Federal ratings of Capital Region caregivers run gamut

Half of the Medicare and Medicaid participating nursing homes in the Capital Region received one- or
Physical therapist Brian Reese, center, works on endurance exerciser with "Steve," left, at Capital Living Nursing and Rehabilitation Center.
Physical therapist Brian Reese, center, works on endurance exerciser with "Steve," left, at Capital Living Nursing and Rehabilitation Center.

Categories: Business, News, Schenectady County

Half of the Medicare and Medicaid participating nursing homes in the Capital Region received one- or two-star ratings, on a five-star scale, under a recently revised federal ratings systems.

The revised system, known as Nursing Home Compare, incorporates more metrics than the system used in the past,

Glendale Nursing Home, a 200-bed facility operated by Schenectady County received two stars in the new ratings.

“There are challenges in long-term care,” said Ed Marchi, the administrator at Glendale Nursing Home, in Glenville. “the process is well intended and definitely needed for the public to be able to compare, but the way the system is currently set up is challenging for people trying to do the best they can.”

2015 NYS nursing home ratings

The federal Centers for Medicare Services created the Five-Star Quality Rating System to help consumers, their families, and caregivers compare nursing homes more easily and to help identify areas about which you may want to ask questions. The Nursing Home Compare Web site features a quality rating system that gives each nursing home a rating of between 1 and 5 stars, with being the highest. Click here for the full list of New York State nursing home ratings.

The recently revamped system takes into account staffing, health inspection reports and more to formulate overall ratings for each nursing home on a five-star scale.

In July, the Centers for Medicare and Medicaid Services (CMS) began including additional quality measures–such as a home’s number of successful discharges and re-hospitalizations in facilities’ ratings, though 2017 will be the first full year in which the new factors are included.

The rating system was updated on Aug. 10 as part of an effort to provide as accurate a picture as possible of what each nursing home has to offer, said Patrick Conway, deputy administrator of the CMS, in a press release. Most administrators say Nursing Home Compare is the industry benchmark for ratings, but the system has its flaws. Consumer representatives say the rankings provide an important tool for families looking for the best facility, though it should be used with other resources.

Out of 36 listed facilities in Schenectady, Montgomery, Saratoga, Fulton, Rensselaer and Albany counties, 18 were listed as one or two-star nursing homes.

The one-star facilities are Albany County Nursing Home, Bethlehem Commons Care Center in Delmar, Diamond Hill Nursing and Rehabilitation Center in Troy, Evergreen Commons Rehab and Nursing Center in East Greenbush, Fulton Center for Rehabilition in Gloversville, Rosewood Rehabilitation and Nursing Center in Rensselaer, Saratoga Center for Rehab and Skilled Nursing Care in Ballston Spa, Wesley Health Care Center in Saratoga Springs, Wells Nursing Home Inc. in Johnstown and Guilderland Center for Rehabilition in Altamont.

Facilities receiving a two-star ranking included Baptist Health in Scotia, Capstone Center for Rehabilitation and Nursing in Amsterdam, Ellis Residential and Rehabilitation Center in Schenectady, Glendale Nursing Home, Hudson Park Rehabilitation and Nursing Center in Albany, Teresian House Nursing Home in Albany, River Ridge Living Center in Amsterdam and Van Rensselaer Manor in Troy.

Of those, the Albany County Nursing Home, Van Rensselaer Manor and Glendale are government operated.

Meanwhile, six facilities in those counties were given five-star ratings. They are Pathways Nursing and Rehabilitation Center in Niskayuna, Seton Health at Schuyler Ridge in Clifton Park, James A. Eddy Geriatric Center in Troy, Eddy Village Green at Beverwyck, Eddy Village Green at Cohoes and Wilkinson Residential Health Care Facility in Amsterdam.

“We’re very proud of being a five-star facility, but we have to work hard to get it and to keep it,” said Jeff Ruso, administrator at Pathways.

In September 2015, the six Capital Region counties combined for seven one-star overall rankings — one fewer than it received a year later. The six counties also combined for only four five-star rankings in September 2015 — two fewer than the most recent rankings.

The three criteria taken into account to determine the overall rating are health inspections, quality measures and staffing. Each category has its strengths and limitations, which are listed on the Nursing Home Compare website.

For example, while health inspections show a comprehensive breakdown of any violations or deficiencies, they also place more emphasis on recent inspections, which means a facility could be penalized for a slip-up after months or years of no issues.

Nearly all facilities, including those that have five-star overall rankings, have some sort of deficiency listed from recent health inspections. In the majority of cases, regardless of ranking, the violations listed for each facility are considered to pose a minimal level of harm to residents. In most instances, lower rated nursing homes had a higher volume of those deficiencies.

Examples of violations listed in the national database include inspectors finding some nursing homes hired employees with a history of abuse. Others failed to provide properly nutritious meals to residents or adequate fluids to prevent dehydration. Some deficiencies referred to issues of record keeping at a facility.

The average number of health deficiencies at facilities in New York state is 5.7 per year, according to the database. For comparison, two-star Glendale had seven violations in that time, five-star Pathways had six and one-star Wesley Health Care Center had seven.

The quality measures rating, which is incorporating more info than in the past, is based on clinical data reported by the nursing home. It assesses factors like how often residents improve while in the care of the nursing home, how often residents are given needed vaccinations, how often residents are discharged and more.

Pathways Rehabilitation Center administrator Ruso said the quality measures are factors that the nursing home would monitor independently regardless of whether it was used for ratings.

The staffing rating is one that has recently changed in light of complaints from nursing home administrators. Previously, the rating was determined on a two-week snapshot of how many registered nurses per resident a facility had and total staffing hours per day.

The staffing ranking method will now show a year’s worth of data at a given facility, providing a better view of typical staffing.

Richard Herrick, president of the New York State Health Facilities Association, said Nursing Home Compare is one of the most important drivers for consumers determining where to take a loved one for long-term care. However, it often captures a snapshot of what a facility offers, and there are other tools available to families, he said.

“It’s a starting point where even if a facility is ranked low, it starts (families) asking the next question about giving the facility a chance to respond to Nursing Home Compare,” Herrick said.

Lisa Marrello, the administrator at Capital Living Nursing and Rehabilitation Centre, which has a four-star overall rating, acknowledges that she pays a great deal of attention to the Nursing Home Compare ratings because they are a measure on which the public relies. But there are some factors that can’t be captured by the database, she said.

“I think the most important thing is to go tour a facility,” she said. “Some could have a bad survey ranking because they had one issue that was isolated, and that lowers the survey score, but it could really be an excellent facility.”

Ruso added that for the nursing homes and their directors, the ratings are used as a yardstick to measure improvement.

Being in a business that involves complexities in caring for patients, and accepting residents who might be prone to medical complications will tend to drive ratings down in some cases. The important thing, he said, is to understand why the ratings are what they are.

“If your clientele is clinically complex, it’s not necessarily a bad indicator,” Ruso said of the ratings. “Different is not always bad, but you need to know why you’re different.”

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