01:00 AM EDT on Sunday, August 22, 2004

The record of a nursing home inspection is supposed to be public information -- but how soon can the public get to it?

In Rhode Island, it can take a month, even if an inspection uncovers serious violations.

The Health Department, in order to be business friendly, allows nursing home operators a grace period in which to attach comments before inspections become public.

In New Hampshire, inspections are public "almost immediately," says Raymond Rusin, chief of facilities regulation for the Rhode Island Department of Health.

Rusin was formerly chief of facilities for New Hampshire's Department of Health & Human Services.

When he took the position in Rhode Island in 2002, he says, he started to make inspection reports public right away. He was told by his staff: that's not how we do it here.

Rhode Island's Health Department has 10 business days to get the report to the nursing home. The nursing home has 15 days to return a "plan of correction."

After that, inspections become public and the documents are posted on the Health Department's Web site. Also, a nursing home is supposed to make its recent inspection available by posting a notice at the facility.

There is another tool for family members -- the federal Centers for Medicare & Medicaid "nursing home compare" Web site.

It gives a particular home's last three inspections and compares nursing homes in each state in several categories.

But click on Rhode Island, and you will find that much of the information is based on 2002 inspections. Why the old data?

The federal agency asks states to send certain information for a nursing home: the annual Health Department inspection and fire inspection.

In Rhode Island, however, the fire marshal's office is behind in putting the data into a computer. The office says it was lacking a certain program to do the federal report.

"A lot of the inspections were done, but didn't get to facilities regulation," Rusin says. "They had a problem with the turnover of clerical staff, and inputting into the system." The federal government won't update a nursing home's information online until it has the complete package of fire and health inspections.

In the meantime, family members might walk into the Health Department and ask for the inspection history of a particular nursing home.

Rusin says: "I'm not prepared resource-wise to do on-demand service. We really can't stop and go make copies."

He will, however, get the information together in a matter of days, he says.

Some visitors just want to know which nursing homes they should avoid.

"We don't have a system for saying, 'Don't go there,' " Rusin says. "We really have to be careful. We can't be in a situation where we are defaming or badmouthing a facility even though they may have deficiencies. That can very quickly turn into a lawsuit."

Jennifer Levitz

Digital Extras:

Reports of Rhode Island nursing home inspections can be viewed at:

www.health.ri.gov/topics/nursinghomes.htm

Federal Nursing Home Compare

www.medicare.gov/nhcompare