Ratings spark rebuke

Centre Crest, Hearthside get lowest scores

By Anne Danahy

A new national rating system for nursing homes is giving low marks to many facilities, including several in Centre County, prompting industry officials to question the ratings’ validity.

The Centers for Medicare and Medicaid Services’ Nursing Home Compare Web site rates the quality of 15,800 nursing homes across the country.

Among the six Centre County homes that are rated are Centre Crest, the county-run home, and The Hearthside Nursing and Rehabilitation Center in State College. Both received an overall rating of one star out of a possible five.

The Centers for Medicare and Medicaid Services says the ratings give families a way to find out the quality of nursing homes. The homes receive ratings of one to five stars in three categories — health inspections, nursing home staffing and quality measures — along with an overall grade and fire safety inspection information.

Three Centre County homes — Fairways at Brookline, Foxdale Village and The Village at Penn State Retirement Community — received four stars overall. Windy Hill Village of Presbyterian Homes in Philipsburg, got two stars.

Five stars is considered “much above average.” A one-star rating is “much below average,” according to the CMS Web site.

“Our goal in developing this unprecedented quality rating system is to provide families a straightforward assessment of nursing home quality, with meaningful distinctions between high and low performing homes,” Kerry Weems, acting director of the Centers for Medicare and Medicaid Services, said in a news release.

Weems said that homes’ conditions can change and, while the ratings are a tool for families trying to choose a nursing home, they can’t replace visits to the homes.

The system scores nursing homes on specific measures within each category. For example, the quality measure includes a range of factors, including the percentage of long-stay residents who get a flu shot and the percentage who spend most of their time in a bed or chair.

Centre Crest Administrator Rich Bruno said the home is continually making improvements and the star rating system doesn’t reflect the most recent standing of the home. Likewise, the state and national associations that represent nursing homes question the validity of the system.

Susan Feeney, spokeswoman for the American Health Care Association, said one area of concern is the method used to rate staffing. For example, she said, the rating that looks at staffing levels doesn’t include some caregivers, such as physical therapists.

“It doesn’t paint the true picture of the care-giving workforce,” Feeney said. She said the idea of a rating system is something the association supports, but she believes this one is flawed and doesn’t accurately assess the quality of care given and quality of residents’ lives.

Christopher Bailey, regional vice president of Hearthside, which has a 157-bed home in State College, said the patients and residents different facilities serve have different needs. A higher-end continuing care home — which has different levels of care — is typically for the more affluent customer, he said. Someone with an average income who has had serious health problems and doesn’t have assets doesn’t typically end up at a continuing care home, he said.

“As with any measure of a business like this, it’s one piece of information,” Bailey said. “Nothing, however, replaces the value of visiting and seeing for yourself.”

He compared choosing a home to planning a vacation: some might be happy with a two-star hotel that doesn’t include frills.

Mary Kahn, spokeswoman for the Centers for Medicare and Medicaid Services, said the seriousness of patients’ conditions is taken into consideration when coming up with ratings, which will be updated quarterly.

According to CMS, about 12 percent of the country’s homes received five star ratings, 22 percent got one star, and the other 66 percent were split among two, three and four stars.

The three homes in Centre County that received one- and two-star ratings are also the ones listed as participating in Medicaid — the federal program for low-income people.

Officials with the county, which runs Centre Crest, have been pushing the state to provide a higher reimbursement rate for residents covered by Medicaid. Centre Crest gets the third lowest reimbursement rate in the state for county homes: $156 a day. That’s less than the home’s 2008 rate of $208 a day.

“I will challenge anybody in the world to come up with a perfect care and service delivery system that can be provided for less than $160 a day,” Bruno said.

Bruno also pointed to the shrinking number of deficiencies the state Department of Health is finding during its frequent inspections of the home, which is located in Bellefonte and has the capacity for as many as 240 residents. Between January 2005 and March 2007, the state Department of Health found 63 deficiencies at the home over the course of 22 visits. That averages to 2.86 deficiencies a visit.

From April 2007 through September 2008, the department found 56 deficiencies during 22 visits. That is an average of 2.54 deficiencies a visit, an 11 percent drop. “I think this demonstrates the facility is making progress correcting problems and addressing such deficiencies,” Bruno said.

Anne Danahy can be reached at 231-4648.