For nursing home clients, list offers another set of eyes

02/11/2014 3:10 PM

02/11/2014 3:10 PM

Eight of Johnson County’s 31 nursing homes were cited for 10 or more deficiencies by state inspectors, according to a survey by a patient advocacy group.

All Johnson County facilities listed in the survey have corrected their deficiencies and are now in compliance with regulations with the exception of Pinnacle Ridge in Olathe, which is undergoing a follow-up survey by state inspectors, said Joe Ewert, commissioner for survey, certification and credentialing for the Kansas Department of Aging and Disability Services, known as KDADS.

Kansas Advocates for Better Care, which advocates for quality long-term care for older and disabled adults, released a list last month of 78 nursing homes across Kansas that were consistently cited for 10 or more deficiencies during inspections over the past three years. The group releases its list each year to ensure consumers have the tools to properly evaluate nursing homes they may consider residing in.

“There are facilities that yo-yo in and out of compliance,” said Kansas Advocates for Better Care Executive Director Mitzi McFatrich. “If they’re on the list, it’s because they’ve had a higher number of deficiencies for at least three years running. The list tells us whether or not the facility is doing a good job staffing and meeting requirements.”

There were a total of 78 nursing facilities on the Kansas Advocates for Better Care list, down from 81 in 2012. Although the number of nursing facilities on the list has trended downward in recent years, McFatrich said that doesn’t mean care is necessarily improving.

“In terms of serious deficiencies — actual harm — far fewer of those deficiencies are being cited in fewer facilities,” said McFatrich. “I hope that means the care in our state is improving, but that’s not borne out in the complaints we hear from consumers across the state.”

McFatrich said she worries that KDADS staff vacancies and turnover might be artificially dampening deficiency reporting.

“The kind of complaints we get from residents or their loved ones who are part of their care-giving team continue to be pretty significant,” she said. “It concerns me that they aren’t showing up on the surveys.”

However, Ewert said Kansas is actually in line with national trends, which show care is improving across the nation.

“We typically dwell on the negative because we’re always looking for deficiencies, but Kansas is actually is ranked second in the nation for highly rated nursing facilities,” Ewert said.

KDADS surveyors rate each deficiency on an alphabetic scale from least (A: Isolated, no actual harm, potential for minimal harm) to most egregious (L: Widespread, immediate jeopardy to resident health or safety). They perform annual unannounced surveys of nursing facilities and respond to complaints made by residents, their family members or by facility staff who self-report.

Ewert said 83 percent of complaints KDADS receives are self-reported by nursing facilities.

Ewert said it’s not unusual for KDADS surveyors to find deficiencies, but if a facility fails to correct those deficiencies after three revisits, the facility’s Medicare and Medicaid funding agreements can be suspended or terminated until it passes inspection.

“If you see a facility with multiple revisits, that’s a red flag,” said Ewert.

Julie Beckert, director of marketing communications for HCR ManorCare, which operates ManorCare Health Services in Overland Park, said people can’t get a complete picture of a nursing facility by looking at the KDADS data, which is what the advocacy group uses to compile its list.

ManorCare in Overland Park was inspected five times in 2013. In October, KDADS cited 17 deficiencies ranging in severity from D (isolated deficiency, no actual harm) to F (widespread deficiency, no actual harm).

“We tend to err on the side of conservatism,” said Beckert, “It’s a company policy. For example if a patient has a bruise, and we don’t know how he got it, we tend to report because we have to discover what happened. We tend to self-report probably more than our peers.”

When consumers compare nursing homes, Beckert said they should consider more than just the survey.

The survey “is encompassing, which is good because you need oversight, but it’s not everything,” Beckert said. “Consumers need to go to visit the center and talk to the patients and their families.”

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