December 23, 2021 – LTCCC publishes a bimonthly newsletter highlighting nursing home “no harm” deficiencies from across the United States. Today, we’re releasing a new report featuring all of the Elder Justice Newsletters published in 2021 and a user-friendly guide detailing the 32 “no harm” deficiencies covered this past year. Users can sort the guide by F-Tag, provider name, CMS star rating, state, city, and zip code.

Example from the Elder Justice Newsletter:

  • A black eye: Nursing home fails to prevent physical abuse.
    In this deficiency, a facility staff member struck the resident in the face and left the resident with a bruised eye. The altercation began when the resident took an item from a medication cart, and the staff member tried retrieving the item by reaching over the top of the resident. When the resident (identified as having the potential to exhibit physically aggressive behaviors) hit the staff member, the staff member retaliated by striking the resident in the face. The resident suffered a bloody nose and a bruised eye. Still, the surveyor cited the violation as no harm.

Federal data indicate that most health violations (more than 95%) are cited as causing “no harm” to residents. The failure to recognize resident pain, suffering, and humiliation when it occurs too often means nursing homes are not being held accountable.

Broken Promises: An Assessment of Nursing Home Oversight

What is a “No Harm” deficiency? Nursing homes voluntarily participating in the Medicare and Medicaid programs agree (and are paid) to adhere to minimum standards of care established by the federal Nursing Home Reform Law and its implementing regulations. These standards exist to ensure that every nursing home resident is provided services that help attain and maintain their “highest practicable physical, mental, and psychosocial well-being.” Under the Reform Law, nursing homes that fail to meet the federal requirements are subject to various penalties, based on the scope and severity of the violation(s).

The Elder Justice Newsletter, published bimonthly with the Center for Medicare Advocacy, provides examples of health violations in which surveyors identified neither harm nor immediate jeopardy to resident health, safety, or well-being. The newsletter aims to provide readers with real stories of resident pain, suffering, and humiliation from across the country, so that readers can judge for themselves whether a violation was “no harm.” The examples are taken directly from Statement of Deficiencies (SoDs) on CMS’s Care Compare (formerly Nursing Home Compare) website.

To receive the bimonthly Elder Justice Newsletter, please sign up for LTCCC alerts at