Internet list slams area nursing homes
A national Internet list warning of nursing homes that endanger residents contains three of four long-term care centers in Kootenai County, one of two in Bonner County and Boundary County’s only facility.
The National Nursing Home Watch List at www.memberofthefamily.net contains 30 of Idaho’s 82 nursing homes and cites them for poor laundry practices, robbing residents’ dignity and failure to prevent bed sores, among other problems.
The list also contains 95 of Washington’s 266 nursing homes, including four in Spokane. No nursing home in Idaho or Washington made the Web site’s honor list.
But Idaho officials place limited value on the watch list they say isn’t updated often enough and leaves out important information.
“The material is dated, and they don’t give you a context,” said Ross Mason, Idaho Department of Health and Welfare spokesman. “It’s an effective tool but should play a minor role” in the search for a nursing home for a family member.
The Web site lists quality-of-care information for 1,600 Medicare- and Medicaid-certified nursing homes in the United States. Its information is based on government inspection reports, which often surpass 100 pages per facility.
Dr. Edward Watters started the Web site in 1996 after a bad experience with a nursing home in Maryland. Watters writes on the Web site that a nursing home’s staff wasn’t following his orders for a patient going blind. According to Watters, he confronted the staff, wrote about it in the patient file and the staff removed his notes to avoid punitive measures by state regulatory agencies.
Watters and his partner, Daniel Steele, learned to obtain and read government inspection reports, which are public. The first findings they posted on their Web site were about nursing home care of veterans in Washington, D.C., and North Carolina. In 1999, Watters and Steele expanded the Web site to include reports on nursing homes nationwide.
They began a watch list to alert people that reports on some nursing homes contained observations of situations that hurt or had the potential to hurt residents. Those situations ranged from wanton abuse and unnecessary physical restraints to unchanged diapers and untreated bedsores.
Watters and Steele also started an honor list. The 174 nursing homes on the current list meet the government’s minimum standard of care, show no deficiencies in their last three inspections and have no substantiated complaints under investigation. Watters and Steele state on their Web site that they have no interest in, or connection to, any nursing home.
While the watch list offers valid information on nursing home deficiencies, it doesn’t tell when and if nursing homes corrected their problems – a major omission, said Jan Young, North Idaho’s ombudsman for seniors. As an ombudsman with Aging and Adult Services, Young tries to visit every nursing home in North Idaho monthly.
“Things happen all the time in nursing homes,” she said. “It’s what you do about it that counts. Anytime facilities are surveyed, they have to send in a plan of correction.”
Medicare also runs a Web site – www.medicare.gov – that offers nursing home inspection reports. Assessments are nearly identical to those offered by Watters and Steele except that the Medicare site includes the date each problem was corrected.
The North Idaho nursing homes on the watch list are Boundary County Nursing Home in Bonners Ferry, Life Care of Sandpoint, Life Care of Coeur d’Alene, and Pinewood Care Center and Ivy Court, both in Coeur d’Alene.Surveyors from Health and Welfare’s Bureau of Facilities Standards, which surveys nursing homes in Idaho, cited Ivy Court on Aug. 24 last year for reducing the quality of life for residents. A staff’s failure to help a resident find his misplaced dentures, causing him to change his diet and possibly eat and speak less, among other changes, is an example of this type of deficiency, Young said.
Both Web sites show the Ivy Court deficiency, but Medicare.gov includes the Sept. 29 date of correction; Watters’ site doesn’t. Neither site explains how Ivy Court reduced quality of life.
Four of five North Idaho nursing homes were cited for failing to turn patients in their beds enough to prevent or treat bed sores. Reports on Medicare.gov show the date each center corrected the problem; Watters’ site doesn’t.
Pinewood Care Center was cited for either not reporting and investigating abuse or neglect of residents or having people on staff with abuse and neglect in their pasts, according to reports on both Web sites. The problem was corrected, and Young said the facility most likely hadn’t run a complete background check on an employee. Neither site explained the deficiency. Watters’ site didn’t mention the correction.
Young said few nursing homes will escape without some sort of deficiency from an inspection, just by the nature of the business. Administrators walk a fine line between offering quality care and keeping costs down, a common order from the corporations that run them, she said.
How quickly and well nursing homes correct problems is an indication of the quality of the facility, Young said. Medicare.gov shares that information, but it doesn’t tell how willingly a correction came about.
Within two weeks of each inspection, Health and Welfare mailed warning letters to three Coeur d’Alene nursing homes that the state would withhold Medicare payments to them for new residents if they didn’t correct problems for which they were cited, Mason said. How soon warning letters follow an inspection depends on the gravity of the deficiency, he said. The three nursing homes corrected their problems before the state’s deadline, so Medicare wasn’t withheld.
“There’s no question they can lose reimbursement,” he said. “It doesn’t happen often, but it’s a strong carrot to stick out there. Almost every nursing home runs with 80 to 85 percent Medicare or Medicaid clients.”
Administrators of the North Idaho nursing homes on the national watch list hadn’t heard about the list and were surprised their facilities were on it. Gregg Calvert, regional director of operations for the for-profit corporation that runs Ivy Court, acknowledged that the Coeur d’Alene nursing home was in need of changes a year ago. But those changes were made and that information isn’t on the Web sites, he said.
“We have a new administrator, a new director of nursing,” he said. “I’ve seen a huge change, decline in complaints called in to the state or ombudsman. People have to understand we’re people in the business of taking care of people. When the state comes in, it’s a snapshot. The watch list is not a real objective scorecard.”
Calvert and other administrators advise people searching for a nursing home to study the latest inspections, which each center keeps on site, and visit various homes.
“Use your five senses. Look, smell, taste the food, talk to the people,” Calvert said. “Everyone needs a spot to be comfortable in. If we can encourage the consumer how to find the right spot, that’s the biggest benefit.”
Young said she would have no problem putting someone in her family in any of the five North Idaho nursing homes on the national watch list. She said she’s watched good changes occur at Ivy Court. Her father lived at Life Care of Coeur d’Alene last year and received good care under her watchful eye, she said.
“The facility in Bonners Ferry is lovely. They have activities all the time. The community is so involved,” she said. “At times there might be problems in any of them. I investigate. I’m happy with how they react. I would feel safe in any of them.”