Report Says Nursing Homes Underreport Bedsores, UTIs and Falls


A report based on public data analysis says that nursing homes underreport serious injuries like bedsores, urinary tract infections (UTIs) and falls.  The report comes from Integra Med Analytics, and Austin-based company that performs analysis of public healthcare data.  The goal of their analyses is to prevent fraud and nursing home abuse or neglect

Report shows Nursing Homes Underreport Injuries

The report from Integra Med Analytics compares data from the Minimum Data Set.  It compares the rate of bedsores, UTIs and falls against records generated by hospitals for readmitted residents.  The research only includes injuries that were “present on admission.” That way, it eliminates conditions that could have developed while the patient was in the hospital. 

The report shows direct evidence of underreporting of bedsores.  There was no direct correlation between nursing homes and hospital reporting for any of the three injuries.  The report notes that nursing homes with low reporting rates may have higher hospital-based rates.  It says,

“SNFs [skilled nursing facilities] with low self-report rates may have high hospital-based rates and vice-versa.  For example, a SNF home we analyzed had a low self-reported UTI rate of less than 1 in 1,000 which is in the first percentile of the self-reported rates.  However, 5.8% of this SNF’s admissions were re-hospitalized with a UTI, which is in the 86th percentile for the hospital-based measure.”

Most Underreported Injuries in Nursing Homes

The Integra report shows that the three most underreported injuries in nursing homes are bedsores, UTIs and falls.  Their report shows the following:


In the case of bedsores, Integra notes that more than 50 percent of nursing homes underreport bedsores.  While they do not attempt to discern motive for not reporting, they note that any reason for not reporting a bedsore and getting medical attention is concerning. 


For UTIs, Integra notes that facilities with low self-report rates often have high re-hospitalization rates.  One facility analyzed in the report had a UTI rate of less than one in 1,000 residents.  However, almost six percent of residents were re-hospitalized with a UTI, which is in the 86th percentile for hospital-reported cases.   


For falls, the measures relate more to long-stay nursing home residents, rather than short-stay hospital patients.  The report notes that nursing homes good at fall prevention for long-stay patients should be good at fall prevention for short-stay patients.  Unfortunately, no such correlation was noted in data.  This suggests a gap in fall prevention strategies among nursing homes. 

More Data On the Way

Integra is allowing the public to access their research.  They are continuing to study nursing homes across the United States.  They also say that they plan to extend their research to include evaluations of nursing homes on additional metrics.  Upcoming research includes staffing levels, potential abuse or neglect and previous risk of excessive treatments. 

Importance of Metrics for Nursing Homes 

Nursing home metrics are important for a variety of reasons.  Primarily, metrics provide the public with a glimpse of how nursing homes perform on quality metrics established by the Centers for Medicare and Medicaid Services (CMS).  When the public has access to this information, they can better determine if a nursing home is appropriate for their loved one. 

Metrics are also important for the healthcare industry.  Quality measures help healthcare providers understand where there are gaps in care inside facilities.  Providers can then make sure that patients are getting the care that they need. 

Metrics are also important for regulators and advocates who help ensure that the rights of nursing home residents are protected.  Quality metrics and performance helps regulators understand where laws and policies may need to change.  It provides a look at what is working and what may need improvement. 

Have Concerns about Care at a Nursing Home?

If you have a loved one living in a nursing home and they develop a bedsore, UTI or fall injury, you may have concerns about their care.  Nursing homes must adhere to a certain standard of care, including making sure that residents are treated fairly, have adequate services to meet their needs and have access to medical care.  When nursing homes fail to meet these standards, they put resident comfort, health and wellbeing at risk. 

If you have questions or concerns about nursing home care, or believe that your loved one is being abused or neglected, contact Nursing Home Abuse Center.  Speak with one of our legal professionals to find out how you can protect your loved one.  For a free consultation, call us at 1-866-548-9636.


meagan cline

Written By Meagan Cline

Meagan Cline is a professional legal researcher and writer. She lends her expertise to FNHA and our websites, including Birth Injury Guide and