Nursing Homes - An explanation of state Audits

I spent several years working within the Rehab/ nursing home settings; and suffered through numerous state "rounds". Most nursing homes do not go by the Nursing Home title any longer. They are typically dually certified- which means that the facility takes state medicaid and is certified through the federal government to accept Medicare payments for Rehab. This being said- they often prefer to be called Health care and Rehabilitation facilities. This is a nationwide trend.

The federal government sets wide criteria for these facilities; and the state adds more detailed criteria for the facilities to receive payments. The state and federal programs are "tied together"; if a facility is not meeting state criteria they automatically lose the federal funding for the time allotted by the state.

Many websites encourage families to review the state findings which are available on the net as well as within each facility(this is required by law).

Facilities have state audits several times a year IF complaints have been made. Anyone can file a complaint (often disgruntled employees will call in complaints) the state is then obligated to investigate.

Nursing homes are highly regulated, more so than hospitals. This does not mean I am in favor of skilled nursing facilities for elderly. They are necessary on occasion; especially for Alzheimer's patients with wandering tendencies.

Each compliant results in an on site review by the government. The auditors or surveyors- as they are sometimes called- will review all aspects of the facility on each visit. They will occasionally decide to do a paper review and be gone in a day; but for the most part will remain for 3-5 days. These surveyors interview patients, staff, and families, they review admissions, discharges and will remain quiet about the actual complaint being made(to protect patients?).
At the end of the review they will tell the administrator and supervisory staff their findings, then write up a report which will be posted at the front of the building. The findings will reflect the initial complaint and any negative events that were not related to the complaint but need to be addressed.

A score is then given based on the findings from the past year of complaints. This score may not (in my opinion) reflect the daily events within a building.

It is more important to look at the cleanliness of the residents. Odors, it is against federal cover odors. SO the more often they are bathed and changed the better the building will smell. Friendliness of staff, do the CNA's know the residents by name- these are things to pay attention to. Check the bathrooms- my grandma taught me that- not for this reason- but it still applies- look in the corners of the rooms- On a tour you will see people that will yell out- they will appear confused, and those things can't be prevented. Also- ask a resident if they like the food. The audits are important but they do not tell you the whole picture.