Nurs­ing homes face dou­ble-edged sword

High com­plaint lev­els show process for im­prove­ment works, in­dus­try ex­pert says

The News-Times - - OPINION - By Luther Turmelle [email protected]­medi­

A new anal­y­sis of fed­eral nurs­ing home data found Connecticu­t fa­cil­i­ties fare worse in some cat­e­gories than oth­ers when it comes to pa­tient care.

An anal­y­sis of the most re­cent data com­piled by the fed­eral Cen­ters for Medi­care and Med­i­caid Ser­vices con­ducted by The Se­nior List, a Port­land, Ore.-based in­for­ma­tional web site for the el­derly found that Connecticu­t nurs­ing homes had some of the high­est per­cent­ages of com­plaints re­gard­ing qual­ity of care and res­i­dents rights.

Connecticu­t’s nurs­ing homes were tied with their coun­ter­parts in Illi­nois for first in terms of the high­est per­cent­age of qual­ity-of-care com­plaints. Nurs­ing homes in Connecticu­t also had the fourth-high­est per­cent­age of res­i­dents’rights com­plaints in the coun­try.

But the state’s nurs­ing homes fared bet­ter in terms of rank­ing when it comes to over­all de­fi­cien­cies per nurs­ing home and the more se­ri­ous sub­stan­dard care de­fi­cien­cies per fa­cil­ity.

Connecticu­t nurs­ing homes were ranked 25th na­tion­ally with 7.51 de­fi­cien­cies per fa­cil­ity. And in terms of sub­stan­dard care de­fi­cien­cies per fa­cil­ity, the state’s nurs­ing home were ranked 37th na­tion­ally with 0.50.

Matthew Bar­rett, pres­i­dent and chief ex­ec­u­tive of­fi­cer of the Connecticu­t As­so­ci­a­tion of Health Care Fa­cil­i­ties, a trade as­so­ci­a­tion of 150 skilled nurs­ing home mem­ber fa­cil­i­ties, said he wasn’t sur­prised by the Cen­ters for Medi­care and Med­i­caid Ser­vices data.

“Connecticu­t’s nurs­ing home cul­ture is one that en­cour­ages air­ing nurs­ing home res­i­dent griev­ances as a key part of on­go­ing qual­ity im­prove­ment,” Bar­rett said. “It fol­lows that CMS data shows ev­i­dence that nurs­ing homes have a healthy griev­ance process with higher than av­er­age com­plaints.”

Staffers at Connecticu­t nurs­ing homes re­ceive an­nual res­i­dent rights train­ing, he said. All nurs­ing homes have griev­ance re­port­ing poli­cies and al­most all nurs­ing homes have res­i­dent coun­cils where nurs­ing home res­i­dents them­selves bring con­cerns about their care to nurs­ing home ad­min­is­tra­tors, ac­cord­ing to Bar­rett.

“All Connecticu­t nurs­ing home post in a con­spic­u­ous place in the fa­cil­ity in­for­ma­tion on how to lodge for­mal com­plaints to state reg­u­la­tors and the long term care om­buds­man,” he said.

The Cen­ters for Medi­care and Med­i­caid Ser­vices rates all nurs­ing homes with a star sys­tem that gives five to the best fa­cil­i­ties and one to the worst.

Connecticu­t has the 13th-high­est per­cent­age of nurs­ing homes with five-star rat­ings with 28.70 per­cent. Just 13.5 per­cent of the state’s nurs­ing homes had one-star rank­ings, which puts Connecticu­t 32nd out of 50 states.

“The very same nurs­ing home cul­ture, reg­u­la­tory over­sight, and res­i­dent rights pro­tec­tions also ex­plains why Connecticu­t nurs­ing homes con­sis­tently score higher on qual­ity mea­sures, staffing and an­nual sur­vey re­sults, which is also very clear in the CMS data,” Bar­rett said.

If nurs­ing homes aren’t in com­pli­ance with fed­eral guide­lines, the Cen­ters for Medi­care and Med­i­caid Ser­vices can is­sue fines. Connecticu­t nurs­ing homes paid fines to­tal­ing $487,403 in the last 12 months, which puts the state 25th na­tion­ally.

The lat­est nurs­ing home data is be­ing played out against back­drop where even as mem­bers of the baby boom gen­er­a­tion con­tinue ag­ing, the num­ber of nurs­ing homes around the coun­try and in Connecticu­t is shrink­ing.

The num­ber of nurs­ing homes de­creased by 4.5 per­cent na­tion­ally be­tween 1995 and 2016. Dur­ing the same pe­riod in Connecticu­t, nurs­ing home lev­els de­clined by 15.7 per­cent, ac­cord­ing to data from the Na­tional Cen­ter for Health Sta­tis­tics.

Dur­ing the same pe­riod, the num­ber of nurs­ing home res­i­dents na­tion­ally fell by 8.9 per­cent com­pared to a 22.4 per­cent de­cline in Connecticu­t nurs­ing home res­i­dents be­tween 1995 and 2016.

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