A study from the U.S. Department of Health and Human Services reveals Nevada has the third-worst record among the states for failing to report nursing home falls that result in a major injury and require hospitalization.
Falls are the leading cause of death for Americans 65 years of age and older, and are responsible for more than 30,000 deaths a year, according to the Centers for Disease Control and Prevention.
The Nevada Health Care Association represents assisted living and skilled nursing facilities. It did not respond to requests for comment on the report’s findings.
Nationally, 43% of nursing home falls involving Medicare patients are not being reported, according to the report. In Nevada, 60% of nursing home falls were not reported. The rates for failure to report ranged from a low of 21% in South Dakota to a high of 64% in Washington, DC., followed by California with 61%.
The data, which is supposed to be provided to the government by nursing homes, is used for the Centers for Medicare and Medicaid Services Care Compare website, which is intended to provide consumers with quality of care information.
Failing to report “leads to inaccurate fall rates on Care Compare,” the report says. Facilities with the lowest fall rates on the government website were the least likely to report, suggesting that “low fall rates for nursing homes on Care Compare are likely driven by nursing homes’ failure to report falls, rather than an actual low incidence of falls.”
A large, nonprofit nursing home with more than 200 beds in New York had a 5-star overall rating on Care Compare, the highest possible, and reported three falls with major injuries that required hospitalization. The Office of Inspector General, which wrote the report, found the nursing home had 13 falls.
“Providers may have a disincentive to report events, such as falls, that could result in lower scores on quality measures,” says the report. “Previous analyses by OIG and others have identified under-reporting by providers.”
The report is based on data from falls reported to have occurred between July 2022 and June 2023. The OIG found:
- For-profit, chain nursing homes, and larger facilities failed to report falls most often;
- Nursing homes failed more often to report falls of younger residents, male residents, short-stay residents, and residents with only Medicare coverage;
- Reporting of falls was worse in “nonrural” nursing homes;
- Most falls involved the oldest residents, and the percentage of unreported falls (38%) was lowest among those 85 years and older;
- The percentage of unreported falls was highest (55%) among those younger than 65 years, who qualified for Medicare because of disability or end-stage kidney disease.