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"Nursing homes say reputations, not grades, are true test"

Original source:

Denver Business Journal

Friday, December 26, 2008 | Modified: Sunday, December 28, 2008, 7:49pm
Silicon Valley / San Jose Business Journal - by Cathy Weselby

Silicon Valley nursing homes scored higher overall on a new online report card than those throughout the country, but operators and reform advocates say they are not pleased with the grading system.

“I don’t think the underlying inspection system equals the quality of care,” said Mike Connors, spokesman for California Advocates for Nursing Home Reform.

The Centers for Medicare & Medicaid Services surveyed 16,000 nursing homes nationwide and posted the results in December on its Web site, The ratings range from one star (low) to five stars (high) and are based on health inspection results, staffing levels and quality measures such as percentage of residents with bed sores.

Of the 56 nursing homes evaluated in Santa Clara County, 16 percent received a five-star rating while 20 percent received a one-star rating. Nationally, 12 percent of homes received a five-star rating while 22 percent scored only one star.

Connors said although there’s some value to the Web site, he’s concerned that some of the ratings might be misleading.

Only federal standards are measured on the site, Connors said, and California has many standards, such as more stringent minimum staffing requirements, that are not captured in the ratings.

Gery Yearout, executive director at Lytton Gardens Skilled Nursing Facility in Palo Alto, said the federal ratings favor facilities that have fewer acute-care residents.

“If you’re a nursing home that takes in sicker patients, you’re going to get a lower score,” Yearout said. Her 145-bed facility received a three-star rating on the site.

“If they find something that we report voluntarily, such as a patient telling us about a wound and we report it, that report becomes part of what is used in the scoring,” she said.

Yearout said that providing data on a Web site that’s easy to understand is a good idea for people who don’t know the industry, but she would like to see a site that does this with a more representational rating system.

Villa Siena Executive Director Corine Bernard said the Medicare Web site bases its scores on subjective information.

“I’m not so sure the site measures as accurately as intended,” Bernard said. “Inspection survey results are sometimes subjective and sometimes they’re disputed.”

The Mountain View-based facility received a five-star rating, but Bernard said nothing replaces visiting a facility.

“We encourage people to always visit and assess how well the staff is communicating and how happy the residents appear,” Bernard said. “You can tell by the environment.”

Pilgrim Haven in Los Altos also received a five-star rating on the Web site.

However, Director of Sales and Marketing Marilyn Sell said most of the residents come to the continuing care retirement community through word of mouth rather than the Internet.

“Most of our residents are referred by hospital discharge planners, physical therapists and physicians,” Sell said.

Despite their drawbacks, Connors said the ratings do hold some weight when evaluating skilled-care facilities.

“Close to 550 nursing homes in California were rated with one or two stars, and with very few exceptions, we think those are homes that people should avoid,” he said. “The ones rated higher, people should look beyond those ratings and visit the facility.”