By LIZ SKOCZYLAS
OBSERVER Mayville Bureau
One area nursing home has been issued a five-star rating by the federal Centers for Medicare and Medicaid Services, while three have received a rating of one star.
The Centers for Medicare and Medicaid Services, CMS, provide a Five Star Rating System to more than 15,000 nursing homes throughout the country. It provides an overall rating, as well as ratings for health inspections, nurse staffing and quality measures. The information then is compiled in the U.S. News & World Report's latest rankings.
To determine what star rating a home receives, CMS sets and enforces standards for all nursing homes enrolled in Medicare and Medicaid. It does not rank retirement or assisted-living communities.
Receiving the highest rating from CMS was the Absolut Center for Nursing and Rehab in Dunkirk. It was given an overall rating of five stars. In 2011, the facility had received a rating of four stars.
The Absolut Center for Nursing and Rehab in Westfield also scored highly, with an overall rating of four stars from CMS. Its rating, however, decreased from 2011, when it had received a rating of five stars. Additionally, The Absolut Center for Nursing and Rehab in Salamanca received an overall rating of three stars.
Absolut Care was one of two offers that was considered and then rejected by Chautauqua County Legislators for the purchase of the Chautauqua County Home in Dunkirk. It offered a $1.6 million-a-year lease on the home with an option to buy outright for $16 million.
Also scoring highly overall was Heritage Village Rehab and Skilled Nursing, in Gerry. CMS gave it an overall rating of four stars. In 2011, it had received only three stars from CMS.
Holding down the middle ground, with three stars overall, were Heritage Green Nursing Home in Greenhurst, which had been rated one star in 2011; and Gowanda Rehabilitation and Nursing Center.
The only facility in the area to be rated two stars was Heritage Park Health Care Center in Jamestown. This facility also decreased in star ratings from 2011, when it had been rated four stars by CMS.
Finally, receiving one star ratings were the Lutheran Retirement Home in Jamestown, which had been rated two stars in 2011; the TLC Health Network Lake Shore Hospital Nursing Facility in Irving, which had also been one star in 2011; and the Chautauqua County Home in Dunkirk, which had been rated three stars in 2011, when discussions to sell the home began.
"The agency collects information from states and individual homes and assigns each home (other than a few too new to have built up enough months of data) a rating of one to five stars in each of three categories: state-conducted health inspections, nursing and physical therapy staffing, and quality of medical care," wrote Avery Comarow, on how the ratings were done. "The ratings are combined to produce an overall rating of one to five stars."
Very few of the 10 nursing homes in the area scored highly on the Health Inspection portion of the ratings. The majority ranked in the middle, while one facility scored five stars and another was rated with only one.
"Because almost all nursing homes accept Medicare or Medicaid residents, they are regulated by the federal government as well as by the states in which they operate," Comarow wrote. "A home's rating is based on the number of deficiencies and their seriousness and scope, meaning relatively how many residents were or could have been affected."
The Absolut Center for Nursing and Rehab in Dunkirk earned its second five-star rating for 2013 in the Health Inspection category. It had two health deficiencies listed, while the state average is six and the national average is seven.
Heritage Village Rehab and Skilled Nursing in Gerry also matched its overall rating with four stars from CMS.
Three stars were awarded to Heritage Green Nursing Home in Greenhurst; the Absolut Center for Nursing and Rehab in Westfield; the Absolut Center for Nursing and Rehab in Salamanca; and the Gowanda Rehabilitation and Nursing Center.
Receiving two stars from CMS for Health Inspections were Heritage Park Health Care Center in Jamestown; the Lutheran Retirement Home in Jamestown; and the TLC Health Network Lake Shore Hospital Nursing Facility in Irving.
Finally, rating only one star for Health Inspections was the Chautauqua County Home in Dunkirk. It had eight health deficiencies and other issues.
Of the 10 area nursing homes, none were rated with five stars or one star in the area of nurse staffing.
"CMS determines the amount of time per day patients receive from the nursing staff, because even first-rate nurses and nurse aides can't deliver quality care if there aren't enough of them," Comarow wrote.
Factored into the ratings are the number of registered nurses, licensed practical nurses, licensed vocational nurses and certified nurse aids and assistants on the payroll during the two-week period before the latest health inspection. Also factored in are the number of hours each works.
"That information is compared with the average number of residents during the same period and crunched to determine the average number of daily minutes of nursing time," Comarow wrote. "To receive five stars in the latest CMS ratings, the nursing staff had to provide nearly four-and-a-half hours of care a day to each resident, including about 43 minutes from registered nurses."
The Absolut Center for Nursing and Rehab in Westfield and Skilled Nursing in Gerry and the Chautauqua County Nursing Home in Dunkirk each ranked highest in the area, with four stars apiece in this category. Residents at the County Home receive an average of one hour and 19 minutes per day with a nurse. Absolut spent an average of one hour and 46 minutes per resident. The state average is one hour and 32 minutes, while the national average is one hour and 36 minutes.
The facilities rated three stars in this category are Heritage Park Health Care Center in Jamestown; the Heritage Green Nursing Home in Greenhurst; Heritage Village Rehab and Skilled Nursing in Gerry; the Absolut Center for Nursing and Rehab in Dunkirk; and the TLC Health Network Lake Shore Hospital Nursing Facility in Irving.
Finally, rated two stars by CMS were the Lutheran Retirement Home in Jamestown; the Gowanda Rehabilitation and Nursing Center; and the Absolut Center for Nursing and Rehab in Salamanca.
Finally, facilities are given star ratings for quality measures, based on an 18-point system.
According to Comarow, CMS requires nursing homes to submit clinical data for the latest three calendar quarters detailing the status of each individual Medicare and Medicaid resident in 18 indicators, such as the percentage of residents who had urinary tract infections or who were physically restrained to keep from falling from a bed or a chair.
None of the 10 nursing homes in the area received a rating of five stars in this category. In fact, three received four stars and three received only one star, while the others received two or three.
The facilities that received four stars were Heritage Park Health Care Center in Jamestown; Heritage Village Rehab and Skilled Nursing in Gerry; and the Absolut Center for Nursing and Rehab in Salamanca.
CMS awarded three stars to both the Heritage Green Nursing Home in Greenhurst and the Absolut Center for Nursing and Rehab in Westfield.
The two homes receiving two stars for quality measures were the Absolut Center for Nursing and Rehab in Dunkirk, and the Gowanda Rehabilitation and Nursing Center.
And, the three facilities receiving only one star for quality measures are the Lutheran Retirement Home in Jamestown; TLC Health Network Lake Shore Hospital Nursing Facility; and the Chautauqua County Home.
AIMING FOR THE BEST
Jackie Jeffery, director of nursing for the Absolut Center for Nursing and Rehab of Dunkirk, said the star ratings issued do have a big impact, both on residents and employees.
"I think they have a big impact on families' decisions," Jeffery said. "I think it is big for the facility."
Regarding the facility's five-star overall rating, Jeffery said Absolut strives to always do better.
"Every year, we strive to get a little bit better," she said. "We look at things that may need to be corrected, or things that could be improved upon. We try to go forward and keep up with, in a timely manner, with all heath care issues."
CMS does warn, though, that its rating system is just a starting point when looking for a nursing home facility. CMS also says that many satisfied residents live in homes which did not rank highly in the CMS star ratings. It also advises against transferring a resident based on the ratings.
"(Transferring) your loved one to a facility that has a higher rating should be balanced with the possible challenges of adjusting to a new nursing home," CMS says in its Frequently Asked Questions.