8/20/2019 5:18:00 PM REQUIEM III Not gone, but often forgotten
Wayne Howard Staff Writer
Ten years ago, Sam Roe, a reporter for the Chicago Tribune wrote an article in which he said,
"The inspectors knew there was trouble as soon as they entered the nursing home.
"The lobby smelled of urine. In one room, they found a 97-year-old woman, lying in her own waste. She had severe bruises on her arm, foot and both legs that the staff could not immediately explain. Another resident had a bed sore larger than a golf ball and dripping blood.
"This was life in a 'one-star' nursing home."
The good news is that we have only two one-star nursing homes in our area on the latest list from the Centers for Medicare & Medicaid Services (medicare.gov) website.
The Nursing Home Compare website features a quality rating system that gives each nursing home a rating of between 1 and 5 stars. Nursing homes with 5 stars are considered to have much above average quality and nursing homes with 1 star are considered to have quality much below average. There is one Overall rating for each nursing home, and a separate rating for each of the following:
Health Inspections – The health inspection rating contains the 3 most recent health inspections and investigations due to complaints. This information is gathered by trained, objective inspectors who go onsite to the nursing home and follow a specific process to determine the extent to which a nursing home has met Medicaid and Medicare’s minimum quality requirements. The most recent survey findings are weighted more than the prior year.
Staffing – The staffing rating has information about the number of hours of care provided on average to each resident each day by nursing staff. This rating considers differences in the levels of residents' care need in each nursing home. For example, a nursing home with residents who had more severe needs would be expected to have more nursing staff than a nursing home where the resident needs were not as high.
Quality Measures – The quality measure rating has information on 17 different physical and clinical measures for nursing home residents. The rating is based on how well nursing homes are caring for their residents’ physical and clinical needs.
One of the reasons I decided to write this series of articles is because a long-time friend who is a nursing home resident recently had her quality of life diminished by what I consider a pointless rule the administration of the home where she now lives insists on enforcing--even if no valid reason for the rule can be provided.
I purchased an Amazon Echo Show for my friend early last year. After a little over a week of using it, she was told she wasn't allowed to have it. While the device does contain a camera, the camera is on the front of the unit (like a webcam on computers) and it was placed so it showed only her sitting up in her bed. Using the device, she was able to converse with me and with others who had a similar device and see the person with whom she was talking.
When they told her she couldn't keep it, I asked why and was told "we don't allow any kind of recording device." While I wondered what they might be doing that they didn't want anyone to see, I pointed out that other residents had cell phones that also had cameras and the capability of recording both audio & video. "We're thinking about taking those away, too," I was told.
I bought my friend an Amazon Echo Dot. It does many of the same things the Show does--tells the weather and news when asked, plays music on request, etc. It doesn't have a camera. She was able to enjoy using it for over a year; then earlier this month, she was told it was also not allowed. The only reason that could be provided was, "that's our policy."
I talked with Cindy Englert, the Ombudsman Program Coordinator serving residents who live in Adult Care Homes and Nursing Homes in Gaston and Lincoln counties, and she talked with the administrator at the nursing home in Cherryville (Carolina Care) and with their corporate office in Asheville. While Cindy tells me that residents in other nursing homes in her territory are allowed these devices, the operators of Carolina Care wouldn't budge--"it's our policy!"
Needless to say, both of these devices provided an improved quality of life for my friend, who was distraught at not being able to have them.
Pointless policies and staffing shortages appear to be common in some nursing homes. I decided to investigate what the Center for Medicare & Medicaid Services had to say about the quality of care residents receive.
North Carolina's nursing homes are rated as the 7th worst in the nation. While we have only one one-star (Overall rating) nursing home in our area, several are two-star (below average). Carolina Care, where my friend is a resident, is one of those. Their health inspection rating was one-star (much below average) and their staffing two-star according to the latest report.
The North Carolina Dept. of Health & Human Services also provides a rating of nursing homes, but their report only gives an overall rating. Carolina Care got three stars (average) on their ratings but that was in July 2017. Inspections have occurred since then, but the results haven't been posted online.
One thing that became apparent in reading the ratings was that nursing homes with the same name aren't necessarily the same in all locations. Peak Resources in Cherryville got a five-star overall rating while the Peak Resources location in Gastonia got only three stars. Brian Center in Lincolnton got four stars overall, in health inspections & quality measures and three stars for staffing. The Brian Center in Gastonia got five stars on everything but staffing and three stars there. But the Brian Center on 13th Ave. in Hickory got two stars overall, one star in health inspections, and four stars in staffing.
It's also true that sometimes deficiencies that cause a low rating can be corrected and the nursing home may be better than it was when the rating was done; likewise loss of staff or a change in administrators may cause the quality of care to deteriorate.
While these figures aren't an absolute way to judge the quality of any particular facility, they are the latest overall ratings posted on the medicare.gov website:
Lincolnton Rehabilitation Center, four stars
Cardinal Healthcare, three stars
Brian Center, Lincolnton, four stars
Peak Resources, Cherryville, five stars
Carolina Care, Cherryville, two stars
Abernethy Laurels, Newton, four stars
Stanley Total Living Center, five stars
Alexandria Place, Gastonia, one star
Conover Nursing & Rehab, five stars (also five stars in all areas except staffing & four stars there, best ratings in the area)
Accordius Health, Gastonia, two stars
Peak Resources, Gastonia, three stars
Brian Center, Gastonia, five stars
Trinity Ridge, Hickory, five stars
Courtland Terrace, Gastonia, five stars
Brian Center, Tate Blvd., Hickory, three stars
Meadowwood Nursing Center, Gastonia, one star
Belaire Health Care Center, Gastonia, four stars
Trinity Village, Hickory, four stars
White Oak Manor, Kings Mountain, three stars
Brian Center, 13th Ave., Hickory, two stars
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