Two New Jersey nursing homes now require more frequent inspections because they’ve amassed too many health violations, according to an update issued in late January by the Center for Medicare and Medicaid Services, part of the U.S. Department of Health & Human Services.
Mount Laurel Center for Rehab and Healthcare, a 220-bed long term care facility in Mount Laurel, has been under increased scrutiny for 14 months, yet remains on a list of places “that have not improved,” according to the report.
Meadow View Nursing & Respiratory Care in Williamstown, which has 180 beds, was added to the “Special Focus Facility” list two months ago.
“It’s not a list you want to be on,” said Mark Levine, a former nursing home administrator who now is a consultant in the industry. “It’s the worst of the worst.”
Nursing homes in the federal monitoring program have unannounced inspections every three months, instead of every 12-18 months, Levine said. They stay on that schedule until they can prove their progress is permanent.
If they don’t get off the list, eventually they will be kicked out of Medicaid and Medicare – a death knell for this kind of business.
Most nursing homes will have some kind of “deficiency” noted in an inspection – just as health inspectors typically find small problems at restaurants, according to information provided by the monitoring program. The Center for Medicare and Medicaid Services says the average is 6-7 deficiencies.
But some places chronically have twice that number, bounce in and out of compliance, or have problems that carry a higher risk of harm to their residents. There are currently 86 nursing homes nationwide that require extra scrutiny.
The two New Jersey facilities have very different reasons for being on the list.
Meadow View, the center just added to the program, gets very low marks in the category of health inspections, yet maintains high marks for its staffing levels. Most importantly, it has attained the coveted five star Medicare rating for how patients fare there.
Those “quality measures” look at how many patients improve, how many get bed sores or infections, and how many report being in pain, among other things.
Those are important measures of patient health that can’t be faked or fudged, Levine said, who has served as a court- appointed patient care ombudsman. By contrast, he said, the opinions of an inspector are can be more subjective.
To get five stars in any category, as Meadow View has, a facility must be in the top 10 percent nationally, Levine said.
However, Meadow View got only one star for its health inspection, which found many violations in building and kitchen maintenance: cobwebs, peeling sheetrock, dusty ceiling vents, a filthy microwave, and an emergency CPR cart stored behind “a large Christmas tree, some boxes, an organ, 2 large televisions, a podium, and a row of chairs.”
Its report card meant it now has two stars on Medicare’s “Nursing Home Compare” website.
The nursing home changed owners in late 2015, when it was acquired by Genesis Health Care in Pennsylvania, a company that owns nearly 500 health care facilities in 34 states.
Many of the problems occurred under previous ownership, said a Genesis spokeswoman. Since it takes two years for older inspections to drop out of the federal calculation, the current report “is not an accurate reflection of the care provided at Meadow View today,” the spokeswoman said.
The facility has hired a new executive director and nurse executive since the acquisition, the spokeswoman said.
Mount Laurel Center for Rehab and Healthcare has just one star overall. Its health inspection rating is one star, while its staffing and quality care grades are three stars.
In an inspection last June, the inspector noticed a resident with an ankle that was obviously injured. The home’s records indicated no one bothered to interview the staffers in charge of the patient’s transport.
In another incident, a patient was supposed to be wearing mittens to prevent pulling out a tracheotomy tube when he or she became agitated. Instead, staffers decided on their own whether to put on the mittens.
“Everyone at Mt. Laurel Center was disappointed at the special focus designation, said Jeffrey Jacomowitz, a spokesman for Center Health Care, the Bronx-based company that owns nursing and rehabilitation facilities in New Jersey, New York, and Rhode Island.
Next week the facility will have a new administrator brought in from outside the company. Veteran administrator Mark Sorrento “has a history of turning around homes that have been in Special Focus and guiding them to 4-star status,” Jacomowitz said in a prepared statement.
The company has also hired new supervisors of nursing, come up with a plan to retrain staff, and augmented its maintenance teams. These changes will be implemented with no disruption of patient care, he said.
Levine said homes in the Special Focus program typically stay there for at least 18 months – long enough so that regulators are convinced that systemic problems have been fixed.
In the meantime, inspection results are updated quarterly on the Medicare website.
Another New Jersey nursing home, Waters Edge Healthcare & Rehab, recently improved enough to “graduate” from the Special Focus program after 27 months, according to the recent federal update.
Kathleen O’Brien may be reached at kobrien@njadvancemedia.com. Follow her on Twitter @OBrienLedger. Find NJ.com on Facebook.
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