Western PA nursing homes receive poor grades

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The availability of the inspection reports gives a broader perspective on the ratings on the Medicare website.

For example, the Latrobe center has below-average ratings from CMS in all categories but its staff, which is rated above average. But, consumers could read a detailed June 2011 inspection report for more information.

At that time, the center was cited with a D for failing to report an allegation of physical abuse to the Department of Health. The report stated that a nurse’s aide was accused of throwing a resident into bed, causing him to hit his head on a cement wall, and tossing a diaper into the face of another resident and telling him “he could change himself.”

There was no determination of whether the allegation was true in the report.

Every nursing home in the state is visited by a long-term care ombudsman at least once a year and more often if it is considered troubled, said Wilmarie Gonzalez, the director of the Advocacy and Protection Bureau at the Pennsylvania Department of Aging.

She suggests taking the time to contact the nearest Area Agency on Aging to speak with an ombudsman about nursing home choices.

“They can talk about conditions and what homes might meet particular needs,” she said. That information about the quality of care is “going to be what makes your loved one feel safe and protected.”

Some nursing home officials and experts said that inspection grades can be misleading and shouldn’t be the only measure of a facility.

A G grade in one instance was issued when a resident went missing for a half-hour and was found cut and bruised at the bottom of a concrete stairwell with his wheelchair on top of him; at another nursing home, mouthwash and a disposable razor left on the sink of a shared bathroom constituted a G.

Inspections — also referred to as surveys by the industry — provide a sometimes biased glimpse of nursing facilities, said Ron Barth, president and CEO of LeadingAge PA, a Mechanicsburg-based trade association that represents not-for-profit senior service providers.

“We have a really broken survey system,” he said. “The survey really depends on the surveyor, the day and the mood the surveyor is in…. It really doesn’t do a good job of assessing quality. What it does do a good job at is playing ‘gotcha.’ ”

Looking for trends in deficiencies may prove helpful, Barth said, but the best research comes from visiting the facilities.

“See for yourself,” Barth said. “Talk to the residents, visit at meal time, look at how much staffing they have. Are people occupied or are they sitting around looking lost?”

Watching for mistakes

Valerie Warning picked Cedars of Monroeville for her father because doctors recommended its rehabilitation program, she said. She thought it would provide relief.

Instead, she said she felt compelled to stay at the facility at all hours because of instances such as when her father was given his roommate’s medication or when she felt there was a disconnect between his treatment and what was stated on his chart.

An April inspection at Cedars yielded four deficiencies. Of them, the reports show a resident got a blood-clotting medication that was not prescribed for him and another’s care plan was not updated.

The facility re-educated its nurses on medication procedures and each care plan was reviewed, according to the Department of Health.

“The most recent inspection reflects the current status of compliance with regulations,” wrote John Silvestri, Cedars’ lawyer, in an email. “Any issues raised by prior inspections, that were appropriately raised, were corrected.”

Warning said any transparency is helpful.

“I didn’t go after Cedars for a financial gain,” she said. “I wanted them to be exposed for what they did. There were, and I bet there still are, so many other families that complained, but they were afraid because they couldn’t be there like I was.”

Ultimately, Warning felt responsible, in a way, for her father’s death.

“This was a time for me to show the appreciation for everything he did for me, and that’s why I still feel guilty,” she said.

(Reach Halle Stockton at 412-315-0263 or hstockton@pubicsource.org.)

(View this story on the PublicSource site: http://publicsource.org/investigations/western-pa-nursing-homes-receive-poor-grades.)

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