An audit of the state's nursing home inspectors found that they are too slow and lenient, and that poor practices in nursing homes "potentially compromise quality of care and resident safety."

Jim Martin, director of the Colorado Department of Public Health and Environment, blamed budget cuts during the recession that left inspection teams too short-staffed to do the job.

He said the department expects to suggest changes next year in the number of inspectors, the work they do and the license fees paid by nursing homes.

Nursing homes provide care for very sick patients, who would have been in a hospital under the standards of 10 years ago. The average nursing home now costs $75,000 a year for private clients. Colorado pays $33,000 to $70,000 for indigent patients.

In one key finding, auditors spot-checked 60 patient evaluations in 10 nursing homes. In 65 percent of the cases, discrepancies indicated that the residents were not getting the right level of care.

As a result, state and federal aid programs, which pay out $465 million a year for nursing home care, are being charged the wrong amounts, the audit said.

But Arlene Miles, spokeswoman for the industry's Colorado Health Care Association, said the sample was too small to be accurate for the state's 220 nursing homes and 17,000 patients.

She also said the negative findings don't mesh with other studies. For example, she said Colorado nursing homes have fewer patients with bedsores and fewer unintentional cases of giving patients psychiatric drugs than facilities elsewhere.

The audit also determined that the department is completely skipping a legal requirement to check whether nursing home owners are professionally competent and have enough financial resources to run their facilities. As a result, the audit said, the state may be providing false assurances to the public.

The department blamed lack of funds. Colorado's license fee is $350, some 13 times less than the average in neighboring states.

The report also said it checked five nursing homes for plans to deal with mass casualty disasters.

None had one, even after Hurricane Katrina killed numerous nursing home residents, including some remaining in their facilities and others being evacuated on a faulty bus.

Problems

Most common incidents at nursing homes, past five years

• Physical abuse 506

• Verbal abuse 132

• Sexual abuse 110

• Misappropriation 99

• Missing persons 88

A recent state audit of nursing home inspections found:

• Auditors found more problems than state inspectors did in seven of 10 nursing homes checked, including failure to follow the individual patients' care plans and infection control problems.

• Federal inspectors who did similar reviews found twice as many problems as state inspectors had. Federal officials estimated state inspectors missed 130 violations.

• Over the past five years, 70 percent of the 160 high-priority incidents, such as unexplained deaths or injuries, were not fully investigated within 15 days as required.Source: Colorado State Audit