ND nursing homes have nation’s lowest rate of serious deficiencies

FARGO – Inspections of North Dakota nursing homes resulted in the lowest number of serious deficiencies in a review of reports for all 50 states.

Figures compiled by ProPublica, an independent news organization, found that North Dakota nursing homes had one serious deficiency during the past three years, and had the lowest rate of serious deficiencies in the nation.

North Dakota’s rate of serious deficiencies per nursing home was 0.01. South Dakota recorded the second-lowest rate, 0.03, while Minnesota’s serious deficiency rate was 0.13.

A spokesman for the Denver region of the Centers for Medicare and Medicaid Services, which oversees North Dakota, said the numbers reflect good nursing home care in the state, not lax oversight.

“This doesn’t surprise us at all,” said Michael Fierberg, a spokesman for Medicare and Medicaid, which pay for nursing home services and oversee care in partnership with the states.

“To me, this is a result of which North Dakota should be quite proud. It’s as simple as that.”

ProPublica, citing an earlier report by the Government Accountability Office, said enforcement of nursing homes varies widely among the states, and often falls short.

States contract with the federal Center for Medicare and Medicaid Services to inspect nursing homes, and the state and federal governments split any fines for violations.

North Dakota inspectors, who noted 1,408 total deficiencies in 83 nursing homes, levied no fines during the past three years, according to the ProPublica report.

South Dakota inspectors found 1,330 total deficiencies and three serious deficiencies in 111 homes, and imposed no fines.

Inspections of Minnesota’s 379 homes found 8,547 total deficiencies and 50 serious deficiencies, resulting in 128 fines totaling $234,077.

The most serious deficiency included in the inspection reports compiled by ProPublica for North Dakota involved inspections of a nursing home in Hettinger in which proper lifts were not used to move residents, and serious injuries resulted.

The problems were addressed, said Bruce Pritschet, who oversees nursing home inspections for the North Dakota Department of Health.

North Dakota rarely imposes civil monetary penalties, and does so only in the most severe cases, he said.

“We call it the big gun,” Pritschet said, adding the penalty is used only for “very serious, very egregious situations.”

The first level of sanction is to freeze a nursing home’s patient admissions until the deficiencies are addressed. Most regain compliance within the 15-day notice period, he said.

“Most of them pull all the stops to get the corrections made,” Pritschet said.

He added: “I don’t believe it’s lax. If anything, we probably hold them to a higher standard,” since the state only has to inspect 83 homes.

The Centers for Medicare and Medicaid Services, which must approve all fines, typically levies fines when nursing homes fail to rectify problems, Fierberg said.

“It’s not our goal here to extract as much money from the outliers as we can,” he said. Getting nursing homes back into compliance with standards is the goal.

In North Dakota, South Dakota and other neighboring states, “When we do find problems they are quickly resolved,” Fierberg said.

Shelly Peterson, president of the North Dakota Long Term Care Association, which represents nursing homes, welcomed the ProPublica findings.

“We’re very, very pleased with the information,” she said. “Facilities work very, very hard to meet the standards.”

Incidents highlighted in the ProPublica report included two nursing home deaths, one in Texas and one in South Carolina.

Readers can reach Forum reporter Patrick Springer at (701) 241-5522

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