Category Archives: Choosing A Nursing Home

WPDE reported that construction for the $55 million Florence VA nursing home started in July and is progressing well.  It’s being built on 33 acres off of National Cemetery Road just down the road from the Florence National Cemetery and the Florence County Veterans Affairs Office. Officials said the Florence facility will cost about $55 million. The nursing home will include 104 bedrooms, a dining area, and a recreational facility.

The S.C. Department of Mental Health operates all VA nursing homes in the state. The VA center will create 100 new permanent jobs and generate nearly $20 million in revenue for the Florence economy during the construction phase of the project, according to Florence County Senator Hugh Leatherman (R).

Many people in the community said they’re excited that veterans will have a resting place and the new jobs created at the nursing home.

 

CMS last month announced that it would add a new icon—which is a red circle with a white stop hand in the center—to the site to alert consumers when a nursing home has been cited for incidents of abuse, neglect, or exploitation. According to the data-analysis company StarPRO, CMS has affixed the icon to ratings for only 760, or roughly 5%, of the 15,262 facilities on the site.

CMS said the consumer alert icon would appear next to facilities that have been cited in inspection reports for abuse that caused a resident harm within the past year, as well as abuse that could have potentially caused residents harm in the past two years, and the move has been applauded by experts and consumer advocates in the nursing home industry.

CMS’ Nursing Home Compare website assigns a certain number of stars to nursing home facilities, similar to systems used to rate hotels. The best possible rating Medicare can give to a nursing home is five stars based on staffing, quality measures, and other factors. The ratings are designed for both consumers and providers. CMS added the icons to the site, and they appear directly next to the names of facilities that have received citations.

CMS said it will use the agency’s latest inspection data to update the icons each month, and it will remove the consumer alert icon when nursing homes have fixed the issues that caused the citations. According to the Wall Street Journal, CMS will remove the icon once a flagged facility goes without an abuse citation for one year.

Consumer advocates praised the icon’s introduction, but said the tool is imperfect and is based on an inspection system that often misses cases of abuse.

Richard Mollot, executive director at the Long Term Care Community Coalition, said, “We just hit the tip of the iceberg here. We are not finding the harm that’s out there. If we see a few occasions that are getting out, I think it’s an important alert for the public.”

 

The next state-operated, federally funded nursing home for veterans is likely to land in Sumter. Thanks to Representative Murrell Smith.

“There are a lot of retirees in Sumter, and they’re aging. They’re going to need these resources in these later years of life,” state Rep. Murrell Smith, R-Sumter, said. “It’s a perfect opportunity.”

Smith is chairman of the House Ways and Means Committee and is on the Joint Bond Review Committee; he claims it’s a win-win for both Sumter and the state.

“It’s a way to show appreciation for our members of the military who served, who were stationed here at Shaw [Air Force Base] and to incentivize them to retire here,” he said.

Members of the state General Assembly’s Joint Bond Review Committee agreed to a new project last month for what would be the sixth such facility in South Carolina. The homes are funded based on a cost-sharing formula between the Veterans Administration and state Department of Mental Health, with the VA providing 65%.

There are already three state veterans’ nursing homes in South Carolina: The E. Roy Stone Veterans Pavilion in Columbia, the Richard Michael Campbell Veterans Nursing Home in Anderson and the Veterans’ Victory House in Walterboro. Those are at capacity with a total of 530 veterans.

According to The Post and Courier, more than 1,000 veterans throughout the state want to live at a state nursing home, which are touted as high quality and low cost.

Three new homes received federal approval in April 2018, starting the design phase in Florence, Gaffney and Columbia, but construction costs increased since the state applied for the federal funds in 2015, Binkley said. When two facilities could be built, according to 2015 estimates, for about $82 million, the state is estimating only one for that much.

“We’re estimating high to not get caught short again,” Binkley said. “In 2015, we thought it would take about $40 million for one, but when we bid it in 2019, the low bids were in the $60 million range.”

Not having enough money allocated in the state budget to build three nursing homes, the Florence and Gaffney facilities were approved in June by the VA. The Columbia facility was nixed, the process starting over with an eye on Sumter.

Binkley is requesting $37 million in state appropriations in next year’s budget to put toward the Sumter facility and one more, if approved, at an undetermined location.

Using the $20 million leftover from not building the Columbia location, the $37 million includes $9.1 million that the General Assembly must appropriate in its spring 2020 session to meet an August 2020 deadline certifying the state has matched enough funds for the Sumter location. The rest is for what would be required in state matching funds for the seventh state nursing home.

The Florence and Gaffney homes began preliminary site work in May for an anticipated opening date of summer 2021, Binkley said. Sumter’s facility may be ready by 2023, but after the state funds are matched and certified, the VA still must appropriate its share. The state should know by June 2020 if the VA will match.

The 148,000-square-foot facility in Sumter would serve 104 residents and employ a 100-person staff. Binkley said the state is looking at modifications in design to lower construction costs for any future sites, such as semi-private rooms and eliminating in-home dining, that are permitted using state rather than federal guidelines.

