SALT LAKE CITY — A federal report has named five Utah nursing homes for having "a persistent record of poor care," including one that requires additional oversight.
The designation, which changes monthly, puts each facility at risk of losing Medicaid funding, which could end up closing their doors.
"We're not going to allow that to happen," said David Mahrt, who runs Lomond Peak Nursing and Rehabilitation, the one facility in Utah that has been designated as a "special focus facility" by an ongoing federal survey process. "Our patients — this is their home. They love being here and we will do everything to make sure it is an option for them to continue to reside here."
He said the facility, which is under completely new management after previous owners filed bankruptcy, is "committed to patients," and has "improved significantly" since a history of poor reviews plagued it.
The Utah Department of Health, under contract of the U.S Centers for Medicare and Medicaid Services, documented problems in Lomond Peak's care process last November, but the latest March survey shows things are turning around. The Ogden facility, located at 524 E. 800 North, currently houses 52 patients and has room for a few more.
Without going into detail, Mahrt said that all-new staff at the facility has made improvements after "mistakes" landed them on a watch list years ago.
"We are putting our best foot forward to ensure quality care is given," he said, adding that being a special focus facility puts state officials in direct contact with the facility more often, which Mahrt believes makes the facility better.
"It was in pretty poor shape when they came in, but they're determined to make it better," said Joel Hoffman, director of the Utah Department of Health's Bureau of Licensing and Certification. He said there's always one facility that will be "at the bottom of the list."
"Lomond Peak is very determined to do better," he said. "They will do better. They don't want to be in this position."
The Deseret News on Wednesday filed a Government Records Access and Management Act request with the bureau for details contained in the reports regarding Lomond Peak, but that request has not yet been granted.
Of the 103 nursing home facilities in Utah, Lomond Peak, Hoffman said, has had enough poor inspection scores, including "a couple of serious deficiencies" to warrant extra attention from the government.
"Improving safety and quality in America's nursing homes is one of CMS' top priorities," said Dr. Kate Goodrich, chief medical officer at the Centers for Medicare and Medicaid Services. She said quality care is important to the agency, as it is to families.
While government officials have always had access to a list of "nursing homes that persistently fall short," as the report states, this is the first time it has been made public. Two U.S. senators from Pennsylvania released the names of all the facilities not measuring up in order to increase transparency and help families make a more educated choice about nursing home care.
The report names 400 facilities across the country where the latest of the long-term survey process has identified problems or potential issues with quality of care.
In addition to Lomond Peak, four other facilities in Utah were identified as candidates for special focus, meaning they are basically on a watch list. Those facilities include Pine Creek Rehabilitation and Nursing in Salt Lake City, Rocky Mountain Care — Hunter Hollow in West Valley City, Copper Ridge Health Care in West Jordan and Mountain View Health Services in Ogden.
Hoffman said the five facilities just happen to be the bottom of the list in Utah, which he said means they could use some help.
Should any of them continue with poor performance, as indicated on upcoming surveys of the facilities, they stand to lose their eligibility for Medicaid and Medicaid contracts.
"They would not survive without that," Hoffman said. "There are not enough private paying or VA patients to keep them viable. The cost of nursing homes is so expensive."
A nursing home's license to operate, he said, is based on compliance with the federal agency's rules.
"If your loved one was in one of these facilities, you'd probably want to sit down and talk with them about why they're not meeting quality standards and what is being done about it," Hoffman said. "You'll want to get a report on that facility."
Granted, he said, "there always will be (facilities) on the bottom."
Centers for Medicare and Medicaid Services requires states to survey poor performing facilities at least once every six months, instead of once every nine to 15 months.
There could be more facilities performing poorly, but the list of special focus facilities or candidates for the program is limited to the availability of federal resources. In recent years, budget reductions have resulted in fewer facilities being surveyed, the report states.
There are currently 88 U.S. facilities designated as special focus, with 400 listed as candidates. The list is not related to the CMS star rating system.
"The reason for special focus is to invoke improvement," Mahrt said. "It is punitive in nature, however, the goal is to receive support and oversight from the department of health to improve care and improve processes."
He said that Lomond Peak is "performing at an optimal level" with the extra — and very welcome — oversight.
The home will remain a special focus facility until it performs well on at least two consecutive quality indicator surveys. Despite what the federal report indicates, Lomond Peak has improved since an initial report in November found "evidence of substandard care."
"Change can happen fast in a nursing home," Mahrt said. "Just because mistakes were made in the past that put us in a position to require action from CMS, that doesn't mean the same things are happening today."
Surveyors screen medical records, conduct resident interviews and observe practices at every Medicaid-eligible facility to help determine the quality of care that is offered at nursing homes. CMS keeps a rolling list of facilities that could benefit from additional oversight.3 comments on this story
A facility with special focus designation has up to 18 to 24 months to improve before Medicaid eligibility is pulled.
Medicaid and Medicare is often the only method of payment for the elderly or disabled Americans who live in the more than 15,700 nursing homes in the U.S. There are 9,500 licensed beds in nursing homes across Utah and about 6,000 of them are being used.
Because of historically poor nursing home performance across the country, CMS is required to maintain an online reference, called Nursing Home Compare, to help families compare the nursing homes in their communities.