New Hampshire nursing homes get high marks
Twenty-two of the state's 76 nursing homes get the top, five-star rating from a federal oversight agency in the latest quality ratings posted online.
Only six New Hampshire nursing homes rated the lowest score, one star, from the Centers for Medicare & Medicaid Services (CMS). The comparative ratings are based on on-site health inspections, staffing levels and quality measures.
State officials and nursing home administrators say the CMS ratings can help families find the best home for their loved ones. But they stress people shouldn't choose a nursing home based on ratings alone.
Michael Fleming is bureau chief of the state health facility certification unit, which inspects, or “surveys,” nursing homes for CMS. He said it's critical for families to visit different homes to find the right fit for their loved ones.
“I would not buy a car, for instance, because the commercial says they have a five-star crash rating. I'd want to test-drive it,” he said. “So you go visit a facility and, most importantly, talk to the residents.”
Fleming said there are some misconceptions about what the CMS ratings mean; he recalled one family who commented that they couldn't afford a “five-star” home, so they'd have to choose a lower-rated one. It's not about cost, but quality, he said.
A one-star rating indicates a nursing home ranks “much below average,” two stars are “below average,” three stars “average,” four stars “above average,” and five stars “much above average.” About three-quarters of the state's CMS-certified nursing homes are rated average or above.
John Poirier is president and CEO of New Hampshire Health Care Association, which represents nursing homes and assisted-living centers. He said recent revisions have improved the CMS rating system to make it a better tool for families.
But he, too, advised against relying only on ratings to choose a home. “It's what will be the most comfortable home,” he said. “And that's frankly the thing that should be the Number 1 driver. Any of the other information that's out there, including the five-star (ratings), should be used as a guide, a tool.”
Two nursing homes scored five stars across all four measures used by CMS: Kendal at Hanover and St. Joseph Residence in Manchester. Managed by New Hampshire Catholic Charities, the latter is a nursing home for the Sisters of the Presentation of Mary, who own the facility.
Mike Lehrman, vice president of health care services at Catholic Charities, noted five of the eight nursing homes his agency owns or manages scored five stars in the overall ratings. It's not about divine intervention, he said.
“As an organization, we are very focused on both quality of care and quality of life,” he said.
An inspection survey, Poirier noted, is a sort of snapshot, “a point-in-time measurement.”
And like photos, “Sometimes they don't come out as well as you want them to,” he said.
“There are times when good facilities can have a bad survey, and conversely, there are times when bad facilities might have a good survey.”
Brett Lennerton is administrator of the Laurel Center in Bedford, which got only one star in the overall rating, even though it rated as “average” for both staffing and quality measures. State inspectors found 13 health deficiencies during a survey last February, and even though none was deemed serious, that resulted in the low rating, he said.
The state average for health deficiencies is 4.3; the national average is 7.5.
Lennerton, who came to the Laurel Center in May, said he was “disappointed” in the low rating. However, he said families should not discount a nursing home based on one poor inspection.
“I know of facilities that got perfect surveys that I wouldn't put my loved ones in,” he said.
“If you were to come and interview all of our residents, you would find they were very happy. So that alone should speak volumes.”
Lennerton urges families to visit different homes and look beyond “the grand piano and crystal chandeliers.”
“Do residents look happy? Are they engaged? Is the staff happy and engaged?” he said. “That's far more indicative of how the people are cared for than any ... five-star rating can tell me.”
Two county nursing homes earned five stars in the overall ratings: Coos County Nursing Hospital in West Stewartstown and Sullivan County Health Care in Unity.
Laura Mills is administrator at the Coos County home, which she describes as “a big family.”
“We're a small community, so we have family members that live here and family members that work here,” she said. “When they say how would you want your mother treated, in this home, chances are it happens.”
It's not the fanciest place in the state, she said; it was built in 1932 as “an alms house for the poor.” For years, the top floor housed the local hospital; Mills herself was born there.
Still, she's seen many people blossom into “social butterflies” after coming to her facility, she said. “There's definitely a social aspect of moving into a nursing home that people don't always think about.”
Ted Purdy, administrator of the Sullivan County home, said some older folks may still think of a county nursing home as the place “where the poor and the indigent went.”
But all that has changed, he said. “I think our quality and services are just as good or better than any place,” he said.
Nursing homes don't just provide long-term care, Purdy noted. About 30 percent of his residents will go back home after short-term rehabilitation.
Poirier advises families not to wait until a medical emergency to visit local homes. “The best thing that people can do is know the personality of the person and try to match that as best you can with the personality of the facilities,” he said.
He advises families to visit the website careconversations.org for help in raising the issue of long-term care. “It's an adult conversation that we really need to have,” he said.
To view ratings, health inspection reports and other data for nursing homes, visit: www.medicare.gov/nursinghomecompare.
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