updated 7/16/2004 7:27:56 PM ET 2004-07-16T23:27:56

Fire safety problems at nursing homes are widespread and government oversight is lacking, congressional investigators say in a new report spurred by deadly fires in homes in Connecticut and Tennessee.

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Nearly 60 percent of all nursing homes in the United States were cited for fire safety deficiencies during their most recent inspections, according to the Government Accountability Office, Congress’ investigative arm. The agency was formerly called the General Accounting Office.

Many facilities lack sprinkler systems
Weaknesses in federal fire safety standards are especially pronounced in the 20 percent to 30 percent of nursing homes that lack sprinkler systems, GAO said.

Fires in nursing homes without sprinklers killed 16 people in Hartford in February 2003 and 15 people in Nashville in September.

“For example, even in the absence of sprinklers, the standards do not require smoke detectors in most nursing homes,” the report said.

“Moreover, walls between resident rooms are not required to resist the passage of smoke, yet residents in rooms adjacent to where the fires originated died from smoke inhalation,” it continued.

Some older nursing homes are not required to have sprinklers if they have not been substantially renovated, even though sprinklers are the most effective means of combating fires, GAO said. Connecticut and Tennessee have passed laws to require sprinklers in all homes.

Industry officials have said they support requiring older homes to install sprinklers, although they believe taxpayers should foot some of the cost, GAO said.

“If retrofitting is eventually required, it is likely to be several years before implementation begins,” the report said.

Medicare and Medicaid payments to nursing homes top $64 billion a year, GAO said.

In response to the report, Mark McClellan, administrator of the federal Centers for Medicare and Medicaid Services, said his agency already is strengthening its inspections of homes and will propose requiring smoke detectors.

The government also is considering whether to require sprinklers and how to pay for their installation, McClellan said.

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