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Local nursing homes rank 'poor' to 'above average'

By KELLY NIX

Published: December 31, 2010

IT’S GOOD news and bad news for nursing homes on the Monterey Peninsula. A half dozen facilities in Monterey and Pacific Grove fare poor to above average, according to federal government rankings.

The rankings, which Medicare posts on its website, rate nursing homes from one to five stars, five stars being “much above average” and one star indicating “much below average.” The rating system has been in place since 2008.

However, beginning with the first of the year, 1,235 nursing homes in California that receive federal Medicare and Medicaid money will be required to publicly post their star rating for visitors.

The new law — drafted by two Southern California assemblymen — was intended so patients and families could compare and evaluate nursing homes.

Peninsula nursing facilities told The Pine Cone this week that while they are not opposed to displaying their star rating, the ranking system is flawed and doesn’t always reflect the care they offer patients.

Carmel Hills Care Center, a 99-bed facility off of Highway 68, received an overall rating of one star, which the government qualifies as “much below average.”

Administrator Ralph Unterbrink, who has been head of Carmel Hills for only six months, defended the facility, saying the rankings only reflect the last inspections, which are performed once a year. “The facility has improved since I have been here,” he said, with inspectors finding “quite good” results.

The feds give nursing homes an overall star rating. They also issue individual star ratings for health inspections, staffing levels and quality measures — data that nursing homes regularly report about their residents, including health issues, mental status and general well being.

None of the seven Peninsula facilities posted on the Medicare website received five stars. Of the more than 1,200 facilities in the state, nearly 200 got the lowest rating and 190 got the highest.

Pacific Grove Convalescent Hospital on Lighthouse Avenue and Windsor Monterey Care Center on Skyline Drive received two stars, Westland House received three stars, and Monterey Pines, also on Skyline Drive, received four stars.

The rankings are only issued to facilities that accept federal money. A spokesman with the California Department of Public Health told The Pine Cone the state doesn’t rate nursing homes.

Canterbury Woods, which offers skilled nursing as part of its assisted living facility, had already been publicly posting its five-star rating. The facility dropped a notch but is still considered above average, according to the rating system.

“I am surprised to hear [Canterbury Woods has] a four-star rating, because we had been a five-star,” said Norma Brambilla, the facility’s executive director, after being told by The Pine Cone Tuesday of its current standing.

Brambilla said a facility’s rankings can be negatively affected by a few patients’ medical issues, which the government takes into account when rating nursing homes.

“They put it all into this scoreboard and try to put you on a matrix somewhere,” she said. “But so much of it is out of our control and is part of the aging process, which we are trying to treat with dignity and respect.”

Brenda Moore, spokeswoman for Community Hospital of the Monterey Peninsula, which operates Westland House, said the 28-bed, short-term care facility treats many patients who are recovering from major joint replacement.

“In this particular system, we were rated at the highest level for staffing, with our nursing hours per patient significantly exceeding the state and federal averages,” she said. “Our quality rating was largely affected by the percentage of patients reporting moderate to severe pain.”

Higher standards?

While proponents of the new law believe requiring nursing homes to post their ratings will compel operators to maintain higher standards, the federal rankings have also been knocked by critics for failing to include state violations.

In response, federal officials have said they are in the process of refining the rating system, a change Moore said the hospital would welcome. The current system can be confusing. “For example,” Moore explained, “our ratings differed on the state and federal sites, even though they are based on the same data.”

Nursing home administrators also argue the federal ratings do not reflect a facility’s true colors. They say the best way to choose a facility is to walk inside and talk to staff and residents. “I don’t have to go website to tell me how we’re doing,” Brambilla said of Canterbury Woods. “I know we’re doing a great job.”

“Rating systems like this one provide a snapshot of a facility and are a good starting point for the public,” Moore said. “To get a much fuller picture, we encourage prospective patients to visit a facility and talk directly to the people who work there. We know that those who visit Westland House will see firsthand the wonderful care we provide.”

The nursing home component at Forest Hill Manor in Pacific Grove was not ranked because it’s new, with less than 12 to 15 months of available data, according to the Medicare site.

The new law also requires nursing homes post an explanation of the rating system and how to find out about a facility’s state licensing information. Facilities that fail to post the required information will be subject to a range of fines.

To view the federal ratings for nursing homes, go to www.medicare.gov/nhCompare.