With a few exceptions, most Utah County nursing homes are serving their residents’ needs most of the time, data from a Salt Lake Tribune report and Medicare show.

“They really do a good job in general,” said Kristie Fritch, the long-term care ombudsman for Utah, Wasatch and Summit Counties. “Once in a while they mess up, and there’s a couple that mess up a lot, but most of them do a really good job. Of course, they’re not perfect; nobody’s perfect.”

Deficiencies at Utah County nursing homes range from minor infractions, such as having a burned-out call light bulb, to actual harm deficiencies, which can cause harm to nursing home residents, Fritch said.

Immediate jeopardy deficiencies are the most serious and the facilities where they are discovered are fined and placed on a 23-day termination track. If the deficiency is not corrected by the end of this time period, the government will revoke the facility’s Medicaid license.

“The minor ones I really wouldn’t worry about so much,” Fritch said. People wanting to place a loved one in a nursing home should pay more attention to immediate jeopardy, she said.

Fritch said while a few facilities are constant trouble spots, by and large nursing home ratings constantly fluctuate and can vary drastically from year to year for a variety of reasons.

“Sometimes its staff changes — they’ll have a change in the director of nursing or the administration or a big turnover,” she said, “and the residents have a hard time with getting to know the staff and [the administrators] have to go through the process of weeding out staff who don’t treat residents how they should. They show their true colors eventually.”

Data from the Medicare Web site and a series of Salt Lake Tribune articles published last June show the quantity of nursing hours per resident has little impact on the quality of care. One facility had more nursing hours per resident than all but two other nursing homes, but ranked third in deficiencies per year.

When it comes to staff, the quality of the care is what matters, Fritch said. “That’s the key,” she said. “If you are going for the goal of making sure residents have a higher quality of care, you’re going to hire a good staff.”

Bruce Allison, the administrator of Alpine Valley Care Center in Pleasant Grove, agrees. His facility is one of five non-profit nursing homes owned by Mission Health Services and has an overall Medicare rating of five stars. Allison attributes the center’s quality to its management, staff, stable environment and the implementation of what he calls “culture change,” a care program that revolves around the wants of residents.

“That’s where a lot of the quality comes in,” he said. “I think any nursing home could do it, but you’ve got to have the corporate people behind you.”

The temperance of the residents also factors into violations, as some abuse others, but Allison said Alpine Valley has a good mix of residents. “I don’t have any really aggressive people in here,” he said. “That makes a huge difference.”

Fritch said another factor that often affects nursing home ratings is the care for residents with mental illness. When patients at the Utah State Hospital begin to require additional care, they are placed in a nursing home. They often have a breakdown after they are placed because of the change in structure. “They act out and have a psychotic episode and end up in the hospital,” she said.

By law only 30 percent of a nursing home’s population can be mentally ill, and as a result, Fritch said, facilities are running out of space. “They do have some support, but not a lot,” she said of the nursing homes. “If they ever decide to discharge someone, it’s really hard.”

In March U.S. News and World Report released its annual rankings for the top 10 best and worst states for top nursing homes. The rankings, based off government ratings on a five-star scale, pegged Utah as the No. 10 worst, with just less than 10 percent of its 91 nursing homes receiving five stars.

According to the Medicare Web site, only two of Utah County’s 15 nursing homes have a five-star rating — Alpine Valley and American Fork Hospital Transitional Care Center. That puts the county’s average at 13 percent, higher than the national average of 11.9 percent. What’s more, the Tribune’s report showed that most Utah County nursing homes were far below Utah’s state average of 37 deficiencies a year from 2000 through 2007.

“The nursing homes in this area are way higher quality than in the Salt Lake area,” Fritch said. “My facilities here in this area have a lot less deficiencies than the ones in Salt Lake do.”

The Utah County facility with the highest average of deficiencies from 2000 to 2007 was Rock Canyon Nursing and Rehab, with 14.1. The nursing home was undergoing a management change at the time of the Tribune’s report and now has a four-star Medicare rating.

While ratings can fluctuate, people looking to place a loved one in a rest home can still find reliable ways to find out the quality of the facility. According to the National Institute on Aging’s Web site, people should look at the different options first, then ask others what they think the best care centers are.

Fritch said she advises stopping by rest homes to take a look. “My advice to anybody would be to tour the facility,” she said. Both she and Allison recommended that people notice the smell and speak with the residents. In addition, the Utah Health Care Association Web site suggests finding out what group activities are offered to residents, speaking with the facility’s dietician about nutrition and looking at inspection reports.

“Their goal should be that the residents have the highest quality of life possible,” Fritch said.



Copyright Brigham Young University 14 Jun 2009