Tag Archives for nursing home

Internet will soon be good source for information on nursing homes

Published in The Pawtucket Times, May 2003

A growing number of Americans are doing their shopping for products and services, via the Internet.  But if the federal government has its way consumers in five states will rely on Medicare and Medicaid programs and their family members, will be able to cruise the world wide web to find the best nursing facilities to meet their specific needs.

Rhode Island is among five states chosen by the Centers for Medicare and Medicaid Services (CMS) for a pilot project that will identify collect, and publish nursing home quality information on the Internet for easy access and comparison of facilities.

The other states are Colorado, Maryland, Ohio and Washington.  Eventually, this federally-funded initiative will be expanded nationwide.

People covered by Medicare and Medicaid have the power to choose the best care to meet their individual needs, but they have to have more reliable information to choose quality care, HHS Secretary Tommy G. Thompson, who oversees the Medicare and Medicaid programs. “Our efforts will help beneficiaries all across the country to compare the performance of their local nursing homes, and will provide the recognition that high-quality nursing homes deserve”.

In April 2002, the newly compiled performance information becomes available online at www.medicare.gov and will also be disseminated through Rhode Island Quality Partners, an agency contracted by the federal government to oversee the quality of health services provided to Rhode Island Medicare beneficiaries.

So what information can consumers find when shopping for the right nursing facility on the world wide web?

Currently, the CMS’s website provides nursing facility-specific information compiled from state annual surveys.

As a result of this five state pilot project, consumers will be able to see data culled from the Minimum Data Set (MDS), a standardized medical collection form that every nursing home is required to complete on every patient upon admission and on a regular schedule thereafter.

For those seeking a long-term placement, CMS will bring together comparative state-wide information that indicates quality care is being provided.  When shopping you will be able to find out how many residents are being physically restrained, how many have pressure sores, how many are taking anti-psychotic drugs without a psychiatric diagnosis, how many have lost weight, how many have acquired an infection, and finally how many residents can no longer take care of themselves.

For those seeking short-term stays after hospitalization, CMS will provide state-wide MDS data compiled from nursing facilities that can tell you how many residents are in pain, how many residents fail to recover from delirium, along with how many are re-hospitalized and improvement in walking.

Dr. David R. Gifford, principal clinical coordinator with Rhode Island Quality Partners, told All About Seniors that CMS chose Rhode Island for the pilot project because of the state’s interest in public reporting of consumer information.  He noted that CMS was aware of Lt. Gov. Charles Fogerty’s legislation, recently enacted that now requires reporting of nursing facility quality information.

“We’re very pleased to be involved in the pilot project because it allows us to help shape the national data dissemination effort,” Gifford adds.

How will consumers not computer savvy gain access CMS’s new quality measures?

Dr. Gifford notes that each state participating in the pilot project must develop other avenues for non-computer users to tap into the MDS data compiled on its website.

Roberta Hawkins, Executive Director of the Alliance for Better Long Term Care and the state’s ombudsman, applauds the new federal effort to help consumers in choosing nursing facilities.

However, Hawkins is concerned that the MDS does not always provide “insight into the personality of a nursing facility.”

“MDS won’t tell you if a facility’s staff are compassionate to residents.”  she says.  Additionally, the newly compiled CMSA information will not provide you with specifics about how some facilities specialize in taking care of ethnic populations.”  she added, specifically, if staff speak a foreign language, sever ethnic cuisine, or plan culturally-related activity programming.

Additionally, Hawkins notes that while CMS’s website may tell you how many persons have bed sores, a higher incidence of bed sores may only reflect that a newly admitted resident came to the facility with bed sores or that a facility specializes in taking care of that medical condition.

At best, internet information can only provide a snapshot of care being provided by facility staff, warns Hawkins.  “Today’s best nursing homes may become next weeks providers of poor care,” she adds, when key staff in leadership positions leave the facility.

Take advantage of CMS’s website to cull nursing facility specific information compiled from state annual surveys.

When in doubt, call the Alliance for Better Long-Term Care at 785-3340.

Nursing Assistant Recognized for Providing 31 Years of Quality of Care   

Published in the Pawtucket Times on February 4, 2002

At the age of 32 in 1963, Adele Lubera had already raised a daughter. Now it was time for her to go to work to bring money into the household.

But after holding very brief jobs at two mills in Central Falls, the former homemaker realized the mill jobs were not her cup of tea. As a foot press operator who manufactured sunglasses, Lubera could not stand the loud, repetitive noise and clatter of machines, nor did she end up liking the tediousness of inspecting baby clothes.

