Failure to Report or Intentional cover-up?

The latest study showing the government’s continued failure to enforce safety regulations in the nation’s nursing homes is no surprise to those of us who have been fighting the systemic abuse and neglect for decades. Underreporting of abuse, falls and pressure ulcers in nursing homes is common place to avoid accountability and responsibility. For the caregivers, and the for-profit corporate masters. JAMA Network Open published full findings recently.

Researchers at the University of Chicago found 40% of hospitalizations related to major trauma/fall injuries were not reported by facility in the Minimum Data Sets. For pressure ulcer hospitalizations, 33.3% went unreported from 2011 through 2017. That should be Medicare/Medicaid fraud. Consumers and others reviewing data on CMS Care Compare website are getting false or flawed information.

“Quality measures have long generated suspicion, and recent work by Sanghavi et al. and Chen et al. found substantial underreporting nationally on at least some quality indicators,” Sanghavi and colleagues wrote.

The failure to report was widespread among the entire industry. The study discovered about 70% of nursing homes reported less than 80% of their patients’ fall and pressure ulcer hospitalizations.

“Underreporting of clinical events to CMS was widespread during the study period,” wrote lead author Prachi Sanghavi, PhD, an assistant professor at University of Chicago. “Although CMS appears to recognize this situation, as evidenced by the lower weighting of quality measures in the ratings, the measures remain on public display. In other words, the quality measures are in limbo, but the public may be using these measures to make important life decisions.”

Obviously, self-reported data is not reliable. The problem is CMS allows facilities to self-report incidents, and they ignore, deny, and cover-up.