Only nuclear power plants, it seems, are more regulated than skilled nursing care centers, comments Patricia Nelson, director of nursing for Lenbrook, a nonprofit senior living community in Atlanta.
A third-generation nurse, Nelson has spent half of her 20-year nursing career in geriatrics and has been at Lenbrook for almost one year. “The elderly and children are the most vulnerable, and the government wants to make sure regulations are in place so they can get the quality of care they deserve,” she said.
When searching for a skilled nursing care facility, one place to start is medicare.gov/nursinghomecompare, a 5-star quality rating system by the federal Centers for Medicare and Medicaid Services. It’s supposed to help consumers look beyond slick marketing brochures and alluring websites to see what kind of care they can expect at certified nursing homes.
Ratings are based on a combination of health inspections, staffing and other quality measures. The system has been in place since 2008, but earlier this year, rating standards were tweaked to put more emphasis on nurse staffing levels and the use of anti-psychotic medications, among other changes.
Using the new rating method, Georgia doesn’t fare very well. Currently, 42 percent of nursing homes in the state have the lowest ratings — 1 or 2 stars out of a possible 5. Just 16 percent of the 356 nursing homes statewide earned 5 stars, the highest rating. Some 20 percent earned a 4-star “above average” rating, and 22 percent were “average” with a 3-star rating. Data is updated monthly.
Kathy Floyd, executive director for the Georgia Council on Aging, said the state’s dismal showing is a combination of factors.
“We do need to demand higher standards from our nursing homes, but we also need a higher (Medicaid) reimbursement rate. We have one of the lowest rates in the country,” she said.
Floyd said 80 percent of nursing home beds in Georgia are paid for by Medicaid, the federal and state insurance program for the poor and disabled.
In the meantime, facilities need to look at the quality measures that can be controlled without extra funding, Floyd said. The ratings include stats like pressure sores, the use of restraints, and vaccinations, among others. Quality measures for each facility can be accessed from the website. Consumers can even peruse facility health inspection reports.
One of the 5-star ratings belongs to Lenbrook’s skilled nursing and rehabilitation health center, which has maintained the highest possible rating since becoming Medicare certified in 2013.
Staffing levels can help boost the overall quality rating. For example, Lenbrook has enough registered nurses on staff to double the average time spent per resident as compared to state and national averages.
Registered nurses can make a big difference in the quality of care, Nelson said. She said they can spot medical problems more quickly, which speeds up the treatment process and gets short-term and long-term patients back home as quickly as possible with fewer readmissions.
Nelson said public expectations do as much to drive up quality as do government regulations.
The skilled nursing care industry is changing because baby boomer consumers, many of whom are seeking assistance for their parents, expect more than previous generations, she said.
“This is not the long-term care that your grandfather was in,” Nelson said. She said the goal at Lenbrook is to go beyond just taking care of health needs.
“It’s about the quality of life and making sure the resident doesn’t give up the things they have always enjoyed. We tell them, you may have a different location now and your body may behave differently, but you’re still you,” she said.