Nursing home deficiencies causing actual harm to residents declined from 7.0 percent to 6.5 percent from 2003 to 2004, while patient abuse remained stable at 17 percent of complaints, according to a new analysis of the ratings HealthGrades annually gives to nearly every nursing home in the country. Overall, the deficiencies cited per nursing home declined 2.0 percent from 2003 and 2004, the analysis found.

"We are not seeing the declines in actual harm to the nation's 1.6 million nursing home residents that we should," said Samantha Collier, MD, vice president of medical affairs for HealthGrades, the leading healthcare ratings company. "But we did discover some interesting facts that will help people make a smarter decision, including the finding that the top ten nursing homes in each state tend to have nearly half as many beds as the worst ten in each state – something everyone should think about when choosing a nursing home."

The ratings for each of 15,375 Medicare/Medicaid certified nursing homes can be found in HealthGrades' Nursing Home Quality ReportsTM, available to consumers at www.healthgrades.com.

The analysis of the nation's nursing homes from the years 2003 to 2004 also finds:

• The typical number of beds for nursing homes in the top 10 of each state was 74 beds, compared to 132 beds for the bottom 10.
• The most frequently cited deficiencies in 2004 were:
• Facility must store, prepare, and distribute food in a sanitary manner.
• Facility must provide services to improve and maintain their residents' well being.
• Deficiencies causing actual harm that did not decline from 2003 to 2004 were:
• Accidents
• Resident status
• Pressure sores
• Patient abuse
• Accidents made up more than 25 percent of all actual harm citations. Maintaining a resident's highest practical functioning and well-being level – also known as resident status -- was 18 percent, pressure sores were 14 percent, and patient abuse was 9 percent.
• Complaint investigations decreased 9 percent. However, the most frequent complaint, about care or services, stayed consistent from 2003 to 2004: Nearly 40 percent of investigated complaints refer to concerns about the resident's care or services provided.
• Patient abuse is the next most frequently cited complaint that was consistent each year. About 17 percent of complaints investigated related to this subject matter.
• Resident neglect, the third most frequently cited complaint, rose slightly from 2003 to 2004, from 13 percent to 15 percent.
• Although food services was the most frequently cited by surveyors in annual inspections, it was the source of only two percent of the complaint investigations.

The findings echo the conclusions of the Government Accountability Office (GAO). Then known as the General Accounting Office, the GAO issued a report in 2002 that found a high proportion of nursing homes with serious quality problems. HealthGrades' analysis supports these government findings.

HealthGrades' Nursing Home Quality Reports include star ratings of nearly every nursing home in the country, allowing individuals to make an informed comparison of local facilities. The reports also include state investigation reports, recurring complaints, and tips on asking the right questions during an interview. Reports are available online for $9.95 for the first purchase, and $2.95 for additional reports.