Two out of five nursing homes in Utah improperly administer drugs, one of three fails to see patients receive adequate daily personal hygiene and one of six violates standards for sanitary handling of food.
Still, conditions in Utah nursing homes are generally better than in other states, according to a massive, 75-volume consumer guide of 15,000 nursing homes nationwide that are eligible for Medicaid and Medicare funding.The U.S. Department of Health and Human Services Department plans to formally release the study next week. However, it released information about national averages earlier this week, and the Deseret News obtained information about nursing homes in Utah on Friday.
The report has come under fire by nursing home and health associations, and HHS itself warns that its information could easily be misinterpreted and is meant only to help consumers ask meaningful questions when seeking a nursing home.
"My own opinion is that the government has spent hundreds of thousands of dollars on something that is basically worthless," said Dennis N. McFall, executive vice president of the Utah Health Care Association, the local not-for-profit association that represents long-term care facilities throughout Utah. "I don't know how anyone is going to use this to any great advantage. It doesn't really tell you anything, and that's the sad part of it."
McFall's primary complaint is that the profile contains only 32 performance indicators - a small portion of the 500 separate requirements a facility must meet.
"The information in the study doesn't reflect the severity or duration of the problems leading to a cited deficiency," he explained. "A deficiency may represent an ongoing problem or a one-time failure of a single staff person. The deficiency might be corrected an hour after the inspection or while the inspectors are there, but it still remains on the report."
However, as some senior citizen advocacy groups say, it does point out when a nursing home has an abnormal number of deficiencies.
For example, one Utah nursing home - Quality Care Murray, 404 E. 56th South - was found deficient in 17 of the 32 selected "performance indicators." (Specific information for all Utah nursing homes is on B2.)
None of the other 89 Utah nursing homes in the survey was found deficient in so many categories.
However one - Eva Dawn Care Center in Salt Lake City - violated 12 of 32 performance standards. And three - Castle Country Care Center in Price, Phillips Rest Home in Provo and Color Country Care Center in St. George - violated 10 of the 32 standards.
Most Utah nursing homes violated only a few categories each (see list on page B2).
Seven nursing homes had completely clean slates with no deficiencies listed. They are: Larsen's Nursing Home, Lehi; Logan Valley Nursing Center, Logan; Crestwood Care Center and McKay-Dee Transitional Care Center, Ogden; Highland Care Center and LDS Hospital Transitional Care Center, Salt Lake County; and Uintah Care Center, Vernal.
The survey found that 29 percent of nursing homes nationally improperly administer prescription drugs to patients - a problem that McFall maintains is common throughout the health care system.
In Utah, the average was higher - 38.9 percent of the nursing homes did not meet standards on administering drugs. The report shows that 21 of 89 of Utah nursing homes violated this standard.
"It is one of the most difficult areas to properly monitor. The violation could mean simply that the medications were given a little later than prescribed on the bottle. Our efforts are to simply minimize mistakes through employee training programs," he said. "We do everything we can to ensure safety in administrating drugs. But if serious violations do occur, they certainly should be cited and action taken."
The report also reveals that slightly more than 42.8 percent of nursing homes fail to store, prepare and distribute food under sanitary conditions. But in Utah, the average was much lower. Nine of 89 Utah nursing homes - or 16.7 percent - violated this standard.
In addition, 29.8 percent of the facilities nationally, and 29.6 percent (16 of 89) in Utah, do not provide residents with adequate personal hygiene, the report revealed.
Two in 100 facilities nationally fail to shield their residents from mental and physical abuse. No Utah nursing homes are not cited in the report for violations in this category.
"We, in fact, are not aware of any major deficiencies in nursing homes in this state," McFall said. "The biggest problems that the industry faces is in staffing - both in adequate numbers and professionally trained people who have experience in health care. We are simply limited in our ability to compensate at a level that would attract trained people into the nursing home industry." McFall believes that with ample staff - people who are happy doing what they are doing - a lot of the problems outlined in this guide would disappear.
However, the study shows that Utah nursing homes have more problems in 14 of the 32 selected performance standard categories than the national average. The most common deficiencies are not properly administering drugs, not providing written health care plans, not providing proper care for those using special medical devices and not providing adequate daily hygiene.
The new nursing home survey was ordered by William Roper, chief of the Health Care Financing Administration, which oversees the Medicare and Medicaid programs. It is the second time Roper has requested a "report card" on the health care industry, and both surveys have drawn sharp criticism from industry representatives.
Federal officials acknowledge the survey's shortcomings, saying it is an attempt to guide consumers through the complicated process of selecting nursing homes.
Families, they say, should tour nursing homes and ask questions. To assist them, the survey includes a glossary, sample questions, tips of what to look for and phone numbers of federal health care officials stationed around the country.
The survey also includes profiles of each nursing home that note the number of beds, type of ownership, survey date and resident indicators, such as how many senior citizens are confined to chairs and how many are confused or disoriented. The indicators are compared to state and national averages.
"The Utah Health Care Association agrees with the Health Care Financing Association that consumers are long overdue in receiving appropriate information about the quality of services available," McFall said. "However, we do not think this guide is a fair or complete representation because of the complexity of the survey process itself."
McFall said at best the year-old information included in the survey is "a starting point from which the consumer could ask questions about a certain facility."
"It is neither the final, definitive word on nursing home performance, nor a guide to answer all questions on selection of a nursing home."