Federal reviewers give 6 nursing homes in Hawaii poor scores
| • | Ratings aim to shed light on quality, offer choices |
By Rob Perez
Advertiser Staff Writer
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Six of Hawai'i's nearly 50 nursing homes received the lowest possible ranking in a new five-star rating system that is akin to what consumers use to select restaurants and hotels.
On the plus side, 11 facilities received the top rating of five stars yesterday by the federal Centers for Medicare & Medicaid Services, which devised the new Zagat-like system to help consumers evaluate quality of care at the nation's roughly 16,000 nursing homes, including 48 in Hawai'i.
One expert, however, suggested that the new system won't do a lot to prod Hawai'i nursing-home operators to improve their care.
"It may not be that relevant," said Cullen Hayashida, a gerontology professor at Kapiolani Community College.
Because bed space is so scarce here, families can't be too picky about where they place their loved ones and often take the first empty bed they find, according to Hayashida.
What's more important in ensuring a high quality of care, he and others said, is frequent family visits to the facility. "It's almost like having that extra eye" checking on the service, Hayashida said.
Hawai'i families tend to visit their loved ones frequently, and because of that, the quality of care here generally is on par with or better than the quality in many other metro markets across the country, he added.
The federal agency, which is releasing the star-ranking results publicly today, has long worked to develop a consumer-friendly way for families to evaluate the care provided by nursing homes. In the new system, CMS assigns one to five stars for quality of care, staffing and state health inspections and for an overall score.
The scores reflect such measures as how many nursing staff hours were provided each day to patients, how many patients developed bed sores and how many were placed in restraints.
The six Hawai'i facilities that received a single star for its overall rating were:
'IT'S A LITTLE CONFUSING'
Donda Spiker of Kuakini Geriatric said she didn't believe her facility's one-star score was justified, particularly given that Kuakini received a four-star mark for quality of care. She also noted that the rankings reflect data going back three years, which can skew the results for any facility that has made substantial improvements since then.
"It's a little confusing," Spiker said of the scoring system.
"We're worried people are going to misunderstand it. Because if we don't understand it, how are regular people in the community going to understand it."
Kurt Akamine, administrator for Garden Isle Healthcare, said getting more information to the public is positive and provides more accountability.
He said Garden Isle has received substantially improved inspection results in the roughly three years his company has run the facility but the overall rating was affected because the nursing home, in Wilcox Memorial Hospital, takes cases that are much more medically complicated than those found at typical homes.
Salim Hasham, chief implementation officer at Hawai'i Medical Center, said his facility's scores were affected by its mission of not turning away complex cases, such as patients with hemodialysis or severe infections.
"We recognize there are areas in which we need to improve, and are working diligently to correct deficiencies we find or that are brought to our attention by other agencies," Hasham said in a statement. He said the hospital expects rapid improvements in those areas.
The three other nursing homes that received the poorest marks couldn't be reached for comment or would not respond yesterday.
LOW NUMBER OF BEDS
Hawai'i has one of the most underserved markets in the country in terms of nursing-home bed space for the elderly. It has about 24 beds per 1,000 elderly residents, compared with a national average of roughly 55, according to KCC's Hayashida.
One of the 11 Hawai'i nursing homes that scored the top mark was Leahi Hospital.
In a November 2007 CMS survey that used different criteria, Leahi was included on the list of the nation's poorest performing nursing homes.
Since then, Leahi appears to have been able to improve its care, according to Keith Ridley, chief of the Department of Health's Office of Health Care Assurance, which licenses nursing homes here. He noted that all 48 homes have meet the minimum requirements for licenses.
Some research has shown that for-profit nursing home operators are more likely to provide poor care than nonprofit ones, a finding that was corroborated by a USA Today analysis of the new CMS data.
But Hayashida said that doesn't seem to apply here.
Six of the 11 top-rated Hawai'i nursing homes are for-profit, while for-profits make up half of the poorest-rated ones.
Reach Rob Perez at rperez@honoluluadvertiser.com.
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