level of staffing based on the number of patients.
• Treatment Plans: Inspectors will look at patient treatment plans and assess if they are being followed.

Nursing home inspection reports can be routine in the Medicare and Medicaid funding process or due to complaints from patients or their families. 

The report includes an impartial look at the facility to ensure it meets the basic requirements for medical care and resident rights outlined by state and federal regulations. [1]

If they do not meet the minimum requirements, the facility will have a specified amount of time to bring it up to standards. They can also face fines. If they do not make changes, they can lose their state and federal funding, which leads many facilities to close.

These reports are critical in ensuring nursing homes keep their patients safe. 

The Role of State and Federal Agencies in Inspections

The Centers for Medicare and Medicaid Services (CMS) govern nursing homes that receive federal funding. To maintain good standing, nursing homes must offer fundamental rights and protections to nursing home residents. [2]

These rights include, but are not limited to:

• Respect: Patients should be treated with respect and dignity regardless of ability. 
• Equality: Nursing home residents should not face discrimination from medical professionals and other residents.
• Free from Abuse and Neglect: All nursing home residents should be free from physical, emotional, sexual, and financial abuse. They also should not face neglect and receive proper care and socialization.

State public health departments conduct investigations to meet these rights and standards. The agencies then certify to the federal government that the nursing homes adhere to all guidelines. If the nursing facilities are approved, they will continue to receive funding. 

Public Access to Inspection Reports

Nursing home inspection reports are publicly available. You can access the latest information in various ways.

• CMS Nursing Home Database: The CMS database includes the latest information on all federally funded nursing homes. The reports must be filed to maintain funding. [3]
• State Department of Health Facility Finder: Many states offer searchable databases that provide information on their local facilities by city or zip code. 
• Medicare Website: The Medicare website allows people to compare facilities. This information includes the inspection surveys. [4]
• From the Facility: Nursing homes should have their reports available and provide them to the public upon request. 

Apps and other resources also allow the public to access inspection reports. These documents are critical in helping families make the right decisions for their loved ones. They promote transparency and drive accountability within facilities. 

Nursing homes are held to a certain standard of care, and the reports help make sure they maintain it. 

Decoding the Inspection Report

Like many reports, the inspection report can be challenging to understand unless you know what you are looking for. Here’s how to decode it. 

Key Sections of the Report

The report is broken down into different vital sections. They can include the following.

• Summary: This is an overview of the report, including key findings and action plans. It is a high-level overview, and the specific details will follow. 
• Findings: The findings are the bulk of the report. They outline what the inspector found during their site visit, including any nursing home violations. The findings can cover various sectors, including safety, care, cleanliness, and more. 
• Plans of Correction: The plans of correction outline what steps the nursing home facility must take to correct any of the issues found. This plan must include actionable steps to address the issues and prevent them from happening again. The nursing home writes the plan of correction, and the CMS or state agency must approve it.

All remedies must be made within 45 days, or the CMS can take enforcement actions. [5]

Understanding the Terminology and Ratings

The CMS uses standard terms across its reports to maintain consistency and fairness across all nursing home facilities. Standard terms within the inspection reports can be:

• Deficiency: The deficiency is a problem found within the facility. It can vary in severity.
• Severity: The severity indicates how serious the issue is. As outlined by the CMS, there are four levels of severity. They include no actual harm with a potential for minimal harm, no actual harm with a potential for more than minimal harm that is not immediate jeopardy, actual harm that is not immediate jeopardy, and immediate jeopardy to resident health or safety.
• Scope: The scope is how many people are impacted by the deficiency. It can be isolated, meaning it is one-off. It can be a pattern that the inspector notices in certain instances. It can also be widespread and found throughout the facility or impact most residents. [5]

Depending on the deficiency and the plan of correction, nursing homes must address the issue promptly. Failure to do so can result in the facility being removed from the Medicare or Medicaid program and losing all federal funding. 

Identifying Red Flags and Areas of Concern

If you are looking at inspection reports, there are certain red flags that you can look out for. They include:

• Recurring Deficiencies: You can look at past reports, and if the same issues occur repeatedly, this can indicate that the facility does not prioritize resident health. 
• Serious Violations: If multiple violations pose an immediate threat to resident safety and are widespread, this can be concerning. 
• Quantity of Violations: Multiple violations within a facility, even of varying severity and scope, can indicate more significant issues. 

If you are able, visit the nursing home in person. You can identify if the nursing facility has addressed the issues and if you notice any additional problems. Viewing the home for yourself can help you visualize the care your family members will receive. 

Common Deficiencies Found in Inspection Reports of Nursing Homes

As you review the document, there are common deficiencies that you can look out for. Just because they are more widespread does not mean they are of less concern. 

