Rockingham Manor Administrator Chad Colby talks with Lonnie Weatherford of Rockingham, who comes to the nursing home to see his wife, Shirley Weatherford, at least three or four times a week. Lonnie’s ability to visit frequently was one of the many reasons he brought his wife to Rockingham Manor for long-term care.
Out of 422 skilled nursing facilities in North Carolina, 275 received ratings of average or below when compared to state standards. Two of the three homes in Richmond County earned three stars and one earned two stars by the Centers for Medicare and Medicaid Services.
Beverly Speroff, Chief of Nursing Home Liscensure and Certification for the North Carolina Division of Health Service Regulation, explained that while the ratings help each nursing home see where they are and how they stack up, they are not set in stone.
“It is important for the public to know that this data is ever-changing,” Speroff said. “A nursing home that receives two stars is not branded with that rating; the rating can change with their next state inspection.”
“Whenever we go to a facility, we inspect based on the homework that we have done.” Speroff said. “We look at the facility’s past history, whether or not they have received any complaints, and if those complaints were followed up on.”
The comprehensive survey results, accessible through the Nursing Home Compare tool on Medicare’s website, gave 16 percent of North Carolina nursing homes two stars, a “below average” rating for overall quality. Among those facilities was Rockingham Manor of Long Drive.
“What I have seen over my time is the health care industry,” said Chad Colby, administrator of Rockingham Manor, “is that the same quality of care is being provided, but providing that care has just become more difficult.”
Ratings are based on a facility’s three most recent state inspections, which are carried out every 12 to 15 months by the North Carolina Division of Health Service Regulation, as well as in-house statistical records provided by the staff of the facility itself.
“I can see what they (Centers for Medicare and Medicaid Services) are working toward,” added Colby, “but I feel like all of the facilities in Richmond County were underrated. For example, there is nothing in that survey that shows the involvement of our activity department, or our interaction with the community.”
The two other Medicare and Medicaid-certified nursing homes in Richmond County, Britt Haven of Hamlet and FirstHealth Palmer Hinson Care Center of Rockingham, received an “average” three out of five stars.
Susan Melton, director of FirstHealth Palmer Hinson, feels that the new system may over-simplify a complicated comparison.
“What this rating system does is lump three different facilities together,” said Melton, “for example, we see a lot of patients who need short-term rehabilitative care. We have 26 beds designated for long-term patients, but it’s rare that we have an opening, so we send a lot of those patients to Rockingham Manor or Britt Haven.”
Snapshot
“What this survey shows is a snapshot of what an investigator saw in the short time they were with us,” said Colby, “but it is not a cumulative average of how things are 365 days a year.”
Jane Kinard, administrator of Britt Haven, is looking into what she feels is a flaw in the data used to rate her facility.
“We received one star for staffing, which means much below average,” said Kinard, “but I know that we staff far above what is required by the state.”
Aside from staffing, issues of patient comfort and safety make up a large part of the survey.
“We are always concentrating on the reduction of pressure ulcers and restraints,” said Speroff, “and we have made great strides in that area in North Carolina.”
Restraint appears to be another complicated issue that is not easily represented on paper.
“We have to be creative in thinking of ways to keep residents safe without restraining,” said Jackie McKenzie, Staff Development Coordinator for Britt Haven. “We have to try out all options for lighter restraint and evaluate them carefully before deciding that more restraint is necessary.”
“But when restraints are low, falls are high,” said Amy McDonald, Quality Improvement Nurse at BrittHaven. “We may try five different restraint methods for one patient, and then that patient falls five times, and then we document five separate falls in our facility.”
“A lot of the deficiencies that we were noted for on the survey came from paperwork and keeping up with staff,” said Melton.
Making decisions
“These ratings cannot replace the personal perspective that you need to make a choice about a nursing home,” said Melton. “When we had to make that decision with my mother-in-law it was very important to us to visit each facility, and to visit at different times of the day.”
Melton suggests that potential residents and their families do the same.
“Go to a place and see for yourself,” said Melton, “Is it clean? Is it quiet? Are there any odors? Is the staff moving around and interacting with the patients?”
Lonnie Weatherford of Rockingham, who took his wife Shirley to Rockingham Manor over a year ago, advocated the same approach.
“They wanted to put her up in Southern Pines, but I wouldn’t do it because I wouldn’t have been able to visit her as much as I wanted,” Weatherford said, “and I’d had dealings with all the nursing homes in the area as part of my job with the Veterans Association, which was for over 21 years.”
“I don’t know about stars;” said Weatherford, when asked about the new rating system, “ you just need to go to a place, see how it’s run, talk to the people there.”
“I wouldn’t have her anywhere else,” he added.
“Before I came to work here, I assumed that nursing homes were places where people laid in bed and watched TV all day,” said McKenzie of Britt Haven, “but, I mean, we have ballroom dances where the residents get all dressed up.”
“And bingo,” said Missy Burdick, director of nursing at Britt Haven, “the bingo is very serious, it’s cut-throat here.”
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