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Five star ratings; National program now ranks nursing home facilities

Sunday, December 28, 2008

(Photo)
Dorothy Little, a resident of the Golden Living Center-New Madrid, is assisted into a rocking chair by Doris Daniels, a certified nursing assistant. The New Madrid nursing home received four out of five stars in the recent ratings by the Centers for Medicare and Medicaid Services. Jill Bock, staff
SIKESTON -- For the most part, nursing home facilities in Scott, New Madrid and Mississippi counties received average scores in the five-star rating system recently released by the Centers for Medicare and Medicaid Services.

There are 12 facilities in the three-county area. One received four out of five stars overall; six were awarded three of five; three received two of five stars; and two ranked at the bottom, with one of five stars.

"It's a really big deal for us," said Kim Kellams Ivie, administrator of the Golden Living Center-New Madrid, which earned four out of five stars. "It's the result of a lot of hard work and dedication on the part of our employees who are committed to working every day to improve our quality of care and patient experience."

The recently released five-star rating system scores the nation's 16,000 nursing homes. It gives an overall rating, in addition to ratings in three other areas: health inspections, nursing home staffing and quality measures. Only the top 10 percent of nursing homes were eligible to receive five stars.

Ivie said the reviews are nothing new. But the five-star rating system, and ability to compare up to three nursing homes, are.

However useful it may be, the online information should not replace any of the steps people currently go through when placing a loved one in a facility -- and a poor score shouldn't be the sole factor in pulling someone out of a lower-rated nursing home.

"Use the information in the five-star program in conjunction with other tools, as well as visiting the facility, talking to the administration and staff," suggested Tracy Niekamp, program manager for licensing and certification with the Missouri Department of Health and Senior Services. "Rely on a lot of things -- you don't want to use just the five-star rating program in determining where to place your loved ones. It is to be used as a tool, but certainly not the singular tool."

And administrators had several suggestions of other research one can do.

"I think they need to visit the facility of their choice and others -- and look at what the building looks like, how friendly the staff are, what the residents look like and how the building smells," said Don Chance, administrator of Clearview Nursing Center in Sikeston. "And get references of families that have had services there -- get a first-hand experience of it."

"Nothing replaces you getting up and going directly into a home," agreed Ivie. "And nothing can replace the atmosphere you feel whenever you enter a facility. The bricks and mortar things sometimes are not nearly as important as knowing that someone will take good care of your loved ones."

Chance said that, after people have toured a facility, they should bring any questions or concerns to administration or staff in the building.

The Centers for Medicare and Medicaid also stresses in its information about the five-star rating it is not a substitute for visits or other research. "This system can give you important information, help you compare nursing homes by topics you considers most important, and help you think of questions to ask when you visit the nursing home," according to its Web page. Those areas are key purposes to the ratings.

Although consumer groups like the concept of the ratings system, there are some potential problems with the data. For instance, it may not be up-to-date.

Chance said the ratings for Clearview Nursing Center, which earned one of five stars, was gleaned from information as much as two years old.

"It doesn't really represent what's going on it this facility today," he said. For instance, in October the state found the facility to have minimal deficiencies with no actual harm, and those were cleared within an hour and a half on Dec. 17. "That was a good survey," said Chance.

Ivie also has some concerns with how the ratings were figured. "I could run a five-star facility for an entire year," she said. But in the snapshot of time during which the data is taken there could be a flu or other health problem going around among staff, which would in turn affect the staffing at the facility.

"Is it really fair to compare on this five-star rating for a look of actually just a 10-day or two week period?" Ivie said. "I think there are some exceptions to the rule."

Niekamp agreed. "I think you always have to look at the information in the context for which it is provided," she said. "There are a lot of changes that occur in a facility in three years."

Current information for facilities is available on the DHSS Web site, www.dhss.mo.gov, on the long term care page.

"You can get on there and actually see the statements of deficiency that are issued to particular facilities," she said. "You can see the actual citations and what the facility's plans of correction are."

And a strength of the system is that it will hold facilities more accountable and give an extra incentive to be the best. "I think it will help the other facilities to strive to improve their ratings," said Niekamp.

And with data in Nursing Home Compare being updated monthly, Ivie said, nursing homes have the ability to move up or down in the ratings, based on how their care evolves over time.

Ivie said no matter what, her No. 1 goal is taking care of patients. "That's the most important thing," she said. "There's nothing that's ever going to take away from me knowing that I take good care of people."

For more information, or to look up and compare area nursing home facilities, go to www.medicare.gov/NHCompare.

(Photo)
Riley High, a resident of the Golden Living Center-New Madrid, walks back to his room at the nursing home with Linda Richards, a certified nursing assistant. Jill Bock, staff
The Associated Press contributed to this report.

Questions to ask when choosing a facility

* Can the facility meet my or my loved one's needs?

*Does it have a current state license?

*Does it accept Medicare and/or Medicaid?

*What problems were identified during the last survey or inspection? (A copy of the home's last inspection should be posted or available in the home.)

*Are the residents treated with dignity?

*Is the home clean and odor free?

*Is there an ombudsman who visits regularly?

*Talk to residents and family members. What comments do they have?

Source: Missouri Department of Health and Senior Services