Be it fate, destiny or just being in the right place at the right time, Lubera eventually fell into a fulfilling lifelong career that has spanned more than three decades. A tip from a friend led the frustrated mill worker to seek employment as a nursing assistant at the Cumberland-based  Grandview Nursing Home. Lubera was one of the facility’s first hires for nursing assistants.  In time, she would take several other positions, including one at Manchester Nursing Home in Pawtucket, which ultimately would lead her to her current position as a certified nursing assistant at Harris Health Care North in Central Falls.

Last week, more than 300 people from Rhode Island’s nursing home industry, gathered for a breakfast to recognize their own, as well as state officials, politicians, and community volunteers who bring quality of care to the state’s 106 nursing homes.

Along with other award recipients, Lubera received her 15 minutes of fame that day. She was recognized by the Rhode Island Health Care Association (RIHCA) as recipient of the group’s First Annual Quality Award. “The President’s Award,” for her 31 years of providing quality of care to residents in her current position. The RIHCA award is given to a dedicated certified nursing assistant who exhibits caring and compassion while delivering quality of care.

When presenting the prestigious award to Lubera, Jimmy Flanagan, RIHCA’s past president, told the packed banquet room that in 31 years at her current position, Lubera had never called in sick or even arrived late to work.  Quite a track record.

Being an advocate for long-term care, Lubera has always been three to reassure families. She goes the extra mile for resident’s too, Flanagan said.

“Lubera is a wonderful role model for other workers,” he added, noting that she has led by example and displays loyalty, caring, and consideration for her fellow 13 workers.

Later that afternoon, at a party organized by Harris Health Care North, Central Falls Mayor Lee M. Matthews, quickly popped into the facility to shake hands and exchange greetings with: Luber; Michael, her husband of 51 years; daughter Dera DiBenedetto and her three children Dana, Ashley, and Drew; friends; facility staff and residents.

The mayor left behind a mayoral proclamation, celebrating the certified nursing assistant’s achievement by declaring the day to be “Adele Lubera Day” in Central Falls.

At the facility gathering, Lubera, holding her engraved plaque, reflected on her long career as a nursing assistant.

The time just by so fast, she said.

“It is hard work, but I enjoy every day,” she said. “The residents are like family to me.”

Resident Anna Golembeski, 89, who has resided in the facility for 38 years, describes Luera as helpful, kind and caring.

“She has been so good to her residents that it is about time she was recognized for her efforts,” Golembeski said.

Adds Elizabeth Daily, 88, a resident in the facility for six years, “There isn’t a person here who doesn’t love Adele.”

Administrator Elizabeth A. Sarro, of Harris Health Care North, calls Lubera the unofficial Mayor of Central Falls. Lubera knows almost everyone in the one-mile radius community, Sarro says.

“Everyone in Central Falls knows of Adele’s loving work,” she said. “She is pretty close to being a saint.”

Charley Harris, who owns Harris Health Care North and two other skilled nursing facilities, believes that certified nursing assistants are the backbone of the care delivery in any nursing facility.

“It is time that certified nursing assistants are finally getting the recognition they deserve<” he said.

“Nursing facilities are having tremendous problems staffing their facilities, particularly with front-line caregivers,” RIHCA Executive Vice President Alfred Santos stated. “With turnover rates estimated to be as high as 100 percent, people like Adele – whose commitment to her residents remains strong year after year are worth their weight in gold.

“It is great to see her receive recognition for her dedication,” says Santos.

Congressional report spotlights nursing home abuse

Published in The Times dated August 6, 2001

Congressional investigators have recently released a scathing report charging that within the last two years more than 30 percent of the nation’s nursing homes – about 5,285 facilities – were cited by state inspectors for at least one abuse violation that had the potential to cause harm.

These facilities were cited for almost 9,000 violations during the two-year congressional study, the report said.

Citing information gleaned from a sampling of state inspection reports or formal complaints, the 15-page report released last week at a hearing called by Henry Waxman (D-Calif), Minority Chairman of the House Committee of Government Reform, found that in more than 1,600 nursing facilities, approximately one out of every 10, the abuse violations were serious enough to cause significant harm to residents or to place them in immediate jeopardy of death or serious injury.

Abused residents were punched, choked or kicked by staff members or other residents, the report said, stating that the attacks frequently caused serious injuries such as fractured bones and lacerations.  In other instances, residents were being groped or sexually molested.