State Sen. Thomas McElveen, D-Sumter, said while Sumter has always been at the forefront of prioritizing South Carolina’s veterans, he is seeing a “rapid change” across the rest of the state.

“Sumter is a natural fit for something like this. We’re very welcoming to our military and very friendly with our military out at the base,” he said. “Our delegation consistently advocates for issues that are important to veterans, and this was just the icing on the cake. Everything has lined up well for Sumter.”

Federal officials have started affixing a bright red “stop” hand icon next to facilities that have received recent abuse citations from the Centers for Medicare & Medicaid Services.

CMS unveiled the labeling plans as part of an unfolding five-pillar plan that includes improving transparency for consumers. Starting Oct. 23, the “Do not proceed” symbol will be placed next to facilities that have been cited for abuse, neglect or exploitation. Authorities call the open-palm display in a red circle “a consumer alert icon.”

It will appear next to facilities that have been given a citation for abuse that led to the harm of a resident within the past year or cited for abuse that could have potentially led to resident harm in each of the previous two years.

The icon will be updated on a monthly basis at the same time as inspection results. CMS said the monthly updating will come quicker than current quarterly updates and ensures that nursing facilities “will not be flagged for longer than necessary if their most recent inspections indicate they have remedied the issues that caused the citations for abuse or potential for abuse and no longer meet the criteria for the icon.”

“Through the ‘transparency’ pillar of our five-part strategy to ensure safety and quality in nursing homes, we are giving residents and families the ability to make informed choices,” CMS Administrator Seema Verma said.

While consumers can already learn about nursing home violations through health inspection reports available through the website, the CMS said they’re too difficult to access now and that the new icon will make it easier for consumers to find out about abuse citations.

She said the added information is meant for “incentivizing nursing homes to compete on cost and quality.

Blue Ridge in Georgetown nursing home and rehabilitation center was named to a list maintained by the federal government of poorly performing facilities.  Blue Ridge in Georgetown was already fined nearly $44,000 for health violations in 2018. The facility received 33 health citations during its last inspection in October 2018.

Blue Ridge joined four other nursing homes in the Palmetto State as candidates for a federal oversight program. Commander Nursing Center in Florence has been officially flagged for the government to focus on since July.  Blue Ridge of Sumter was added to the list of candidates for the SFF program in June. Magnolia Manor in Columbia and The Retreat at Brightwater in Myrtle Beach were added in July.

The Centers for Medicare and Medicaid Services, the federal office in charge of administering the programs, keeps a list of nursing homes that consistently don’t meet standards and agreed to publicly release a monthly update to that list in June.

The most severe offenders are then designated as Special Focus Facilities. This designation increases the frequency that a nursing home must be inspected and sets guidelines for where and how quickly a facility must improve. Around 400 facilities are designated as SFF candidates at one time.

Facilities that do not graduate from the SFF program within 18 months risk losing their ability to participate in the Medicare and Medicaid programs.

 

WoodTV had an interesting article about Illuminate HC which took over management of SKLD and 10 other Michigan nursing homes a year ago. Of SKLD’s 11 homes, four have one-star ratings (much below average), four have two-star ratings (below average), two have three-star ratings (average), and one has a four-star rating (above average).

Brandee Davis has been complaining about the care and treatment of her mother for months. Davis, whose mother lives at SKLD nursing home in Wyoming, has filed formal complaints with the state twice since May.

“It’s really hard to watch someone you love with all your heart suffer… beg for help, beg to leave,” Davis said in an interview.

SKLD has a one-star rating on the federal website medicare.gov, a score that’s described as “much below average.” Of the 25 licensed nursing homes in Kent County, SKLD is one of just three with a one-star rating.

Davis is going to court in September to try to get guardianship over her mom, Michele, so she can move her.

“I shouldn’t have to keep calling and reporting,” Davis said. “My mom shouldn’t have to call me, begging me to call the home because her call light has been on for two hours and nobody’s coming to her room.”

Among Davis’ complaints to the state is that SKLD workers failed to answer her mom’s call light or change her diaper for hours; ran out of appropriately-sized briefs, thus forcing her to wear too-small briefs which ripped her skin; left her in the same clothes for five days and placed an aggressive dementia patient into her room despite her inability to protect herself.

“They decided to place a known violent dementia patient… in a room with an incapacitated adult who can’t do anything for herself,” Davis said.

State investigators who inspect nursing homes on behalf of the Centers for Medicare and Medicaid Services substantiated several of Davis’ complaints, including the one about her mom’s new roommate, who was moved to another room after she “went through (Davis’ mom’s) things … smacked her legs” and attacked staff, bruising a nurse, according to a state report.

“Review of documentation and interviews, revealed (Davis’ mom) was vulnerable and unable to defend herself from (the dementia patient) who wanders, has physical behaviors and a history of blocking the doorway to the residents’ room so staff could not get into the room. Which placed (Davis’ mom) at higher risk of harm,” a state inspector wrote.

Inspectors issued statements of deficiencies and ordered the home to create plans of correction after their visits in late May and mid-July. Among the deficiencies cited were out-of-reach and unplugged call lights, residents left for hours in urine-soaked briefs and dirty rooms with “dried food and liquids stuck to the residents’ room floors, dirt and dust accumulating under the residents beds, tissues and papers accumulating on the floors.” One room had dust clumps “larger than golf balls” under the bed.

