Ombudsman presence could worsen survey outcomes for nursing homes, study finds

Nursing homes could be subject to worse deficiency outcomes — which could lead to fines and a decreased star rating — if an ombudsman is present during annual surveys, according to new research. 

Investigators with Penn State and Miami universities found that the appointees presence was linked to a 3.9% increase in the number of deficiencies and a 5.9% increase in deficiency scores. Those for quality of life and administration were impacted the most. 

“The additional deficiencies can cause NHs to face monetary fines or cause a NH that is just above the threshold for a certain star rating on the NHC website to lose a star (e.g., going from 5 to 4 stars),” the researchers wrote. “All of these can financially harm the NH and result in fewer resources that could be used to improve quality.”

An ombudsman was present for about 30% of surveys nationwide, the study found. Ombudsmen were present for 82% of surveys in Massachusetts — the most of any state.

The states with the fewest surveys with an ombudsman present were New Hampshire (0.8%) and Kansas (1.5%).

“The survey process may disproportionately affect NHs that have an ombudsman present, and this should be considered when comparing deficiency outcomes across NHs, especially in litigation settings,” investigators concluded while calling for more research on the issue. 

“Ombudsman can have an impact on quality measures and hopefully their work will result in better quality of care and quality of life for their residents,” they added.