Adult children making the difficult choice to place their elderly parents in a Florida nursing home often turn to the Centers for Medicare & Medicaid Services (CMS) when it comes to deciding on a facility. The federal agency has established a Five-Star Quality Rating System to assist consumers, their families and caregivers in order to compare nursing homes and help them more easily identify potential problems. Those with the highest ratings are considered to be top quality, while those at the lower end may have been cited for repeated deficiencies and issues that place residents in direct harm.
However, as a recent story out of Illinois shows, even those scores don’t necessarily tell the whole story. The Des Moines Register reported that despite a proposed fine $30,000 by the state for nursing home conditions allegedly leading to the death of an 87-year-old resident, CMS still gave the facility a five-star rating in terms of quality of resident care. It’s overall rating was two stars, which is considered below average.
The woman reportedly died after suffering from dehydration and severe pain. State authorities opined she may not have had water for several days. Yet the fine hasn’t actually been imposed, which would allow CMS to take over the case. It’s not the first time the nursing home has come under fire. Last year, the state fined the facility for physical and verbal abuse of the residents. The fact that it still has a five-star rating for care has many wondering the measures by which CMS decides one’s ranking and whether they are truly reliable, particularly considering they are based in part on data self-reported by the nursing homes and not verified by state officials.
Nursing home care advocates say there have long been questions about whether the federal government data is accurate. Even the government’s own inspection reports don’t always align with the five-star rating system. Late last year, CMS temporarily froze the rating system in order to initiate a number of revisions.
The system gives both an overall rating for each nursing home, as well as three separate ratings based on: Health inspections, staffing and quality measures.
In this particular case, the woman had lived at the facility since 2002, when she was 72. Staffers would later report that in the days prior to her death, she was in severe pain, crying and moaning. She was given Tylenol for treatment, and one aid reported a nurse “blew it off.” In late February, staffers reported her feet were blue, her eyes were dark and sunken and aides were unable to feel a pulse or get a blood pressure reading. Yet it wasn’t until three hours later she was transported via ambulance for tests. When hospital staff asked why there was a delay in bringing her in, a registered nurse reportedly responded that they didn’t believe her to be “that bad yet,” and that the staff had other things to do besides “sit there and watch the clock.” An emergency room doctor told inspectors that lab tests taken there indicated nursing home resident likely hadn’t had any water for four or five days, and probably limited fluids in the weeks prior. She was comatose on arrival, but awake and alert after given a liter of water. She was soon after returned to the nursing home, where she died the same day.
The state cited the nursing home for failure to adequately address both the needs of this patient and another, who was found dead in her bed an hour before this occurred. Another citation was issued for failure to assess a resident who suffered from a painful colon inflammation.
Last year, nursing home abuse at the facility spurred a $58,000 fine from CMS, wherein one worker allegedly physically and verbally abused residents. The nursing home is operating without a full-time administrator.
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Highly rated Iowa nursing home cited for abuse, neglect and resident deaths, July 24, 2018, By Clark Kauffman, Des Moines Register
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