RI Nursing Homes with the Most Health + Safety Violations
Thursday, September 04, 2014
Thirty local nursing homes have racked up at least eight or more violations of national health and safety standards, according to federal inspections data for the past three to four years.
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Four nursing homes had serious deficiencies, meaning that a resident was harmed or was in immediate risk of being harmed.
Topping the list was Cortland Place in Greenville, with 16 serious deficiencies. The others were: Hebert Nursing Home in Smithfield, Charlesgate Nursing Center in Providence, and Park View Nursing Home, also in Providence. One of those, Park View, has been flagged by federal authorities as a “Special Focus Facility” because it has a “history of persistent poor quality of care.”
GET THE LATEST BREAKING NEWS HERE -- SIGN UP FOR GOLOCAL FREE DAILY EBLASTNursing 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. Inspectors mark deficiencies when a home fails to meet a particular federal standard. There are over 200 of them and they range widely, from using the wrong kind of plates to failure to secure a building so patients with dementia won’t wander off.
Nursing home had resident fall four stories
Park View’s last most serious deficiency was in 2011, after a resident fell out of a fourth-floor window. According to a federal inspection report, a nursing assistant had briefly left a resident to get some sheets for her bed. She returned to find the resident at the window, with her head and one leg outside. “The NA stated she tried to pull the resident back into the room holding on to the resident as long as she could but the resident became combative and struggled against her and fell out the window landing in the mulch below,” the report states.
The resident suffered a fractured ankle, fractured ribs, and a punctured lung. The nursing home was slapped with a $27,900 fine for failing to include window checks in its monthly safety rounds. By the day inspectors arrived—later in the month—windows had been properly secured.
Three years and as many inspections later, Park View has improved, said its administrator, Margaret Vaccaro. “All deficiencies have been corrected and we are continuously working on quality improvement,” Vacarro told GoLocalProv.
She declined to elaborate, except to note that the most recent inspections had been “good.”
The last inspection, in early December 2013, turned up two deficiencies. The home was cited for failure to immediately report a theft of $800 from a resident to the Department of Health. The other violation involved exposed wood flooring, which presented a tripping and splinter hazard.
A spokesman for the Rhode Island Department of Health, which is the agency that carries out inspections on behalf of federal investigators, did not respond to several messages seeking comment.
Vaccaro has served as administrator through the period of bad inspections up through the present improvement. But other facilities have changed administrators as violations stated to pile up.
The Morgan Health Center in Johnston was cited for 19 deficiencies in a March 2013 inspection. The current administrator, Kenneth DeLisi said he had just taken over as administrator in mid-2012 and was in the process of implementing changes to how the home was run, while working with his predecessor, who was still on staff. He says the January 28, 2014 report, which found three deficiencies, reflects the positive impact of the changes he made.
When asked if the home had replaced administrators because of inspections issues, DeLisi declined comment.
Federal data shows that fines also can vary widely. The biggest fine in recent years was issued to the Charlesgate Nursing Center. The home was faulted for failing to train employees in emergency procedures “specifically, adverse severe heat temperatures.” Inspectors determined that the deficiency was serious enough to place many residents in “immediate jeopardy.” The home was hit with a $93,500 fine.
Some homes racked up 25 or more violations
Over the past three to four years, some homes have accumulated deficiencies more than double the state average. Cortland, which also has the most serious deficiencies, overall has the most, with 45, according to the federal data, which was obtained through a database maintained by ProPublica.
Two had 25 deficiencies: Herbert Nursing Home and the Morgan Health Center.
The statewide average number of deficiencies over that period is 10.8, according to the Kaiser Family Health Foundation.
But a high number of deficiencies in of itself is not an indicator that a facility offers poor care, according to Virginia Burke, the president of the Rhode Island Health Care Association, a trade organization which represents nursing homes. “Deficiencies are not equivalent to lousy care—they range in significance from crumbs under the toaster to failure to secure a locked unit,” Burke said.
Given the high number of standards to which homes must adhere, she suggested it’s almost inevitable that ever-meticulous inspectors will find a deficiency. “If you’re measuring a facility against perfection you’re going to find something,” Burke said.
The deficiencies to focus on, she said, are those deemed as “serious”—posing a threat to resident safety and health or causing actual harm to them.
Overall, she said Rhode Island fares much better that almost all over states in terms of quality of care. Rhode Island has the highest percentage of deficiency-free nursing homes and the lowest average number of deficiencies noted during an inspection, according to Burke. In fact, Rhode Island’s annual average of 2.7 deficiencies per facility is the lowest in the nation. The national average is 8.4, according to the Kaiser Family Foundation.
“We have a culture of quality care,” Burke said.
“We do a good job. We do better than almost all states,” Burke said. “There’s always room for improvement.”
Correction: An early edition of this report incorrectly stated that eight or more violations is triple the statewide average. In fact, the average number of violations over the three to four-year period is 10.8. The article has been adjusted to clarify that 10.8 inspections is the average over the three to four year period.
Related Slideshow: Top 30 RI Nursing Homes with the Most Deficiencies
Below are the top 30 nursing homes with the most deficiencies in federal health and safety standards. Homes are listed in order of most to least deficiencies, starting with those that had serious deficiencies that caused actual harm to a resident. 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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