Targeted nursing homes defended
Posted: 2/14/2008
Targeted nursing homes defended
01:00 AM EST on Wednesday, February 13, 2008
By Felice J. Freyer
Journal Medical Writer
The state's long-term-care ombudsman, Roberta Hawkins, yesterday defended the nursing homes that the federal government last week listed as needing improvement, saying the list does not reflect the true quality of care.
"I go after people who don't provide good care,"Hawkins said, "but we need to straighten out this message."
Hawkins, who heads the Alliance for Better Long-Term Care, said that all but one of the 12 on the list are good-quality facilities. The exception, she said, is the Haven Health Center of Pawtucket, which is in receivership.
Last week, the Centers for Medicare & Medicaid Services listed nursing homes around the country that had a high prevalence of bedsores or inappropriate use of physical restraints. CMS stated that these were not necessarily the worst nursing homes, but rather ones that CMS would target for improvement in one or both of those two areas.
Richard Gamache, chairman of the Rhode Island Health Care Association, a nursing home trade group, said that the list did not take into account that certain nursing homes take in sicker patients and some specialize in wound care. Such homes have a high percentage of bedsores because patients are admitted there specifically to treat those wounds.
Hawkins gathered the administrators of many of the nursing homes in the Health Department lobby yesterday to protest the list. (No one representing the Health Department appeared, however.) She said that many residents arrive at the nursing home already afflicted with bedsores, often acquired in the hospital.
Sister Theresa Robertson, administrator of the Jeanne Jugan Residence - Little Sisters of the Poor, in Pawtucket, said that despite being on the CMS list, her 44-bed nursing home has had no deficiencies in Health Department inspections for five years.
Linda Wheeler, administrator of the Pine Grove Health Center, in Burrillville, said her nursing home specializes in wound care and admits people with multiple, severe problems. "We ensure they don't get infections," she said.
Virginia Burke, president and chief executive officer of the Rhode Island Health Care Association, said in an interview earlier yesterday that at least two other nursing homes on the list - Kent Regency Center, in Warwick, and Epoch Senior Health Care on Blackstone Boulevard, in Providence - have programs specializing in wound care.
Additionally, the list included three nursing homes with fewer than 50 beds - Jeanne Jugan, Bethany Home of Rhode Island, in Providence, and Harris Health Center, in East Providence. In those nursing homes, small fluctuations can look deceptively large percentage-wise.
For example, Burke said, the 32-bed Harris Health Center originally had no patients who were at high risk of bedsores. Then it admitted one high-risk patient - who arrived already suffering from a bedsore. In the data, that one patient means that 100 percent of Harris's high-risk patients had bedsores.
Dr. William Taylor, director of the division of quality improvement at the CMS Boston regional office, said small nursing homes "have a strong argument" in saying their statistics can be skewed or misleading. In such cases, he said, further investigation will show that they don’t need quality-improvement efforts.
Taylor said the targeted nursing homes were selected based on data, reported by the nursing homes, that have long been publicly available on the federal government’s Nursing Home Compare Web site (http://www.medicare.gov/NHCompare). CMS created the list to focus its voluntary quality-improvement efforts on the places in greatest need of help, and publicized it as part of an effort for transparency, he said.
He noted that even if a patient arrives at a nursing home with a bedsore acquired elsewhere, that doesn't change the nursing home’s responsibility. "They should be able to manage it," he said.
Asked how people choosing a nursing home should regard a list like this, Taylor said people should talk to the nursing home’s administrator because there can be "extenuating circumstances" behind any statistic. He recommended visiting the nursing home as well. The Medicare Web site ( www.medicare.gov) has a guide to choosing a nursing home, as does the Health Department’s ( http://www.health.state.ri.us/topics/nursinghomes.php).
In addition to Kent, Haven Health of Pawtucket, Epoch, Bethany, Harris, Jeanne Jugan and Pine Grove, the disputed list included Haven Health Center of Coventry; the Friendly Home, in Woonsocket; Hopkins Manor, in North Providence; Morgan Health Center, in Johnston; and Watch Hill Care and Rehab, in Westerly.