Quality of Care Deficiencies

Residents expect a certain standard of care in a nursing facility. However, some homes fall short of these expectations. Residents may face several issues regarding their quality of care, including:

• Medication Errors: They could receive the wrong medicine, incorrect dosage, expired medicine, or have their medicine withheld.
• Inadequate Staffing: Facilities may have high turnover, leading to staffing shortages, improperly trained staff, and other shortcomings that can impact the quality of care.
• Neglect: Patients can be neglected while in nursing homes. They can be left alone, not taken to the bathroom, not repositioned in the bed, or isolated from human connection. 
• Abuse: Patients can be physically, emotionally, sexually, or financially abused while in care. 

The CMS outlines the minimum quality of care in skilled nursing facilities. If they are not met, the home can be found deficient. 

Infection Control Deficiencies

Nursing homes house many vulnerable elderly residents, and it can be easy for infections to spread. To protect their residents, facilities must take reasonable steps to stop the spread of germs. A simple infection can lead to serious medical complications and even death.

Common violations can include:

• Hygiene: There may be unsanitary conditions within the nursing home that can spread germs.
• Failure to Take Preventive Measures: Staff may improperly use personal protective equipment or not isolate sick residents. 
• Sanitation: Surfaces and eating utensils may not be adequately sanitized, so germs can spread.

The nursing facility is responsible for taking reasonable measures to stop the spread of infection within its walls. If it does not, it can be found deficient. 

Resident Rights Deficiencies

The CMS takes residents’ rights deficiencies very seriously. All residents of nursing facilities have the right to the following:

• Respect: All patients deserve to be treated with respect and dignity. 
• Self-determination: Patients have the right to make decisions about their care unless otherwise noted.
• Care:  All patients have the right to receive proper medical, mental, and physical care. 
• Free from Abuse, Neglect, and Discrimination: Everyone should feel safe and secure with the care they are receiving.  

These are federal rights for all nursing home residents and should be upheld in daily living within the facility.  

Safety and Environmental Deficiencies

The nursing facility should have a homelike environment free from hazards to prevent abuse. If it doesn’t, it can be found to have safety and environmental deficiencies, including:

• Fall Risks: Items that are not secure can pose fall risks for patients.
• Fire Safety: There can be fire hazards or a lack of safety equipment to prevent fires.
• Sanitation: Facilities may lack proper sanitation stations, threatening patient safety. 

The level of harm on the deficiencies notes can vary. Not all residents affected by the deficiency may be impacted, but they could face harm. 

The Impact of Deficiencies on Residents

The inspection team notes all deficiencies that are uncovered. The level of harm faced by residents may vary and include the following. 

Physical and Emotional Harm

Deficiencies can cause physical and emotional harm to residents. It can impact their:

• Health: Residents may develop new health conditions, or existing conditions can get worse. 
• Well-being: Emotional distress can cause changes in mood and behavior, impacting a person’s overall well-being. 
• Quality of life: Residents may experience a decrease in their quality of life in a facility, including a lack of access to programming, socialization, and other amenities. 

The physical and emotional effects of deficiencies can be tangible or intangible. 

Increased Risk of Injury, Illness, and Death

Deficiencies can cause serious injury to residents depending on the level of harm. They can also lead to serious health complications and even fatalities if they are not taken care of promptly. 

What to Do if You Find Concerning Deficiencies

Residents affected by deficiencies have legal rights, and there are steps that you can take to help you seek justice. 

Contacting the Nursing Home

You should communicate your concerns to the nursing home administration. Get everything in writing and request a copy of the report. They should investigate each claim and help residents and their families seek resolution for the issue. 

Residents have a right to make claims without fear of retaliation.  

Filing a Complaint with State Agencies

If your reported care deficiencies are not met, you can file a claim with your state public health department or with your local ombudsman. They can officially investigate your claim. The facility must address the deficiencies cited. If not, they could lose funding. 

Consulting with a Nursing Home Abuse Lawyer

Contact nursing home negligence and abuse lawyers if you suspect your loved one has been harmed due to negligence or abuse in a nursing facility. They have a right to quality care, and you have rights if a deficiency leads to harm. 

Secure Expert Legal Representation

The lawyers at Nursing Home Law Center are experts and can help you navigate nursing home inspection reports. We can also help you understand your legal options, listening to your concerns with care and compassion.

Call (800) 926-7565 or fill out our contact form to receive a free consultation today. We are here to help hold nursing homes accountable for their total deficiencies and get our clients justice. 

References: [1]  Cornell, [2]  CMS, [3] CMS database, [4] Medicare website, [5] CMS