In Pennsylvania, 40 percent or more of nursing homes have gotten the lowest scores from the government’s five-star quality rating system.
Kaiser Health News senior reporter Julie Appleby, who tracks the industry, said the government’s online tool is just a starting point.
“You cannot skip on visiting the home,” she said. “Go to the home at odd hours, go at dinner time. What are people eating? Go late in the evening. How many staff are on duty, what does the place look like, what does it smell like, what kind of activities are there for residents?”
Families weigh many factors when deciding which home is best — and star ratings aren’t the only consideration, Appleby said.
“Say, for example, the local home has a specialized treatment program for people with Alzheimer’s, and that’s what you are looking for,” she said. “Or maybe just the fact that it’s only five miles from your house, and that means you can visit every day.
“There have been lots of studies that have been done that correlate better care with how often a person — a resident — in a nursing home gets visitors.”
Teresa Osborne, secretary of Pennsylvania’s Department of Aging, said the state’s poor showing is “concerning.” Medicare’s rating tool is a good source with reliable information, she said, but families can also consult a local ombudsman about nearby facilities.
“That ombudsman is a person who is an advocate for the older adult and his or her family, can help them find a home, can help them make regular visits. And if they are having any problems, make sure their rights are protected,” she said.
The Pennsylvania Health Care Association is a trade group that lobbies for the nursing-home industry. CEO Stuart Shapiro says his group also advocates for patients.
While staffing levels lag in Pennsylvania, Shapiro says an above-average percentage of facilities across the commonwealth have strong scores for quality and patient outcomes.
“How are residents doing on pain? Are there pressure ulcers, are the residents falling? Are there urinary tract infections and catheter use?” he said.
Shapiro refers shoppers to ProPublica’s tool Nursing Home Inspect.
The state department of health oversees yearly nursing-home inspections.
Medicaid in Pennsylvania pays about $23 less than what it actually costs to care for a nursing home patient, Shapiro said, adding that “under-reimbursement” makes it difficult to hire additional staff.
A report commissioned by an association of long-term care providers documents other Medicaid “shortfalls.”
In the Kaiser foundation analysis, 32 percent of the nursing homes in New Jersey earned one or two stars. Delaware was among the best in the country, Appleby said, with just 20 percent of nursing homes in the First State earning two stars or fewer.