|Ron Clark of Davidsville visits with his mother, May Clark, 88|
The responsibility of finding the right long-term care facility for
his mother, whose memory is clouded by dementia, gnawed at Ron Clark.
Though he sometimes asks 88-year-old May Clark if she remembers him,
she seems to know when her son needs consoling. She grips his thick
palm, weathered from years as a power plant mechanic, and the familiar
touch evokes a smile of relief.
“It’s a shock when you realize you have to put your mother in a
nursing home,” he said, pausing to corral his emotions. “You know you
have to do it, you don’t know where to turn …. It’s one of the most
excruciating things to do, but you have to make a decision.”
Most people will face this responsibility for a friend or family
member at some point in their lives as people live longer. It’s
particularly likely in Pennsylvania, which has the fourth largest
percentage of residents 65 and older in the country.
Often, the search leaves people dizzy with choices and worried that
their selection could end up being harmful to a loved one. The horror
stories of mistreatment or worse are well known.
But now there are more helpful tools than ever as government agencies
face the need for improved systems of looking at care and help for
families making these decisions.
The federal government is improving its ratings system of nursing homes throughout the country. In January
, staffing information and quality measures that used to be self-reported by nursing homes for the Nursing Home Compare
tool will instead be pulled from auditable reports.
That information will expand on the full text of inspection reports
that the Centers for Medicare and Medicaid Services [CMS] began
releasing in 2012.
However, elder-care advocates and long-term care officials caution
consumers against using only online tools to choose a facility. They say
the No. 1 priority should be to visit a facility, not just once during
the day, but a few more times, during meals and at night.
It can become a job on its own, and it has for some people, like
Eileen Graham, an elder-care adviser in Southwest Pennsylvania who
helped the Clarks of Davidsville find a personal-care home for their
Ron Clark and his wife, Rosalyn, told Graham they valued safety and
cleanliness, and hoped for a nearby facility that had the comforts of
home. They also wanted it to specialize in working with residents with
Graham considered the pros and the cons of several facilities, took
tours and then shared her notes with the Clarks. She also helped them
access benefits for spouses of veterans. She charges $85 to $125 an
Together, they decided on the Amber Hills unit of the Cambria Care
Center in Ebensburg, about 25 minutes away from their Somerset County
“There’s a lot of stigma, that nursing homes are dark and gloomy,”
Graham said. “It’s never going to be perfect ... but there are really
great facilities out there.”
Where Pennsylvania stands
The most comprehensive tool to determine what nursing home may be suitable is the online Nursing Home Compare.
Users can see what health violations nursing homes have had, how many
hours of care they provide daily to each resident and how many
residents develop pressure sores or use antipsychotic medication.
The data also tell a story about Pennsylvania nursing homes in general.
For instance, the news website ProPublica used the data
to show that Pennsylvania nursing homes have one of the lowest average
rates of serious deficiencies per home in the country. In addition, 28
states have had more Medicare or Medicaid payments suspended because of
On the other hand, CMS data show more than half of long-term
residents become incontinent, which surpasses the national average, and
Pennsylvania is home to the facility with the second-highest fine amount
in the country, according to CMS.
That title is held by the Golden LivingCenter in Lancaster, which was
fined more than $582,000 between January 2013 and February 2014 for
persistently poor care.
For two years, it has been a Special Focus Facility
meaning it’s subject to more frequent inspections and escalating
penalties, according to CMS. In November, CMS listed it among facilities
that have shown improvement.
Executive Director Stephen McShane wrote in an email that the home
takes “immediate action” when deficiencies are found, and he has hired
additional staff and new leaders. The home is currently in compliance
with all standards, he said.
With 699 nursing homes in Pennsylvania, according to Nov. 19 data,
each home has averaged eight deficiencies per year over three years and
three months of mandated annual inspections and complaint
The national average is six to seven deficiencies per inspection, according to CMS.
Five Harrisburg nursing homes had the highest average rate of
deficiencies among the state’s 10 most-populous cities, at 16 violations
per nursing home per year. It is followed by Lancaster and Scranton
with averages of 10 deficiencies per home annually.
Pittsburgh matched the statewide average of eight, and Philadelphia
was slightly higher with each nursing home cited with an average of nine
violations a year.
PublicSource used federal data that reports the city based on the nursing home’s postal code to determine this.
While the number of deficiencies can show a pattern, it’s the type
of deficiency that truly matters to Ron Barth, president and CEO of LeadingAge PA
, a trade association that represents 365 not-for-profit senior service providers.
“You can get a deficiency because literally there were three
burnt-out light bulbs in the facility, or you can have a deficiency
because people aren’t getting fed,” he said.
The deficiencies are rated on a scale of A to L, with L being the
most severe. About 85 percent of Pennsylvania violations were graded as
Ds and Es, meaning there was no actual harm, just the potential for it.
Eight nursing homes were responsible for the 11 most severe violations in the state.
Forbes Center for Rehabilitation and Healthcare of Pittsburgh
accounted for three Ls, and Harrison Senior Living of Christiana, Pa.,
in Lancaster County got two scarlet letters. An L grade means the
violation put several or all residents in immediate jeopardy.
Forbes earned its Ls in June for fire safety violations
Not inspecting or testing generators, not maintaining sprinkler
systems, and there was no approved program for fire alarm systems. The
home reported it made corrections in July.
Eric Dudik, the current administrator, declined to comment because he wasn’t at the home at the time.
In March, inspectors reported
that Harrison Senior Living failed to supervise residents at risk of
wandering off the premises and neglected to take action after noticing a
strong gas odor. It was also cited for not having a current emergency
plan. The home told inspectors it updated procedures by May.
“Our mission is to provide a high level of care for our residents,”
said Harrison Saunders, chief operating officer of Harrison Senior
Living. “We’re thankful to have the light shed on these deficiencies so
we can correct them and turn them around, and we certainly have.” (Continue reading
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Avoid the guessing game in search for nursing home