Medicare ratings: For area nursing homes

TRI-COUNTY AREA (11/18/15)--When it comes to Medicare- and Medicaid-certified nursing homes, many of the facilities in the surrounding area are listed as either average or below average in their overall ratings. Nursing Home Compare on medicaid.gov contains quality of care information on every Medicare- and Medicaid-certified nursing home in the country, including more than 15,000 nationwide. Nursing homes aren't included on Nursing Home Compare if they aren't Medicare- or Medicaid-certified. These nursing homes can be licensed by the state.
The rating system that medicare.gov uses compares area facilities based on three criteria: health inspections, quality measures (QMs) and staffing. Health inspection ratings are based on the three most recent comprehensive annual inspections, and inspections due to complaints in the last three years. More emphasis is placed on recent inspections. Quality measures are derived from clinical data reported by the nursing home. This includes resident assessment data that shows how well the nursing home cares for residents' needs. The current data available on the website is collected from quality measures from July 1, 2014 through June 30, 2015 for short-stay residents, and Oct. 1, 2014 through June 30, 2015 for long-stay residents.
Staffing ratings are based on two measures: Registered Nurse (RN) hours per resident per day, and total staffing hours per resident per day. Total staffing includes: RNs, Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs), and Certified Nurse Aids (CNAs). Staffing data is submitted by the facility and is adjusted for the needs of the nursing home residents.
The Penn Yan Manor, located at 655 North Liberty St., has an overall rating of four stars out of five on medicare.gov, an above average rating. They received three stars (average) in both the health inspections and staffing categories, while receiving five stars (much above average) in quality measures.
Administrator Colin Maher said while the medicare.gov ratings are a useful tool, he noted it only represents a snapshot in time of a facility's performance throughout a given year. He added there are a lot of factors that go into the five star rating. Maher said while he is glad his facility has no deficiencies, he said it is not uncommon for the scores to change from year to year, adding the manor had five stars his first year there, and three stars last year.
"It might not cover the whole spectrum of care throughout the year," Maher said.
Maher said the staff tries to improve on their quality of care every day, meeting once a month to look at things like fall prevention, reduction of medications and resident conditions. Depending on what they find, he said they may reevaluate their care on a daily basis in order to find what works and does not work for residents. Maher encourages those who are looking for a nursing facility for their family member to go and visit each facility and be aware of things like how the staff interacts with residents, lighting, smells, etc.
"The best way to gauge is to visit," Maher said.
The Soldiers and Sailors Memorial Hospital Extended Care Unit (ECU), located at 418 North Main St. in Penn Yan, has an overall rating of two stars on medicare.gov, a below average rating. Also known as The Homestead, it received an average three stars for health inspections, a below average two stars for staffing and a much below average one star for quality measures.
Lara Turbide, vice president of community services with Finger Lakes Health, said in either February or March of 2015, the rules changed related to how the five star ratings are determined. She said prior to these changes, The Homestead was a facility that had been rated four stars.
One of the reasons Turbide noted their score is lower is because The Homestead is a facility that offers a specialized unit, which she claims is the only one in the region serving an important community need.
"At The Homestead we have a neuro-behavioral unit where the unique medical needs of the residents often warrant different treatments and medical interventions," Turbide said. Specifically, residents [in] these specialized units have distinct needs and characteristics that set them apart from some other skilled nursing residents. Many are at a higher risk for falls based on their conditions, and more, as part of some of their care plans, may be prescribed psychotropic medications. Both the falls and medication usage criteria are ones in particular where the new rules and weightings for the ratings negatively impact facilities where these residents with different needs and higher risks are penalized under the new system."
Turbide said in addition to the neuro-behavioral unit being a significant proportion of their residents, those who are able to progress and are able to be cared for in a more traditional skilled nursing unit often transition to other more traditional skilled nursing units at The Homestead. The Homestead's resident population therefore reflects this as well.
"The residents of our neuro-behavioral unit are different from those of some of our other Finger Lakes Health long-term care facilities, as well as different from neighboring facilities by virtue of the resident population we serve," Turbide said.
In the surrounding area, Finger Lakes Health, located at 196-198 North St. in Geneva, had a one star overall rating, a much below average rating. It had a below average two stars in health inspections, an average three stars in staffing and a much below average one star in quality measures.
In Schuyler County, the Schuyler Hospital Inc. and Long-Term Care Unit Skilled Nursing Facility (SNF), located at 220 Steuben St. in Montour Falls, received a below average two star overall rating. They received three stars for health inspection and staffing, but only one star for quality measures.
In nearby Horseheads, The Bethany Nursing Home, located at 3005 Watkins Road, received a two star, below average overall ranking. The home had two stars in health inspections, three in staffing and three in quality measures.
The Elcor Nursing and Rehabilitation Center at 48 Colonial Dr. in Horseheads also received a below average two star overall rating. They took two stars in each of the three categories.
The data comes from two sources: the Center for Medicare and Medicaid Services' (CMS) health inspection database and the national database known as the Minimum Data Set (MDS). The CMS health inspection database includes the nursing home characteristics and health deficiencies issued during the three most recent state inspections and recent complaint investigations. Data about staffing and penalties made against nursing homes also comes from this database. Data for quality measures comes from the MDS Repository.
All of this data is reported by the nursing homes themselves. Nursing home inspectors review it, but don't formally check it. This information changes frequently as residents are discharged and admitted, or residents' conditions change. The state recommends this information should be interpreted cautiously and used along with information from the Long-Term Care Ombudsman's office, the State Survey Agency, or other sources when considering a facility.