Hawaii nursing homes were cited for violations by federal regulators more than 400 times in the last two years, according to a new online tool that allows users to search and review problems at thousands of nursing homes nationwide.

ProPublica, an investigative news outlet, recently launched the app to help concerned citizens access timely government inspections of the facilities that provide care for 1.5 million older Americans.

A search on Nursing Home Inspect for Hawaii’s deficiency reports turns up 51 results. These can be sorted by degree of severity, date, city and name of the facility.

The feds tagged Hawaii nursing homes with 409 deficiencies between July 22, 2010 and April 2, 2012. Most were on the less severe side of the rating scale.

A random review of the reports reveals a range of issues that long-term care residents experienced: significant unintentional weight loss; nurses giving residents new pills without their consultation; dead geckos in rooms; a failure to monitor the efficacy of medication; and a two-hour wait for a change of wet underwear.

Ka Punawai Ola had the most severe deficiencies. In December 2010, inspectors dinged the Kapolei facility for a variety of violations where harm occurred but did not pose an immediate threat to resident health or safety. The full report is available by clicking here.

The most recent report in the database was April 2 for Kulana Malama. The Ewa Beach nursing home was cited for nurses walking into residents’ rooms without knocking and improperly storing food. The full report is available by clicking here.

But as ProPublica reported, nursing home officials caution against drawing comparisons about the quality of care based on what’s in the inspection reports. They say that inspectors in different regions of the country have different thresholds for issuing a citation, and that could unfairly make one state’s homes appear worse than another’s.

In Hawaii, the state Department of Health’s Office of Health Care Assurance responds to complaints about nursing homes. The office licenses and certifies health care facilities to ensure compliance with established standards of care. Susan Naka, interim director, could not be reached for comment for this story.

John McDermott serves as the state’s federally mandated long-term care facility ombudsman. In this role, he advocates for folks living in nursing homes and other care facilities.

He hadn’t heard about the new Nursing Home Inspect tool, but was familiar with a similar one managed by the federal government called Nursing Home Compare.

McDermott said he tells families about Nursing Home Compare in terms of educating them. He said when state inspectors look at facilities, they review three main things: how widespread is the issue; how severe; and whether there’s a pattern.

“We use it as a tool to get people to be aware of how good a facility is,” he said. “But if someone wants to move, for instance, and is not sure where they want to move to, nothing beats going on a tour. That information is a year old because the surveys are only done annually.”

ProPublica expects its database will make the inspection reports and other public information about nursing homes more accessible.

Arguing that awareness is an answer, advocates for nursing home residents have long pressed oversight agencies to make inspection reports readily available to the public. But until last month, consumers, researchers and journalists had to file formal Freedom of Information Act requests to view them — or visit in person, because homes are required by law to make them available, ProPublica reported. Users can search across all the reports by any keyword, such as elope — a feature the federal government’s official nursing home website doesn’t have. The results can then be sorted by both the severity of the violation and by state.

McDermott said a facility can dramatically change for the better or worse with a new administrator, director of nursing or director of social services. The inspection reports are important information, he said, but shouldn’t be the only thing people rely on.

McDermott has been pushing — unsuccessfully — for the state to develop a website for folks who want to know more about the inspections of nursing homes as well as all the different types of long-term care facilities.

Nursing Home Compare and Nursing Home Inspect, for instance, are only for nursing homes. But most of the state’s elderly who are receiving long-term care are in other types of facilities.

McDermott said that as of April 2012, Hawaii has 11,555 long-term care beds at 1,646 facilities. There are 51 nursing homes with 4,397 beds; 500 adult residential care homes with 2,676 beds; 11 assisted-living facilities with 1,872 beds; 1,084 community care foster family homes with 2,610 beds.

There are different legal and technical distinctions between the different types of facilities, such as number of beds allowed and certification requirements for the nurse on duty.

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