01:00 AM EST on Wednesday, February 13, 2008
By Felice J. Freyer
Journal Medical Writer
The state's long-term-care ombudsman, Roberta Hawkins, yesterday defended the nursing homes that the federal government last week listed as needing improvement, saying the list does not reflect the true quality of care.
"I go after people who don't provide good care,"Hawkins said, "but we need to straighten out this message."
Hawkins, who heads the Alliance for Better Long-Term Care, said that all but one of the 12 on the list are good-quality facilities. The exception, she said, is the Haven Health Center of Pawtucket, which is in receivership.
Last week, the Centers for Medicare & Medicaid Services listed nursing homes around the country that had a high prevalence of bedsores or inappropriate use of physical restraints. CMS stated that these were not necessarily the worst nursing homes, but rather ones that CMS would target for improvement in one or both of those two areas.
Richard Gamache, chairman of the Rhode Island Health Care Association, a nursing home trade group, said that the list did not take into account that certain nursing homes take in sicker patients and some specialize in wound care. Such homes have a high percentage of bedsores because patients are admitted there specifically to treat those wounds.
Hawkins gathered the administrators of many of the nursing homes in the Health Department lobby yesterday to protest the list. (No one representing the Health Department appeared, however.) She said that many residents arrive at the nursing home already afflicted with bedsores, often acquired in the hospital.
Sister Theresa Robertson, administrator of the Jeanne Jugan Residence - Little Sisters of the Poor, in Pawtucket, said that despite being on the CMS list, her 44-bed nursing home has had no deficiencies in Health Department inspections for five years.
Linda Wheeler, administrator of the Pine Grove Health Center, in Burrillville, said her nursing home specializes in wound care and admits people with multiple, severe problems. "We ensure they don't get infections," she said.
Virginia Burke, president and chief executive officer of the Rhode Island Health Care Association, said in an interview earlier yesterday that at least two other nursing homes on the list - Kent Regency Center, in Warwick, and Epoch Senior Health Care on Blackstone Boulevard, in Providence - have programs specializing in wound care.
Additionally, the list included three nursing homes with fewer than 50 beds - Jeanne Jugan, Bethany Home of Rhode Island, in Providence, and Harris Health Center, in East Providence. In those nursing homes, small fluctuations can look deceptively large percentage-wise.
For example, Burke said, the 32-bed Harris Health Center originally had no patients who were at high risk of bedsores. Then it admitted one high-risk patient - who arrived already suffering from a bedsore. In the data, that one patient means that 100 percent of Harris's high-risk patients had bedsores.
Dr. William Taylor, director of the division of quality improvement at the CMS Boston regional office, said small nursing homes "have a strong argument" in saying their statistics can be skewed or misleading. In such cases, he said, further investigation will show that they don’t need quality-improvement efforts.
Taylor said the targeted nursing homes were selected based on data, reported by the nursing homes, that have long been publicly available on the federal government’s Nursing Home Compare Web site (http://www.medicare.gov/NHCompare). CMS created the list to focus its voluntary quality-improvement efforts on the places in greatest need of help, and publicized it as part of an effort for transparency, he said.
He noted that even if a patient arrives at a nursing home with a bedsore acquired elsewhere, that doesn't change the nursing home’s responsibility. "They should be able to manage it," he said.
Asked how people choosing a nursing home should regard a list like this, Taylor said people should talk to the nursing home’s administrator because there can be "extenuating circumstances" behind any statistic. He recommended visiting the nursing home as well. The Medicare Web site ( www.medicare.gov) has a guide to choosing a nursing home, as does the Health Department’s ( http://www.health.state.ri.us/topics/nursinghomes.php).
In addition to Kent, Haven Health of Pawtucket, Epoch, Bethany, Harris, Jeanne Jugan and Pine Grove, the disputed list included Haven Health Center of Coventry; the Friendly Home, in Woonsocket; Hopkins Manor, in North Providence; Morgan Health Center, in Johnston; and Watch Hill Care and Rehab, in Westerly.
