updated 11/13/2003 5:41:28 PM ET 2003-11-13T22:41:28

Many nursing homes have serious quality problems despite recent industry improvements, and state inspectors are failing to catch a large number of the problems, congressional investigators said Thursday.

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Twenty percent, or about 3,500, of the nation’s nursing homes were cited for harming patients or placing them at risk of serious injury, the General Accounting Office report said. The investigation covered mid-2000 through 2002.

Examples of negligent care include improperly stored medical equipment and patients with untreated bed sores.

Twenty-nine percent of nursing homes received serious citations in the prior 18-month period, from mid-1998 to 2000. The report acknowledged the situation had improved somewhat but emphasized that the current degree of poor care was unacceptable.

The GAO also said that states are getting better at reporting problems at nursing homes, but they need to do more.

The congressional investigation revealed serious quality problems in 22 percent of nursing homes that state surveyors had cleared. The discrepancy was larger — 34 percent — in a previous study.

The GAO called for improvement in nursing-home inspection procedures and oversight.

Donna Lenhoff, executive director of the National Citizens’ Coalition for Nursing Home Reform, called for better oversight and harsher penalties for nursing home operators that fail to meet standards.

“The law cannot provide nursing home residents with adequate protections if it isn’t enforced,” she said.

The problems were partly the result of poor investigations and a large number of inexperienced surveyors.

Also, the timing of state inspections often is predictable, so some nursing homes get the chance to hide their worst infractions, the GAO said.

The Centers for Medicare & Medicaid Services, the division of the Health and Human Services Department that oversees states’ inspection of nursing homes, agreed with the report’s findings and has already begun to implement changes aimed at boosting oversight.

The GAO report is “a tool for evaluating our progress in improving nursing home quality, while at the same time highlighting issues that warrant our attention,” CMS administrator Thomas Scully said Thursday at a Senate hearing that discussed issues raised by the report.

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