A study published by researchers from Yale School of Management and London Business School determined that violations of standards of care are more severe in religiously affiliated (RA) nursing homes compared to secular facilities. Through an analysis of five years of CMS data on all recorded violations of standards of care (2010-2015), researchers concluded that complaints are less likely to be filed against RA facilities. This lack of complaints ultimately meant there were relatively longer periods between inspections. Once inspections occurred, worse violations were identified because the violations intensified before they were detected. The authors were clear that this finding was not due to poorer levels of care or inspector bias, but rather to the reduced likelihood of complaints being filed.
Nursing home surveys are performed according to survey protocols and Federal requirements. In addition to state surveyors conducting at least one survey per year, surveys can also be performed on an ad hoc basis when complaints are submitted by residents, their families, or third parties, such as ombudsmen. Monitoring the care loved ones receive in nursing homes is an important tool to ensure quality of care.
The authors note that an organization’s religious affiliation often fosters a “cognitive and emotional link between the organization and its members.” Furthermore, members might act with the organization’s interests in mind instead of their own. The authors contend that it is the attributions of “religious organizing, instead of a belief in God, that likely plays a role in reporting and, in turn producing wrongdoing in religious organizations.” The researchers recommend policymakers recognize the important role residents and their families play in enforcing quality standards in nursing homes.
April 21, 2022 – C. St. John
 CMS. (n.d.). Nursing Homes. CMS.gov. Available at: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/GuidanceforLawsAndRegulations/Nursing-Homes
 Institute of Medicine (US) Committee on Nursing Home Regulation. (Jan. 1, 1986). Monitoring Nursing Home Performance. Improving the Quality of Care in Nursing Homes. Available at: https://www.ncbi.nlm.nih.gov/books/NBK217555/
 Human Rights Watch. US: Concerns of Neglect in Nursing Homes. (Mar. 25, 2021). Available at: https://www.hrw.org/news/2021/03/25/us-concerns-neglect-nursing-homes