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Analysis: Racial Disparities Uncovered in Quality of Nursing Home Care

It’s been well-documented that the state of nursing homes in the U.S. warrants improvement. However, a recent, multi-pronged analysis suggests the degree of care received by minorities is markedly below what their white counterparts receive.

The research, published by the Center for Public Integrity, noted some stark differences between nursing homes catering to majority white residents, versus mostly minority residents. For example:

  • Majority-white facilities had, on average, 60 percent higher rates of registered nurse care levels as compared to Latino-majority nursing homes and nearly 35 percent higher than facilities catering to majority black residents.
  • Majority-black nursing homes allowed for an average of just 20 minutes of registered nurse care per patient per day.
  • Eight of the 10 states with the largest levels of reporting discrepancies are in the South.

The amount of care a patient receives – particularly by registered nurses – is known to directly correlate with the overall quality of care. So this kind of disparity is especially troubling, especially when considering researchers controlled for issues such as rural versus urban, the level of patient self-sufficiency upon admission and the percentage of days paid by state and federal health care assistance programs.

However, even when residents were equally sick and equally poor, minority residents continued to receive a level of care that was far less than those received by white residents.

Title VI of the Civil Rights Act of 1964 bars discrimination on the basis of race, national origin and color by health care providers taking in dollars from federal programs like Medicaid and Medicare.

While it’s not clear whether certain facilities are violating individual civil rights, patient advocates say it’s clear some centers are taking advantage of certain situations in which there are lower expectations.

Researchers, who sifted through more than 14 million records, also took note of the fact that nurse staffing levels as reported to the U.S. government for its Nursing Home Compare ratings were higher than what were reported to Medicare for reimbursement. This is indicative of the fact that many nursing facilities have taken to a practice of “staffing up” in anticipation for inspections and annual reports.

The federal government has sought to change this by requiring nursing homes to submit quarterly staffing reports, which will hopefully give a more accurate reflection of actual staffing year-round. That might allow the government to pinpoint facilities that have chronic staffing deficits.

In one example, a nursing center on Miami Road in Fort Lauderdale reported nearly 5 hours each day of per patient care to the Nursing Home Compare regulators. But when the actual hours of patient care were compared based on Medicare cost reports, it was actually closer to 4 hours. While more than 1 hour of registered nursing home care was reported, cost reports indicated the actual figure was less than half that.

Those kind of disparities existed across the board (more than 80 percent self-reported higher registered nursing homes than what the Medicare cost sheets indicated), but they were significantly more pronounced in facilities catering to mostly black or Latino populations. In a quarter of all cases, the amount of registered nursing care listed on the federal Compare site was double or more what the reimbursement documents indicated.

What this means is families believe their loved ones are receiving one level of care, when in fact they are often getting less.

It’s usually only after a family learns of nursing home abuse, neglect, deterioration or avoidable complication that its revealed a center was sorely understaffed.

Freeman Injury Law — 1-800-561-7777 for a free appointment to discuss your rights.

Additional Resources:

How data-driven journalism revealed disparities in U.S. nursing homes, Feb. 13, 2015, By Jeff Kelly Lowenstein, The Center for Public Integrity

More Blog Entries:

Report: Addicted Nurses Pose Risk to Patients, Dec. 10, 2014, Fort Lauderdale Nursing Home Abuse Lawyer Blog

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