Nursing home ranks at bottom

https://www.t-g.com/story/2506038.html

In a September 2016 court filing, federal prosecutors said Glen Oaks Health and Rehabilitation of Shelbyville was providing “grossly substandard, and/or worthless nursing home services to Medicare and TennCare” patients.

Nearly two years later Glen Oaks is still in need of improvements.

In recently released reports rating 28 nursing homes within a 50-mile radius of Shelbyville that are ranked by the Center for Medicare and Medicaid Services, Glen Oaks Health and Rehabilitation of Shelbyville got the lowest possible ranking.

One star

Based on the survey conducted late last year, Glen Oaks was ranked with one out of five stars, a “Much Below Average” rating.

Of the 517 nursing homes that accept Medicare payments within 200 miles of Shelbyville, 13.5 percent (70) were ranked with just one star.

The most recent health inspections of area nursing homes were conducted in late November and December 2017 and the results were posted recently on the Medicare website (Nursing Home Compare).

Of the 28 nursing homes that accept payment from the Medicare/Medicaid program within 50 miles of Shelbyville four were rated with just one star.

(One of those, Manchester Healthcare Center, is owned by the same company that owns Glen Oaks.)

Six in the area were rated with two stars, “below average,” (including The Waters of Shelbyville).

Five were rated with three stars (average).

Seven area nursing homes were rated with four stars (above average) including two in Lewisburg — NHC Healthcare and NHC Healthcare Oakwood. Lynchburg Nursing Center was also rated “above average.”

Six were rated with five stars (Much Above Average) including two in Tullahoma — NHC Healthcare Tullahoma and Life Care Center of Tullahoma.

About the ratings

The rating system, developed by the Center for Medicare and Medicaid Services (CMS), ranks nursing homes in three broad categories — health inspections, staffing and “quality measures.”

Glen Oaks was rated “below average” in health inspections and “much below average” in staffing (not enough personnel). The facility was rated as average in “quality measures.”

Quality measures

Glen Oaks was rated as “Average” — three stars — in this category.

CMS determines “Quality of resident care” using 16 measures. Each of the measures is expressed in a percentage of the number of patients and is compared with rates in Tennessee and nationwide. The measures include short-term residents and long stay residents.

One common problem associated with poor care or neglect of patients is pressure ulcers, commonly called bed sores. At Glen Oaks the percentage of short term patients with bed sores that were new or worsened was four times worse than the state average — 2.5 percent as compared with the Tennessee average of 0.6 percent and the national average of 0.9 percent.

The rate of bed sores in long stay residents at Glen Oaks was much closer to the state and national averages: 6.2 percent at Glen Oaks, 5.3 percent statewide and 5.6 percent nationally.

Glen Oaks also fell short in the high percentage of long-stay residents whose ability to move independently got worse. Glen Oaks: 34.3 percent got worse; Tennessee: 21.4 percent got worse; and nationally 18.2 percent got worse.

Glen Oaks did do better in some quality measure areas including the number of patients who got flu shots, a low percentage of patients who lost too much weight, low percentage of patients who suffered major injury from falls and low percentage of long term patients who had symptoms of depression.

Staffing

It was in “Staffing” that Glen Oaks did most poorly with only one star — “much below average.”

CMS says of this category: “Higher staffing levels in a nursing home may mean higher quality of care for residents. This section provides information about the different types of nursing home staff and the average amount of time per resident that they spend providing care.”

At Glen Oaks the total amount of time a Registered Nurse is available per resident, per day is 26 minutes, half that of the national average. Tennessee’s average is 46 minutes a day and the national average is 50 minutes. The availability of physical therapy staff at Glen Oaks was also lacking: 3 minutes as compared with the state and national averages of 6 minutes.

Health Inspections

Glen Oaks was ranked “below average” (two stars) in this category.

Glen Oaks was cited for eight violations, as compared with the Tennessee average of four and the national average of 5.8.

In the most recent available “statement of deficiencies and plan of correction” from a July 2017 inspection.

According to the report:

* Glen Oaks failed to immediately report allegations that a resident had been abused. The incident was not reported until seven days later. CMS requires that such allegations be reported within 24 hours.

*Glen Oaks failed to adopt an abuse policy that met CMS requirements.

*Glen Oaks failed to provide care that protects its residents’ dignity.

*Glen Oaks failed to provide proper housekeeping services. This finding was the result of a wheel chair coated with a “heavy accumulation of dried debris”. Wheel chairs are supposed to be cleaned daily.

*Glen Oaks staff failed to properly secure medications, and failed to keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5 percent.

One example of this, was that a prescription medication that was supposed to have been stopped on June 9 was still being given to the patient on July 11.

*Glen Oaks staff failed to properly secure prescription medications. A prescription medication with no pharmacy label or any label indicating patient information was found unopened on a resident’s bedside table.

• Glen Oaks failed to follow infection control practices in dispensing medications to eight patients. The facility’s workers failed to “wash/sanitize hands between residents for two residents, failed “to prepare medications in a safe manner for two residents,” failed “to dispose of unused medications appropriately for one resident,” and failed to “protect respiratory equipment from contamination for seven residents.”

In summary

In a summary of all health inspection deficiencies in recent years, Glen Oaks was cited eight times in the period from March 2017 to March 2018; three times from March 2016 to March 2018 and six times from March 2015 to March 2016.

Fire safety inspection

In July 2017, fire inspectors identified six “smoke deficiencies,” reporting that Glen Oaks did not:

• have walls in “special areas” constructed so that they can resist fire for one hour or more or have an approved fire extinguishing system,

• have a fire alarm that can be heard throughout the facility,

• Inspect, test, and maintain automatic sprinkler systems,

• Properly select, install, inspect or maintain portable fire extinguishers, and

• Ensure smoke barriers are constructed to provide one hour fire resistance.

Glen Oaks corrected all the fire safety issues 44 days after the inspection.

Not first problem for owners

Glen Oaks has been owned by Vanguard Healthcare LLC since July 2007. The company has been in litigation with the federal government since 2016 accused of filing false claims. (See related story.)

• Vanguard healthcare CEO William “Bill” Orand did not return phone calls seeking comment. Glen Oaks administrator Cassandra Callahan also did not return phone calls seeking comment.

Filed under: General Problems