Nursing Home Falls And Pressure Ulcers Underreported: A study published on May 23, 2023 in JAMA Network entitled “Underreporting of Quality Measures and Associated Facility Characteristics and Racial Disparities in US Nursing Home Ratings” investigated what extent are nursing home characteristics associated with reporting rates of major injury falls and pressure ulcers on the Nursing Home Care Compare (NHCC) website.
The report stated: “In this quality improvement study involving 13 179 nursing homes, underreporting of major injury falls and pressure ulcers to the NHCC website was widespread across nursing homes and was associated with few facility characteristics other than racial and ethnic composition. Nursing homes with more White residents had high reporting rates for major injury falls, whereas facilities with more Black residents had higher reporting rates for pressure ulcers … We found that only 60.0% of major injury falls were reported and 67.7% of stage 3 or 4 pressure ulcers were reported.”
The report stated: “The sample included 13 179 nursing homes where 131 000 residents (mean [SD] age, 81.9 [11.8] years; 93 010 females [71.0%]; 81.1% with White race and ethnicity) experienced major injury fall or pressure ulcer hospitalizations. There were 98 669 major injury fall hospitalizations, of which 60.0% were reported, and 39 894 stage 3 or 4 pressure ulcer hospitalizations, of which 67.7% were reported. Underreporting for both conditions was widespread, with 69.9% and 71.7% of nursing homes having reporting rates less than 80% for major injury fall and pressure ulcer hospitalizations, respectively. Lower reporting rates were associated with few facility characteristics other than racial and ethnic composition. Facilities with high vs low fall reporting rates had significantly more White residents (86.9% vs 73.3%), and facilities with high vs low pressure ulcer reporting rates had significantly fewer White residents (69.7% vs 74.9%). This pattern was retained within nursing homes, where the slope coefficient for the association between the 2 reporting rates was −0.42 (95% CI, –0.68 to –0.16). That is, nursing homes with more White residents had higher reporting rates for major injury falls and lower reporting rates for pressure ulcers.”
The researchers concluded: “The findings of this study have policy implications for the current efforts to improve nursing home quality. Underreporting of clinical events to CMS was widespread during the study period. 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. One approach to improving accuracy would be to use more objective data sources such as claims data, as CMS is increasingly doing. Even with alternative data sources, the study found that interpretation of quality measures needs to consider the racial and ethnic composition of nursing homes, which may affect both the prevalence of major injury falls and pressure ulcers and the accuracy of reporting.”
If you or a loved one suffered injuries (or worse) while a resident of a nursing home in the United States due to a nursing home fall and/or nursing home pressure ulcers, you should promptly find a nursing home claim lawyer in your state who may investigate your nursing home negligence claim for you and file a nursing home claim on your behalf or behalf of your loved one, if appropriate.
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