Nursing home fines declined even as the number of deficiencies increased, according to a new report released last week by the Long Term Care Community Coalition (LTCCC), a New York-based nonprofit.
LTCCC’s report, which analyzes deficiencies and fines on a per-resident basis rather than solely per facility to assess the impact on nursing home residents, found that 94% of nursing home deficiencies cited nationwide from 2022 to 2024 were classified below the level of actual harm. Meanwhile, the number and amounts of fines declined.
Although deficiencies increased in 2024 compared with 2022, fines declined 56.5%, with 49 states imposing fewer fines in 2024.
Average fines per resident also fell, from $186 in 2022 to $153 in 2024. Illinois had the highest fines per resident, at $465, while Arizona had the lowest, at $35.
The report also found significant state variations in the number and severity of deficiencies cited in five areas: infection prevention and control, nurse staffing, pressure ulcers, antipsychotic drugs and residents’ rights.
Whereas Tennessee classified 11.3% of infection-control deficiencies as causing harm or placing residents in immediate jeopardy, four states — Alabama, Alaska, Maryland and Nevada — and the District of Columbia cited no infection-control deficiencies at those severity levels during the three-year period.
Thirty states, the District of Columbia and Puerto Rico did not cite harm from understaffing in any nursing home in 2024.
Moreover, 10 states did not classify any antipsychotic drug deficiencies as causing harm or immediate jeopardy during the three years studied.
LTCCC describes the findings as evidence of a “persistent accountability gap” and called for stronger, more consistent and more resident-centered oversight and enforcement.
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