5 nursing facilities accused of ‘persistent poor care’

Several nursing homes and skilled nursing facilities in Delaware are among several hundred nationwide labeled as providing “persistent poor care” in a report released June 3 by Pennsylvania’s two U.S. senators.

The Moorings at Lewes, Seaford Center in Seaford, Brandywine Nursing & Rehabilitation Center in Wilmington, Kentmere Rehabilitation & Healthcare Center in Wilmington, and Regal Heights Healthcare & Rehab Center in Hockessin — five facilities in the state — are on the list of nearly 400 nursing homes with “persistent record of poor care” ratings in the Centers for Medicare and Medicaid Services (CMS) report released by Sen. Bob Casey, a Democrat, and Sen. Pat Toomey, a Republican.

Those ratings were not entered into the Special Focus Facility (SFF) program, which brings extra federal oversight, warning alerts and is a matter of public record so the public is aware of the low performance ratings.

Westminster Village Health in Dover is part of that SFF program.
According to the two senators, the secrecy undermines the federal commitment to ensure transparency for families trying to find nursing homes for loved ones and raises questions about why the names of some homes are not disclosed while others are publicly identified.

“We’ve got to make sure any family member or any potential resident of a nursing home can get this information, not only ahead of time but on an ongoing basis,” said Sen. Casey.

“When a family makes the hard decision to seek nursing home services for a loved one, they deserve to know if a facility under consideration suffers from systemic shortcomings,” said Sen. Toomey.

According to Nursing Home Compare ratings found online at www.medicare.gov:
• Moorings at Lewes scored maximum 5-star (much above average) for both quality measures and staffing, a 1-star (much below rating) in health inspection and a 2-star (below average) overall rating;
• Seaford Center’s Medicaid and Medicare ratings were 4-star (above average) for staffing, 2-star (below average) quality measures and overall and 1-star (much below average) in health rating;
• Brandywine Nursing & Rehabilitation Center rated 1-star in health inspection, 2-stars in overall and quality and 4-stars in staffing;
• Kentmere Rehabilitation & Healthcare Center rated 2-stars for overall, 1-starfor health inspection and 5-stars in both staffing and quality measures;
• Regal Heights Healthcare and Rehab Center scored 2-stars for overall, 1-star in health inspection and 4-stars in both staffing and quality measures.

Carol Holzman, executive director at Moorings at Lewes, offered the following response to the report.

“Let me just say if you look, from the CMS website we are a 5-star in staffing and 5-star in quality measures, and that’s what people should be looking at,” said Ms. Holzman. “It’s called a state survey …”

Lori Mayer, spokeswoman for the Seaford Center, said the Seaford Center supports making relevant, transparent information available to patients, residents and their families to make informed care decisions.

“The public already has access to information that helps them identify facilities at risk of quality problems or issues related to staffing, quality outcomes or other problems.

All of this is information is available through the CMS Nursing Home Compare website,” said Ms. Mayer. “Our facility is rated a 2 star overall which includes a 2 star for quality and a 4 star for staffing. Our Customer Satisfaction score is 4.1 stars.’

Ms. Mayer added that it is important to note “that it takes three years for past surveys to be removed from the calculations, so the survey data is not always an accurate reflection of the care provided.

With that said, we are committed to providing high-quality care to our patients and residents and are always striving to improve quality and performance at the center.”

Ranking data was “not available” for Westminster Village Health, which isn’t rated due to a history of serious quality issues and is included in the Special Focus Facility program.

Westminster Village Health offered the following statement, from Westminster executive director Mary Ann Poling.

“At Westminster Village in Dover Delaware nothing is more important to us than the care, safety, health and well-being of our residents. The inclusion of our skilled nursing center on a list in a recent government ranking reflected prior cumulative Department of Health Care Quality survey results. Our response to those results has been to implement significant process improvements, hire and train new staff and eliminate agency staff,” Westminster’s statement read. “These efforts have met with positive results from our recent Department of Health Care Quality survey and being noted by CMS as having shown improvement. We have also completed renovations to our skilled nursing center and continue to focus on quality of care which is our well known hallmark. Providing top-quality care to every resident in a safe, nurturing environment is to us a sacred responsibility, and will always be our top priority.”

Brian Cunningham, spokesman for U.S. Sen. Chris Coons, said the senator is holding off on comment because it will be a state issue and more information is needed.

Mr. Cunningham said the state gets a chance to make recommendations about which candidates to put into the program, and “by design there will always be more candidates than slots in the program in any given state.

CMS has already announced that they are evaluating publishing the list of candidates after it is updated each month following the interest generated by this release.”

Budget cuts seem to be contributing to the problem with reduction of money available for focused inspections that are required for nursing homes on the shorter list who are publicly identified by CMS.

About 80 nursing homes are getting special scrutiny to help them resolve documented quality problems.

The nearly 400 facilities that are candidates for the shorter list “qualify for the program because they are identified as having a ‘persistent record of poor care’ but are not selected for participation as a result of limited resources at (CMS),” the report from Sen. Casey and Sen. Toomey said.

“Despite being indistinguishable from (special focus nursing homes) in terms of their qualifications, candidates are not publicly disclosed,” the report added.

In a letter last month to Sen. Casey, CMS Administrator Seema Verma singled out federal budget problems as a factor.

“The total number of (special focus) slots and total number of (special focus) candidates nationally are based on the availability of federal resources,” Ms. Verma wrote.

She added that as recently as 2010, there was room for 167 nursing homes in the special focus program and 835 candidates.

“That’s now down to as many as 88 special focus slots and up to 440 candidates.

According to Ms. Verma, federal budget cuts in 2014 reduced the number of available slots. She said her agency is evaluating whether it can publicly release the list of “candidate” nursing homes.

The Trump administration has asked Congress for more money for health care inspections, but the final amount and how it will distributed remain unclear.

In a statement, CMS said its starred ratings on the Nursing Home Compare website are already the best yardstick “for consumers to understand and use.” About 2,900 nursing homes have the lowest one-star overall rating.

Ratings information
For ratings and information, visit: https://www.medicare.gov/nursinghomecompare/results.

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