NCPA - National Center for Policy Analysis


December 21, 2004

Two years ago the Bush administration launched a $120 million initiative to provide a public scoring system for nursing homes. The idea was to spur improvements in the nation's 16,500 facilities. Unfortunately, the new system has not improved quality of care, says the Boston Globe.

Comprised of a grading system in eight categories of preventable problems, the program also scores the frequency of pressure sores and the use of restraints on residents. Results are mixed, says the Globe:

  • In one Boston nursing home, the percentage of residents requiring restraints fell from 11 to 2 based on the national grading system.
  • The same nursing home reported only 2 percent of residents experiencing chronic pain, down from 21 percent in 2002.
  • Nationally, however, the percentage of nursing home residents with pressure sores has increased from 8 to 9 percent.
  • Last year, federal officials reported 1,464 cases in which nursing homes put residents' lives at risk, yet only 2 nursing homes were closed.

Some nursing homes have argued that the scores do not take into account the condition of residents when they first enter a facility, and that people entering nursing homes are simply more disabled now than in the past.

Furthermore, officials believed that posting scores on the Internet would rally the public to pressure for change; however, that has not been the case, as family members often make nursing decisions quickly based on guidelines from hospital discharge planners.

While the scores are based on data provided by nursing homes, federal inspectors are too overwhelmed to visit every single home. Last year in Massachusetts, inspectors failed to address 30 percent of complaints from the public involving abuse and neglect with on-site visits.

Source: Alice Dembner, "Substandard Homes Often Allowed to Keep Operating," and Alice Dembner and Bill Dedman, "Nursing Homes Show Uneven Gains," Boston Globe, December 13, 2004.

For text:


Browse more articles on Health Issues