Consumer Complaints in Nursing Homes: Analyzing Substantiated Single-Allegation Complaints to Deficiency Citations

ABSTRACT

Complaints provide important information to consumers about nursing homes (NHs), but how substantiated complaints map onto deficiency citations is unknown. The purpose of this study is to understand the relationship between substantiated complaints and deficiency citations. Federally collected NH complaint and inspection records were obtained to identify all single allegation, substantiated complaints for NHs across the U.S. in 2017. Overall, the 369 complaint allegations in our sample resulted in a total of 585 deficiencies at the inspection stage; however, 35.2% of the allegations led to no deficiencies. Nearly two-thirds of the 369 substantiated single allegation complaints were categorized at the intake stage as quality of care (31.7%), resident abuse (17.3%), or resident neglect (14.1%). Further, 18% of the inspection deficiencies originated with complaint allegations that were prioritized as immediate jeopardy at intake, but of these, 71.4% were determined upon inspection to constitute “no actual harm with potential for more than minimal harm.” These results provide evidence that complaints have the potential to provide unique valuable information on NH quality of care and draw regulatory attention to consumers’ concerns. Future studies should include qualitative research concerning complaint processes by conducting interviews/surveys of complainants, NH staff/administrators, long-term care ombudsmen, and state officials.

KEYWORDS:

• Complaint investigation
• deficiencies
• nursing home
• substantiation

Acknowledgments

This paper is dedicated to Dr. Kathryn Hyer, who was instrumental in designing this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

We acknowledge support from The Patrick and Catherine Weldon Donaghue Medical Research Foundation.