Families for Better Care Grades States on Nursing Homes

Dorian Martin Health Guide
  • One of the worst experiences in my life took place in late September 2005 when Mom became a resident of a nursing home. She was mad as a hatter at having to be in this facility, even though she needed the assistance due to Alzheimer’s disease as well as extensive damage to her lungs due to chronic obstructive pulmonary disease.

     

    The next two years were a rollercoaster ride. I knew that Mom was in the best place for her health, but I had to be vigilant in making sure that the nursing home staff knew that I was a visible – and, if need be, vocal – advocate for my mother. I found that certain staff were wonderful in their commitment to residents whereas others were just there for a paycheck. I saw some nursing staff go out of their way to meet Mom’s needs; other times, I had to get in people’s faces since Mom’s oxygen tank consistently was empty when I visited.

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    Based on these experiences, I know that the quality of nursing homes can vary greatly day by day, not to mention by facility and by state. Therefore, I was greatly interested in a report by Families for Better Care, a non-profit citizen advocacy group focused on creating public awareness of the current conditions of the nation’s nursing homes and other long-term care facilities. The group has published the first-ever nursing home report card in order to gauge nursing home care by state. 


    “The intent of this report is to applaud those states that provide quality resident care while encouraging additional accountability for those that score poorly,” stated Brian Lee, the executive director of Families for Better Care. “And as our country enters into an unprecedented long-term care era, we ask that public officials further scrutinize and strengthen their nursing home safeguards. Raising the bar will only result in better care for our beloved parents and grandparents.”

     

    The group used the following data to develop a grade:

    • Staffing data from the Kaiser Health Foundation, which included each state’s average registered nurse hours per resident per day and the state’s average certified nurse assistant hours per resident per day.
    • Performance measures from the Center for Medicare and Medicaid Services’ Nursing Home Compare, which included the percentage of facilities with above average registered nurse staffing, the percentage of facilities with above average direct care staffing, the percentage of facilities with above average health inspections, the percentage of facilities with deficiencies in Calendar Year 2012, and the percentage of facilities with severe deficiencies in Calendar Year 12.
    • Complaint data collected from the Office of State Long-Term Care Ombudsman, which included the percentage of verified ombudsman complaints during Federal Fiscal Year 2011.

    Families for Better Care averaged these measures and then ranked states and assigned a final letter grade based on the state’s ranking in relation to the others. A grade of “A” was given to the states who ranked between 1 and 10 while a grade of “B” was given to states who were ranked from 11 to 20. The other grades were assigned accordingly based on similar groupings.

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    The group’s analysis determined that the states with the best ratings for nursing home care (which received an “A”) are Alaska, Rhode Island, New Hampshire, Hawaii, Oregon, Maine, Utah, Idaho, South Dakota and North Dakota. In contrast, the states with the worst records for nursing homes are Texas, Louisiana, Indiana, Oklahoma, Missouri, New Mexico, New York, Michigan, Nevada, Illinois and Iowa. All of these states received a grade of “F".

     

    The report noted that nearly 90 percent of all nursing homes had been cited with a deficiency. Furthermore, 20 percent of the nursing homes in almost half of the states were guilty of abusing, neglecting or mistreating their residents.

     

    The report also identified the best and worst states by category. These states were:

    • Registered nurse hours – Best state: Alaska with 1 hour, 10 minutes per day; worst state: Oklahoma with less than 30 minutes per day.
    • Direct care staff hours – Best state: Alaska with 3 hours, 33 minutes per day; worst states: Illinois and Nevada, with less than 2 hours and 8 minutes per day.
    • Percentage of facilities with above average registered nurse hours – Best state: Alaska, with 100 percent; worst state: Louisiana, with 8 percent.
    • Percentage of facilities with above average direct care staff hours – Best state: Alaska, with 100 percent; worst state: Texas, with less than 20 percent.
    • Percentage of facilities with above average health inspection – Best state: Washington, D.C., at 42 percent; worst state: Nevada, at 23 percent.
    • Percentage of facilities with deficiencies – Best state: Utah, with 35 percent of deficiency-free inspections; worst states: Nevada and Washington, D.C., with no deficiency-free inspections.
    • Percentage of facilities with severe deficiencies – Best state: Rhode Island, with less than four percent; worst state: Michigan, with more than 50 percent.
    • Percentage of verified ombudsman complaints – best state: New Hampshire, with 36 percent; worst states: Montana and Connecticut, with 100 percent.

    So what should you do with this report? Here’s what I’d suggest:

    • Read a copy, taking note especially of the data related to your state.
    • Share the information with your state’s elected officials.
    •  Also share the report with the local and state organizations that are responsible for the aging population and nursing homes.
    • If you have a loved one in a nursing home, share the report with the facility’s administration. Also share it with family members of other residents and the ombudsman. Use it to begin to a discussion about how to improve the services of the nursing home.
    • Be visible at your loved one’s nursing home. Remember the old adage, “They respect what you inspect.” That means that the nursing staff will take notice that you’re there and will (probably) be more aware of the care they’re providing. While there, see if you notice any of the issues that the report brings up.

     

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    Families for Better Care. (ND). Nursing home report grades.

Published On: May 12, 2014