Although the report, “Abuse of Residents is a Major Problem in U.S. Nursing Homes,” prepared by Minority Staff of the Committee’s Special Investigation Division, found that the percentage of nursing facilities with abuse violations is increasing, it noted that the reasons for this increase are unclear.

In his opening remarks, Waxman stated that it had been unwise for Congress to repeal the Boren Amendment in 1997, a federal law which mandated that states provide nursing facilities with adequate funding to operate.  Because of this, he said, Medicaid funding for nursing facility care has not kept pace with the rising costs of providing care.

Waxman’s legislative prescription for attacking the growing abuse in the nation’s nursing facilities is to introduce a legislative proposal that would reestablish the abolished Boren Amendment, mandating minimum nurse staffing requirements, imposing tougher regulatory sanctions on poorly performing facilities, and instituting criminal background checks for nursing facility employees, or increasing internet disclosures on nursing facility care.

What’s playing out in Rhode Island?

According to Wayne Farrington, Chief of Facilities Regulation at the state’s Department of Health, the reporting of Rhode Island abuse complaints has risen by 10 percent.  The statewide increase in reports of abuse, neglect and mistreatment probably mirrors the tragic national problem, he tells All About Seniors, but is smaller because the Rhode Island 1987 statute has made it a misdemeanor for health care professionals or public safety officials not to report suspected abuse, neglect, mistreatment.  The size of the national increase is partially due to abuse reporting being a new requirement in some states.  Farrington added. 

Farrington states that the biggest factor that increases the number of reported calls of abuse, neglect and mistreatment is the severe statewide staffing shortage in Rhode Island’s nursing facilities.

“Overworked staff may become short tempered and this can result in abuse.  Not enough staff in the facility may also result in resident’s needs not being met,” he added.

Administrator Hugh Hall, of Cherry Hill Manor, also feels that the state’s critical staffing crisis contributes to the possibility of increased abuse and that crisis also affects the quality of care provided in the state’s 104 nursing facilities.

“Today’s nursing facility employees are underpaid, overworked creating an environment in which even the best employee may falter,” Hall said.

The administrator urges the General Assembly to increase Medicaid payments to more adequately cover the nursing facility’s actual cost of care, allowing for greater increases in direct care provider salaries.

“While last year’s average cost of care in a Rhode Island facility was $140 per day the state’s Medicaid program only reimbursed facilities $116 for the care provided, creating a serious shortage of funds in many facilities, Hall added.

“There are not enough certified nursing assistants in the system to deliver the care,” Hall said noting that opportunities must be created and a fair wage paid to attract people into this profession.

Meanwhile, Hall believes that the overwhelming majority of nursing facilities in Rhode Island provide quality care.  These facilities do criminal background checks and provide staff training.  They educate their staff about the facility’s expectation on quality patient care, he said.

Hall says facilities that have on going problems with abuse should be prosecuted to “the fullest extent of the law.”

Although Roberta Hawkins, the state’s Long-Term Care Ombudsman and Executive Director of the Alliance for Better Long-Term Care sides with Farrington and Hall about the critical need to directly confront the adverse impact of the staffing shortage in facilities, “it’s not to excuse to provide bad care,” she says.  “If facilities can’t care for residents then they should not admit them.”

A mandated continuing education program for both professional nurses and certified nursing assistants can be an effective strategy for reducing the incidence of abuse while enabling the better trained worker to care for more medically complex residents.

Additionally, Hawkins and long-term care providers are pushing for more state and federal Medicaid dollars to be allocated to provide a living wage for direct care workers.

Although lawmakers this year gave a small increase, “it’s not what was needed but it’s a start,” she acknowledges.

A divided Congress and a conservative Bush White House may well keep Waxman’s legislative proposal that addresses the problem of rising abuse in the nation’s more than 17,000 nursing facilities from every being enabled.

So, change must begin in the Ocean State.

When the Rhode Island General Assembly comes back into session next year, it becomes critical that the serious direct care staffing shortage in Rhode Island’s nursing facilities become a top legislative priority.

As the Republican and Democratic Gubernatorial candidates gear up their political campaigns and dream of becoming the state’s top elected policy official, they might well consider taking up the just cause of improving the care provided in the state’s nursing facilities.

Lawmakers can gubernatorial candidates can ill afford to ignore this key policy issue, one that puts the state’s 10,000 frail nursing facility residents in continued jeopardy of abuse, neglect or mistreatment.

On a political note, hundred of thousands of families and friends of these residents, who are voters, are watching.