Davis said SKLD injured a helpless elderly person.

“It’s mind-blowing and traumatizing,” she said. “And when I was in there two days ago, they’re still using one person to change my mom and she can’t use her arms to stop, to protect herself. So if they roll her and she rolls to the other side, that’s going to be catastrophic.”

Davis’ biggest fear is that her mom will choke and be unable to call for help.

“She can’t really eat or swallow very well, so I always get worried she’s going to choke and she’s going to push her call light and no one’s going to get there in time,” she said.

 

The Post and Courier reported on the six nursing homes in South Carolina identified as consistently poor-performing in a congressional list previously kept secret by a branch of the Department of Health and Human Services.

Riverside Health and Rehab in North Charleston is the only facility in the state given the full SFF designation. The other five South Carolina facilities listed in the report were listed as candidates for the SFF program:

  • Commander Nursing Center, Florence
  • Blue Ridge of Sumter
  • Life Care Center of Hilton Head
  • Compass Post Acute Rehabilitation, Conway
  • PruittHealth — Blythewood, Columbia

The list, current as of April, was released to the Senate Special Committee on Aging at the beginning of June after a bipartisan inquiry from Pennsylvania Sens. Bob Casey, a Democrat, and Pat Toomey, a Republican.

“It is outrageous that we continue to hear stories of abuse and neglect in nursing homes that do not live up to these high standards,” Casey said in a news release. “Choosing a nursing home is a difficult and often painful decision to make. Individuals and families deserve to have all the information available to choose the facility that is right for them.”

Homes that meet safety and health guidelines are typically inspected every nine to 15 months. If a facility is classified as a Special Focus Facility, however, it must be inspected every six months and must graduate from the SFF designation within 18 months or it risks losing the ability to offer Medicare or Medicaid.

The list of SFF-designated facilities has previously been made publicly available. But until now, the Centers for Medicare and Medicaid Services had shielded from the public eye the list of roughly 400 facilities that were considered for the program but didn’t make the cut.

 

McKnights had an article on The Ensign Group.  National nursing home chain The Ensign Group has taken over a skilled care unit in Sonoma Valley Hospital which was originally scheduled to be closed.  The Sonoma Valley Hospital has struggled in recent years to maintain the service, which has lost about $800,000 annually but has now decided to bring The Ensign Group.  Ensign has grown rapidly in recent months and is one of the largest nursing home chains in the country. Its portfolio includes 197 SNFs and 56 standalone senior living facilities. It also owns 26 hospice agencies and 25 home health operators, which it spun off into a second company called Pennant Group earlier this month.

“Under the draft proposal, Ensign would assume operations of the skilled nursing unit on July 1. Sonoma Valley Hospital will receive funds from the operator as part of a revenue-sharing agreement. The medical center will in turn provide certain higher-acuity services to nursing unit patients. This is expected to generate incremental revenues for the hospital while at the same time, SVH will not be held liable for any losses incurred by its partner. The facility will remain under the hospital’s license and oversight.”

The South Carolina Department of Health and Environmental Control is investigating Phaire’s Care assisted living facility in Orangeburg County after receiving a complaint last month.  A woman said her sister lives in the facility and claims she went missing.  The woman said she filed a complaint with DHEC after that incident.

DHEC has found several problems with Phaire’s Care in the past, including medical policy violations. DHEC records from an inspection in January show the department recorded problems like facility staff not administering medication correctly, not keeping patient records on hand and not feeding residents properly.

In February, a man living at Phaire’s care went missing from the center and was found later that day.  Officials from DHEC also announced in February they were taking “enforcement action” against Phaire’s Care following a history of non-compliance.

Despite several attempts via telephone and in-person, officials from Phaire’s Care have not responded to DHEC’s inspection.

THI OF SOUTH CAROLINA AT CHARLESTON, LLC is a nursing home in North Charleston owned and operated by Fundamental Long Term Care Holdings LLC which is now known as Hunt Valley Holdings.  The facility is known as Riverside Health and Rehab.  The facility is awful as most of the facilities in that infamous national for-profit chain tend to be because of the policy to under-staff to increase profits.

Riverside is again facing a wrongful death lawsuit because a resident was neglected and died after the facility failed to take care of her.  An expert affidavit states that based on the medical records of the woman who died, it was documented the woman was at high risk for falls, but the facility’s employees failed to “properly implement fall prevention measures” to keep her safe.

The lawsuit was filed last month and claims a woman was admitted to Riverside Health and Rehab in September 2015.  About a year later, employees at the facility allegedly found her on the floor of her room with a laceration above her right eyebrow.  A couple days later, the resident got a fever and was taken to the hospital and diagnosed with dehydration and severe malnutrition.

A couple days after that, the lawsuit says that woman died as a consequence of the traumatic fall.

Public records from the state’s Department of Health and Environmental Control show this facility has a long history of complaints.

In the last five years, people have filed at least 43 complaints against Riverside. That’s more complaints than any other nursing home in Charleston County.