News From Terre Haute, Indiana

August 18, 2013

Valley nursing homes buck Indiana’s rating trend

Arthur Foulkes
The Tribune-Star

TERRE HAUTE — Uppermost in the minds of people searching for a long-term residential nursing facility for elderly loved ones is the caliber of the care they will receive.

Meadows Manor North is one of a very few “five-star” nursing homes within 25 miles of Terre Haute, according to the federal government’s Medicare Nursing Home Compare, a website designed to help consumers select the best long-term care for their loved ones.  

“We believe this is the residents’ home,” said Wendy Baker, administrator of the facility. “And we’re here to treat them with dignity and respect.” That includes keeping the facility clean, she said.

Not all Hoosier nursing homes, though, have such high status, and a Florida-based advocacy group wants Indiana lawmakers to turn up the heat on nursing homes, especially by requiring greater staffing levels.

“It’s deplorable,” said Brian Lee, executive director of Families for Better Care Inc., which is based in Tallahassee. His organization gave Indiana an overall grade of “F” for its nursing homes. Ten other states — Illinois, Michigan, Iowa, Missouri, Louisiana, Oklahoma, Texas, Nevada, New Mexico and New York — also received failing grades.

Among the eight federal measures used by Families for Better Care in its evaluation was actual face-time between nursing home residents and nursing home staff; Indiana ranked near the bottom.

“[Indiana’s] staffing hours are the third-worst in the nation,” Lee said. “Residents are only receiving two hours and 15 minutes of direct care per day.” In Alaska, the state with the best staffing score, residents receive three and a half hours of direct care per day, he said.

Without adequate staffing, “the residents are in danger of abuse, neglect, mistreatment or harm,” Lee said.

While Indiana may compare unfavorably with most states, Wabash Valley nursing homes are generally doing a good job, according to the federal government’s Medicare Nursing Home Compare database. Of nursing homes within 25 miles of Terre Haute, most score above average with three or more stars. And many also receive above average marks for their staffing levels.

John Turner, the state’s resident advocate in Area 7 (comprised of Vigo, Vermillion, Sullivan, Putnam, Parke and Clay counties), agreed Wabash Valley nursing homes seem above average in many respects. The staff and administrators work well with residents and families, he said.

Many Wabash Valley nursing home residents grew up in the towns in which they are receiving long-term care, Turner said. As a result, “word of mouth [concerning quality] travels fast.” In addition, local churches and other organizations often provide activities, entertainment and more. “I see a lot of that going on,” he said.

As for staffing levels, “I don’t think it’s deplorable,” Turner said. All nursing homes are staffed best during weekdays, he added. Nights and weekends can be the problem times, he said.

“There’s no perfect nursing home,” Turner said. Working in a nursing home is “a tough job. Employees do have bad days. We all have bad days. When complaints repeat over and over, that’s when you have to look into it.”

Most of the complaints Turner receives involve residents’ families, who may disagree on where a resident should be living, he said. Many complaints also come to his office within the initial days and weeks a person arrives at a nursing home for the first time.

“From what I’ve seen, the first few days are tough,” Turner said. “They’re upset.”

Families for Better Care would like to see Indiana enact stricter staffing requirements on nursing facilities, Lee said. Nursing homes in Florida, where Lee once served as an ombudsman, improved dramatically after the state required higher staffing levels, he said.

At Meadows Manor North, staffing is based on resident needs, not on numbers of residents, said Tammy Pupilli, director of nursing. Some nursing homes simply hire staff based on numbers of beds filled, she said. “We are fortunate that our [Terre Haute-based] corporate office does not do that,” she said.

But some nursing homes focus more on the bottom line than on resident care, Lee said. In some places, such as in Florida, competition from new nursing homes is restricted, which also, he believes, depresses quality of care while increasing the profits of existing facilities.

With greater competition, including allowing residents greater control over their Medicare or Medicaid dollars, “nursing homes would change overnight,” Lee said.

Reporter Arthur Foulkes can be reached at 812-231-4232 or arthur.foulkes@trib