Posted 07/18/2003 Spartanburg Herald
Nursing home violations below average in Spartanburg
By ASHANTE DOBBS
Washington Correspondent
WASHINGTON -- Federally funded nursing homes in Spartanburg averaged fewer health and safety violations than state and national averages, recent health inspections reveal.
According to the U.S. Centers for Medicare and Medicaid Services, Spartanburg's nursing homes reported an average of 4.5 violations in the annual inspections. The state average is six and the national average is seven.
The number of violations in South Carolina nursing homes ranged from zero in several homes, to 33 at Ebenezer Senior Services in Rock Hill.
There are more than 150 regulatory standards that federally funded nursing homes must comply with at all times, but some homes consistently fail to meet them.
In recent years, complaints of resident abuse and neglect\line \line have risen significantly. In response, lawmakers and advocacy groups nationwide are calling for higher standards and improved monitoring of the country's 17,000 nursing homes.
On Thursday, U.S. Senator Charles Grassley, R-Iowa, in collaboration with the General Accounting Office, unveiled a report card on the status of the nation's nursing home facilities. The report, "Nursing home care revisited: The good, the bad and the ugly," maintains that some strides have been made during the past few years to boost the level of performance, but many nursing homes are still slipping through the cracks.
Five nursing homes in Spartanburg were inspected: White Oak Estates, Magnolia Place, Mountainview Nursing Home, Valley Falls Terrace and Magnolia Manor. White Oak Manor was omitted because its most recent inspection report was unavailable.
State inspectors visited the nursing homes between Jan. 16 and Feb. 19, in accordance with state mandates requiring annual inspection.\line \line White Oak Estates, inspected Jan. 16, was the only Medicaid-funded nursing home in the city that was not cited for any health deficiencies.
"We pay a lot of attention to customer service and tr ying to meet the needs of our customers," said Gary Catlett, the administrator of White Oak Estates.
Magnolia Place was cited Jan. 22 for nine health deficiencies, including failing to provide adequate care and treatment to residents with bladder problems , administering residents the wrong dose of medication and failing to curb the spread of infections between residents. A representative for Magnolia Place did not return phone calls requesting report information.
Mountainview Nursing Home was cited twice on Jan. 22 for improperly caring for residents with incontinence and mislabeling medication.
Administrator Wilson Dillard said one violation was an isolated incident involving a staff member who incorrectly conducted a dialysis-like procedure. The other violation was failing to label an open medicine bottle, he said.
Dillard said he has boosted staff training sessions and monitoring procedures since the inspection.
"(The violations) were relatively minor," Dillard said. "That's OK, because we need to do better. We don't need to make those types of mistakes."
Valley Falls Terrace was cited Jan. 28 for five violations, among them failing to report cases of suspected abuse or neglect, not providing residents with nutritious meals and inadequately maintaining accurate medical records. An administrator for the home declined to comment.
Magnolia Manor was cited Feb. 19 for six health deficiencies, including failing to report suspected cases of abuse or mistreatment and improperly storing and distributing food.
The state requires all nursing homes to report any suspected cases of abuse within 48 hours. If staffers find a bruise on a resident or any other signs of abuse, they must contact the state immediately.
According to Robert Hilsen, Magnolia Manor administrator, the home failed to report a bruised resident within the appropriate time frame. The state investigated the case and did not find Magnolia Manor negligent.
Still, Hilsen said his staff has implemented measures to improve the overall quality of resident care.
"We made sure the side rails on the beds were insulated to prevent (residents) from being injured," Hilsen said. "We provided (training) to the staff on how to transfer a resident safely. I feel very confident if the state or any federal agency would come in on those same six violations, they would see that they would not be there."
These inspection results only give a glimpse into nursing home performance, said Arthur Starnes, director of the state's certification bureau. The reports do not ac count for complaints filed after the inspection date or investigations currently under way. That information does not fall under the federal Freedom of Information Act and remains confidential.
A more accurate indicator of performance, Starnes said, is the timeframe within which nursing homes correct their violations.
"Even though the deficient practice is there, we also look at the response of the facility to correct those problems," Starnes said. "Is the facility willing to work with you to get the practice corrected?"
On average it took the Spartanburg nursing homes less than a month to correct their health violations, reports show.
Nursing homes that consistently perform poorly on state inspections are fined or denied payment from Medicare, Starnes s aid. CMS may also refuse to provide the facility with newly trained nurses aides until the problems are corrected.
None of the Spartanburg nursing homes has been fined within the past three years.
The federal government may also revoke a delinquent nursing home's license, shutting it down. Last year, CMS dismissed 12 nursing homes from its program.\line \line The CMS, which has oversight of federally funded nursing homes, launched a four-tiered program last year aimed at improving the quality of the nation's nursing care facilities.
But an on-going problem for many nursing homes that may complicate reform is a rampant staffing shortage, according to Deborah Mitchell, communications director for the National Citizen's Coalition for Nursing Home Reform.
"Nine out of 10 homes are dangerously understaffed," Mitchell said, adding that every nursing home resident needs at least 4.13 hours of daily care from a certified nursing assistant. "If a resident doesn't get that, you might as well wheel them out into the street."
The average time CNA's spend with residents nationwide is about 2.4 hours a day, according to CMS. In South Carolina, CNA care time was 2.5 hours.
None of the Spartanburg, Cherokee or Union county facilities meet the NCCNHR recommendation or even come close. In fact, some administrators said they don't get enough funding from Medicare to hire additional nursing assistants.
"I'd certainly like to have more staff, but the money has to be there to do that," Hilsen said. "With 70 some odd percent (of facility funding from) Medicaid, that's very hard to do.
"It's a very competitive market in recruiting and retaining registered nursing and nursing assistants," Dillard said.
