Federal survey ranks elderly care facilities

Published 6:00 am Thursday, January 8, 2009

A recent quality rating of America’s nursing homes released bythe federal Centers for Medicare and Medicaid Services revealedsplit results for four Brookhaven facilities, with two institutionsearning superior marks and two others scoring poorly.

Released in late December, the CMS comparison survey – whichjudges nursing homes on a scale of one to five, with five being thehighest – lists scores for almost 16,000 nursing homes across thecountry that participate in Medicare and Medicaid programs. Theagency plans to update the rankings monthly, but the first batch ofdata held mixed results for elderly care options in Brookhaven.

Golden Livingcenter-Brook Manor received a perfect score of fivestars – “much above average” – in the new study, with Silver CrossNursing Home following closely with four stars.

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Countrybrook Living Center, however, received the lowestpossible score of one star – “much below average”- with Haven HallHealth Care Center ranked only one grade above with two stars. ACountrybrook spokeswoman maintained data used for the survey wasoutdated.

Lee Millman, spokeswoman for the CMS Region IV office inAtlanta, said the new ratings system is used by her agency as a wayfor nursing homes to make quality improvements. For those lookingto locate an elderly family member in a nursing home, she said theratings system is not a substitute for visiting the facility.

“It’s a first step to looking at where [someone] might want toplace a loved one,” she said. “Or, if they want to see the ratingfor a nursing home where a loved one is already in residence.”

The overall score of the CMS survey is made up of combinedscores in three categories: the results of past health inspectionsurveys, measures taken to ensure quality care and staffing levelinformation. Each institution’s fire safety inspection is alsolisted.

To earn its perfect five-star score, Golden Livingcenter-BrookManor – a 58-bed, for-profit corporation – scored a five in thehealth inspections category, a four in quality measures and a twoin staffing levels, with no fire safety or health deficiencies.

Silver Cross Nursing Home’s four-star ranking is composed of athree-star grade on health inspections, a two-star grade on qualitymeasures and a five-star grade on staffing levels. The 60-bed,non-profit corporation had no fire safety deficiencies and sevenhealth deficiencies, which is equivalent with the state healthdeficiency average.

Haven Hall Health Care Center earned a two-star ranking, with aone-star grade in health inspections, a five-star grade in qualitymeasures and a three-star grade in staffing levels, with no firesafety deficiencies but 15 health deficiencies. Haven Hall is anon-profit corporation with 81 beds.

Countrybrook Living Center’s one-star ranking was awardedbecause the 121-bed, for-profit corporation received one-starrankings in all three categories. The lowest-scoring facility inBrookhaven was also found to have eight fire safety deficienciesand 15 health deficiencies.

The CMS nursing home comparison Web site,www.medicare.gov/NHCompare, allows users to select multiplefacilities and display more detailed information side-by-side. Sucha comparison of Brookhaven’s highest- and lowest-scoring nursinghomes brings out large differences.

For instance, according to the CMS data, residents at BrookManor spend an average of 47 minutes per day with a registerednurse, while those at Countrybrook spend less than half of thattime: 22 minutes.

The percentage of long-stay residents who receive influenza andpneumococcal vaccinations during their stay at Brook Manor is 100percent in both categories, while only 26 percent and 8 percent oflong-stay residents receive the same shots, respectively, atCountrybrook.

In the same comparison, certified nursing assistants spend anaverage of just more than two hours per day with residents atCountrybrook, while Brook Manor’s residents see the same personnelan average of one hour and 35 minutes per day.

The numbers are not concrete testimonials, however, and could beopen to dispute.

The CMS comparison Web site warns viewers that different nursinghomes serve different functions and have different affiliations,and important qualities such as the skill and turnover rates ofeach nursing home’s staff are not included in the data.Additionally, to meet each facility’s different health care goals,each uses various types and numbers of medical personnel – a traitalso not reflected in the data.

“There are some questions around how the stars were determined,”said Brook Manor Administrator Stephanie Burton. “Those facilitiesthat did not do well I’m sure are questioning what they can do toimprove their status. All of this information is [online] – it’salways been there. The only difference is now they’ve put starsbeside it.”

Officials with Countrybrook are contesting the results of theCMS study.

Nursing home spokeswoman Dr. Melody Chatelle said the agencyused data that was outdated – indeed, some of the Web site’s healthinspection and complaint investigation data is almost a year old -and inaccurate to compile the survey.

“Our review of this data indicated CMS is relying on historicaldata gained over time instead of real-time data, which reflects acenter’s latest survey outcome,” Chatelle read from Countrybrook’sprepared statement. “We are also concerned that the labor and staffdata are used inconsistently and cannot be routinely verified.”

Chatelle said Countrybrook officials hope the CMS survey willcorrect alleged inaccuracies over time.