Our View

Missouri needs an accessible public database to provide information on nursing home inspections, complaints and results.

The past year has been tough on nursing homes and their residents. During the coronavirus pandemic, COVID-19 infection was a huge challenge. Many residents and staff members contracted the novel coronavirus. Waves of residents and some staffers died. Because of the risk of contagion, access to nursing homes was shut down.

A CNHI investigation into nursing home oversight found federal records show the pandemic dramatically worsened preexisting oversight problems.

There are approximately 1,165 long-term care facilities with more than 81,100 beds licensed and inspected by the Missouri Department of Health and Senior Services. About 500 of those facilities participate in federal Medicaid and/or Medicare programs. Residents and family members of those in the homes rely on a system of inspections — many triggered by complaints — to protect the residents of those facilities.

Those considering nursing home care also depend on that system. The public needs to be able to evaluate homes, to judge the quality of their care and to be aware of abuses. But DHSS provides little information that can be readily evaluated by consumers.

The agency provides only a list of the types and dates of inspections by individual nursing homes. To see any plan of correction, one must download an image file of the document for each inspection. Those documents are a mix of handwritten and typed notes that are not readily evaluated by residents, families or the general public. The documents are not compiled, and there is no straightforward way consumers can judge the performance or safety of the home and no way for them to evaluate the safety of the industry in Missouri.

DHSS has a history of being secretive with the public. Answers about nursing home problems have been hard to come by. Officials refer questions back to individual facilities. And there have been problems with this industry and the agency’s oversight.

From January to April 2019, only about 39% of calls to the Missouri Elder Abuse Hotline were answered, according to records obtained by The Columbia Missourian and the NPR station in Columbia, KBIA. That reporting led to an investigation, which led to the creation of a new online reporting portal. Those reports are often the reason for inspections.

Licensed long-term care facilities are required to publicly post their most recent inspection results in a location readily accessible to residents and the public.

The Legislature should require DHSS to create a database to provide summaries of those complaints, inspections and actions for nursing homes and compile the data in a way that residents and families can evaluate their oversight of facilities and the industry.

Older adults are often vulnerable, both because the cost of care can exceed their resources and because chronic illness and the decline that can accompany aging require extra care and make them less able to defend themselves. Our state has a responsibility to ensure the industry that cares for many of them is accountable and that information is available to the public in a meaningful way.

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