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Check Out Nursing Home Ratings

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By ADON TAFT

Published: December 11, 2007

Two weeks ago the federal Centers for Medicare and Medicaid Services (CMS) issued its first report on the worst of the nation's 16,400 nursing homes. Three of the 54 homes rated the most consistently poor in the quality of care provided to clients are in Florida.
One — the Apollo Health and Rehab Center — is in St. Petersburg. The other two are in South Florida — the Key West Convalescent Center and the Palma Rehabilitation and Nursing Center in Lauderdale Lakes.
Nearly every nursing home, including the five in Hernando County, has some deficiencies, according to CMS. But most are minor and are not life or health threatening. None of the local homes is among the nearly 130 listed as under a "special focus" watch.
The homes are judged on 19 quality points such as adequate nursing and care staff for the number of residents, proper administration of medications, frequency of bed sores among patients, nutritious value and proper handling of food, cleanliness, safety and activities for residents.
Most deficiencies found during annual inspections are not considered serious unless the facility administrators fail to take corrective action over a period of two or three years.
Such homes recently have been under the surveillance of Congress. In the last couple of weeks, the Senate Special Committee on Aging, headed by Sen. Herb Kohl, D-Wisconsin, considered penalties "not to be punitive" but to "see to it that the people in these nursing homes get better quality care or that they get opportunity to move somewhere else."
About 1.5 million elderly and disabled persons live in nursing homes where they receive some $72.5 billion annually in subsidized care.
Testimony by some witnesses before that committee and before the House Ways and Means Committee cited the concerns expressed in earlier investigative articles by the New York Times and other newspapers that part of the problem may result from private equity firms buying nursing home companies, cutting costs and then reselling the chain of homes at a profit.
In some of those situations, the Times reported, the number of safety violations rose, budgets and staffs were cut and patient care suffered after the change of hands.
In light of those reports and since Medicaid and Medicare programs pay for 61 percent of total U.S. nursing home expenditures, the government is concerned about developments such as the acquisition earlier this fall of Manor Care Inc., the largest nursing home owner in the country, by the Carlyle Group for $4.9 billion, excluding assumed debt.
Takeovers by private investment companies do not necessarily mean a cut in the quality of care. Three of the five Hernando County nursing homes looked at by the CNN are owned by for-profit corporations. One of those homes, Heartland of Brooksville, at 575 Lamar Ave., has the lowest number — five — of health deficiencies among local facilities. However, it does have two fire safety issues facing its 100 patients.
One of the nonprofit homes — Evergreen Woods, at 7045 Evergreen Woods Trail in Spring Hill — has the best rating of the local group for its ratio of licensed nurses and nurse assistants to the number of residents. That home has 104 patients and the average time a nurse has with each is one hour and 53 minutes. Certified nursing assistants spend about three hours and 34 minutes with each resident.
However, that facility is tied for the worst record for the number of health deficiencies, nine, and has one fire safety problem, according to the CMS.
That record on health deficiencies is shared by corporately owned Heron Pointe Health and Rehab, 1446 Howell Ave. Heron Pointe has the lowest ratio of LNs to its 114 residents, the largest number of any nursing home in the area. A nurse spends no more than 1 hour and 16 minutes with a patient and a CNA has just two hours and 46 minutes.
Even the best of nursing homes are understaffed, according to Charlotte Harrington, a professor at the School of Nursing at the University of California, San Francisco, who has testified on the subject before Congress.
"Aging Today," the periodical of the American Society on Aging, which is made of care-givers and other geriatric specialists, recently quoted her as saying that most homes fall far short of the number of nurses recommended in a study done for the CMS.
While the study recommended a minimum of 4.1 hours a day of care by nurses and their assistants per resident, the actual average is less than 3.7 hours a day, a level that she notes has not changed since 1997.
In addition, she said, the ratio of licensed nurses to patients has dropped by 14 percent since 2000.
If you want to check out the rating of a nursing home you or a member of your family is considering or where someone close now is a patient, you can find it at Medicare's Web site.
Go to www.medicare.gov/ and click on Nursing Home Compare.

Adon Taft is a resident of Brooksville. If you have questions about any issue connected with aging, except medical conditions, write to "Life to the Fullest," Hernando Today, 15299 Cortez Blvd., Brooksville, Fla. 34613.

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