Friday, July 15, 2011

We'll Put You In One Of Those Crooked Homes We Saw On 60 Minutes

My grandma, Gerda Allermann, died back in 2007. For years leading up to that, she was in a nursing home, Golden Living in Watertown. By that time, we didn't want her in Golden Living. For one, we- and she- would greatly have preferred she die at home. Second, Golden Living was not a good nursing home. There was little stimulation beyond our visits to the point that she was getting bedsores, the physical rehab she was supposed to be getting never happened despite endless prodding from us, and eventually she was left so much to her own devices that Alzheimer's was setting in by the end.

We didn't get her out mainly because she didn't want to go to the other main nursing home in town, and she was the one in charge. By the time we had found a suitable replacement home nearer Milwaukee, she'd taken a turn for the worse and could no longer be moved that kind of distance. She didn't have long after that.

My aunt later found Golden Living listed in one of those ads that was gathering up people for a class-action lawsuit. Last I heard, they're still battling it out in the courts.

As poor as that treatment was, though, there are worse nursing homes. The worst of the worst are listed by the Centers for Medicare and Medicaid Services as "Special Focus Facilities" or SFF's. The idea behind this listing is , normally a facility is inspected once every two years. However, some places would be shown where they're going wrong, make just enough changes to be in compliance, but then by the time the next two-year inspection rolled around, they'd lapsed back into old habits. On that knowledge, the SFF designation was created, under which the facility is inspected every six months until such time as they either show sustained, significant improvement or they're kicked out of the Medicare/Medicaid program, upon which they usually shut down. If they stay open regardless, focus switches to getting the inhabitants somewhere else.

There are five kinds of places listed in the SFF program, the most recent update of which is shown here in full in a PDF file. These are: new listings; facilities that have shown significant improvement since their listing; facilities that haven't; facilities recently graduated from the program; and facilities that got kicked out of Medicare/Medicaid. According to the stat sheet, about half the facilities listed end up graduating within 24-30 months, while 16% are kicked out of Medicare/Medicaid.

By 'significant improvement', as the stat sheet puts it, the CMS "means that the most recent standard survey (and any later compliant investigations" found no deficiencies in which there was actual harm to any resident, and no deficiency in which there was systemic potential for harm".

On that information, from that list, we're going to single out some places: the places that have been kicked out- there are three- and the facilities in the 'not improved' category that have been on the list for the longest time.

While there is caution advised in the stat sheet that there could be some lag time in the data and that there is no substitute for actually visiting the facility yourself, Golden Living wasn't even on the list and my grandma got treated with neglect, so I am advising regardless of lag that if you or someone you know has a loved one in any of the facilities about to be named, get them out. Get them to literally any other nursing home in America.

And if you're considering putting a loved one in a nursing home, I advise first heading here and seeing how places in your area stack up against each other.

First... well, first, here's Golden Living's readout. That done, we go to the ones kicked out of Medicare/Medicaid, and the deficiencies that caused them to get kicked out. For reference, if you see 'actual harm' and 'immediate jeopardy', the latter is the more serious charge.

Arbor Place of Clinton, Clinton, KY
James S. Taylor Memorial Home, Louisville, KY (closed last December)
Fort Worth Nursing and Rehabilitation Center, Fort Worth, TX

And then, the 15 'no improvement' facilities that have been listed the longest, in descending order of months listed as of June 16, each linked to their catalog of exactly what it is that they've done or not done. This is not necessarily the worst 15 of the bunch, but they are the 15 that have had the longest chance to fix things and haven't: If they're not the worst, they're close enough.

1. Hidden Hills Health and Rehab Center, Omaha, NE (77 months) (also known as 6 years, 5 months)
2. Embassy Health Care Center, Wilmington, IL (46 months)
3. Eagle Pointe, Parkersburg, WV (41 months)
4. Mapleshire Nursing and Rehabilitation Center, Morgantown, WV (37 months)
5. The Oaks of Mid City Nursing and Rehab Center, Baton Rouge, LA (32 months)
6. Mount Royal Towers, Birmingham, AL (30 months)
7. Seven Hills Health and Rehabilitation Center, Tallahassee, FL (30 months)
8. Autumn Healthcare of Zanesville, Zanesville, OH (30 months)
9. Cedarwood Villa, Red Lodge, MT (29 months)
10. Pueblo Care and Rehab, Pueblo, CO (26 months)
11. Legend Rehabilitation and Nursing Center, Gardner, MA (26 months)
12. St. Camillus Rehabilitation and Nursing Center, Stamford, CT (24 months)
13. Westview of Derby, Derby, KS (23 months)
14. Britthaven of Chapel Hill, Chapel Hill, NC (23 months)
15. Plaquemine Manor Nursing Home, Plaquemine, LA (22 months)

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