Oregon Nursing Homes With the Most Health and Safety Deficiencies
Tuesday, September 16, 2014
Photo Credit: iStock
The biggest fines are typically associated with serious deficiencies; these are violations of federal health and safety standards that cause harm, put a resident in immediate jeopardy of harm, or create a potential for harm, according to Charlene Harrington, a professor emeritus at the University of California at San Francisco School of Nursing and a national expert on long-term nursing care.
In Oregon, a dozen nursing homes had serious deficiencies.
See Slides Below: 30 Oregon Nursing Homes With the Most Deficiencies
Nursing homes are subject to routine annual inspections to assess their compliance with federal safety and health standards issued by the Centers for Medicare and Medicaid Services. Those inspections are carried out by state agencies. (Usually, that is the Department of Health, which is the case in Oregon, a state spokesman confirmed.)
Inspectors mark deficiencies when a home fails to meet a particular federal standard. There are more than 200 of them, ranging from using the wrong kind of plates to failure to secure a building so patients with dementia won’t wander off.
Eighteen nursing homes had 30 or more deficiencies overall over the last few years, according to federal data first compiled by Pro Publica.
Link: All the data from Oregon here
Nursing home industry officials said that having a high number of deficiencies does not necessarily indicate a poor quality of care, given that deficiencies could range from crumbs under a toaster to failing to secure a facility. Industry officials said there are a number of factors that should be considered when deciding to place a parent or other loved one. Those factors include customer satisfaction surveys, staffing levels, and even the reputation a home has in the local community.
But Harrington said the deficiencies are an accurate measure of health and safety conditions in a nursing home.
“They’re fairly accurate,” Harrington said. “If anything, they’re actually undercounted.”
Fines and Violations
State inspectors typically lower the scope and severity of deficiencies they find, according to Harrington.
She said poor training, low pay, and high turnover are probably the cause for violations.
Because fines are almost always appealed by the home, Harrington said, inspectors are not likely to issue fines unless they suspect there is a major underlying issues at hand.
In Oregon 70 out of 138 homes were issued a fine. A third of the fines were just under $1,000. Most ranged between $1,000 to $10,000.
Those with the most fines also tend to have serious deficiencies.
Marquis Cases
Last February, at Marquis Mt. Tabor in Portland, inspectors found the nursing home had a dysfunctional call-light system in 13 out of 19 rooms and bathrooms and two common rooms on its fourth floor. Inspectors noted that four residents had been using a bathroom or shower without the ability to use the calls lights—if they needed them—and without any staff supervision.
Link: All Rankings in U.S.
“This placed residents at risk for accidents and/or injuries and resulted in an immediate jeopardy situation,” inspectors concluded.
Because of the dysfunctional lights, one resident was unable to call staff after finishing a shower and had to yell for help. It took 10 minutes for someone to respond.
Overall, the inspection resulted in a finding of 12 deficiencies and a $4,550 fine.
“The malfunction of the call-light system was corrected within hours of identification of the problem, with staff fully in place to provide close observation during the down period. No harm or injury occurred to any resident,” said April Diaz, the director of clinical services for Marquis Companies, owner and operator of the home.
Marquis Companies has nursing homes in 26 locations spread out over five states. Most are in Oregon.
Photo Credit: iStock
“Staff 2, RNCM, responded and saw smoke coming from the outdoor smoking area and flames coming from Resident 1. The fire was extinguished, 911 was called and the resident was transported to the hospital. It noted that at the time of the incident, the resident was smoking unsupervised,” the April 2013 report states.
The resident was hospitalized with a third degree burn to his thigh.
Diaz noted that Marquis had self-reported the incident to state authorities.
“Both Marquis Mt. Tabor and Piedmont Post-Acute Rehab are currently fully in compliance with all federal and state regulations,” Diaz said. “Marquis Companies’ overall regulatory compliance remains at higher than state and national averages. …
"With 75 percent of our facilities at a Nursing Home Compare Star rating of 4 or 5 star rating.”
Changes to Management
In some cases, a finding of serious deficiencies results in a change in management.
Gresham Rehabilitation and Specialty Care had 18 deficiencies—two of them serious—over the course of several inspections between April 2011 and March 2013. As a result, fines totaled $5,525.
Those findings prompted a change in management that took effect last May.
“Prestige Care assumed operations of Gresham Rehab and Specialty Care earlier this year, on May 1. All of the findings cited in the ProPublica report predate our involvement with the center,” said Eric Murk, the new administrator. “Since Prestige Care took responsibility for the building, we’ve been working hard to improve the quality of care we provide the residents of the center.”
Murk said the new management had made immediate changes, reviewing the staff in place and hiring an additional 20 employees whom he described as “high-quality, experienced caregivers.” He said Prestige Care had also invested in supplies, equipment and technology.
“Our No. 1 priority is always the health and safety of our patients and residents," Murk said. "We are very proud of our record of creating and maintaining centers across the western U.S. that provide residents with high-quality, compassionate skilled nursing and rehabilitation care.”
The management change was mandated by state authorities at the Milwaukie Convalescent Center; that facility was cited for a total of 48 deficiencies, two of them serious, between 2010 and 2013.
“Because of deficiencies they mandated a management company come in,” said Dane Jensen, the new administrator. “This family needed some help and they got that.”
Compared to other states, Oregon nursing homes overall have lower average annual number of deficiencies, an estimated 6.3 per home, according to data compiled by the Kaiser Family Foundation. That puts the Beaver State 41st in the national overall for the number of deficiencies.
The top two states are North Carolina, which had 4.4, and Rhode Island, at 2.7.
In terms of the average number of serious deficiencies per home, Oregon ranks in the bottom of the top third, with .14 serious deficiencies per home. At the other end of the scale, are states such as Kentucky, which had an average of 1.43 serious deficiencies per home, and South Carolina, which had 1.18, according to the ProPublica data.
Home page photo credit: iStock
Related Slideshow: 30 Oregon Nursing Homes with the Most Deficiencies
Below are the 30 Oregon nursing homes with the most deficiencies in federal health and safety standards. Homes are listed in order of least to most deficiencies. Data encompasses inspections over a three to four-year period in order to provide a more complete picture. Some nursing homes may have since corrected the deficiencies identified during the most recent inspections. Source: federal Medicare data obtained through the ProPublica database.
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