One in three nursing homes in Western New York received the lowest possible score in the latest ratings from the federal government, a marked increase from a year ago.
The federal Centers for Medicare & Medicaid Services gave a 1-star rating to 26 of the region’s 74 nursing homes. The agency uses a 5-star scale to measure how well nursing homes deliver care to their residents.
One in five nursing homes in the region received a 1-star rating a year ago.
Statewide, one in five nursing homes received a 1-star rating in the latest ratings.
[Searchable database: Look up ratings for all nursing homes in the state]
A Buffalo News analysis of the data found:
• The region’s nursing homes, as a group, earned an average overall star rating of 2.5, compared to 3.11 for all nursing homes in New York State and 3.16 for all facilities in the nation.
• The ratings for 26 nursing homes dropped in the past year: two facilities by three stars, eight facilities by two stars and 16 by one star.
• Nine area nursing homes received the highest 5-star rating. Four of them – Harris Hill Nursing Facility in Williamsville, Autumn View Health Care Facility in Hamburg, Briody Health Care Facility in Lockport and the New York State Veterans’ Home in Batavia – have held the highest rating in each of the last three years.
• Three of the 26 facilities with a 1-star rating have received the same score since 2014: Emerald North Nursing and Rehabilitation Center in Buffalo, Niagara Rehabilitation and Nursing Center in Niagara Falls, and The Pines Healthcare & Rehabilitation Center in Olean.
“I think the state and federal governments are increasing their standards. I think they’re being much tougher on nursing home operators,” said Roger J. Soricelli, the administrator of Jennie B. Richmond Nursing Home in Springville, which earned a 1-star rating. “I’m not sure that the quality of care is lowered. The standards have been tougher to comply with.”
The federal government uses three main metrics to calculate the overall star rating: information gathered and any deficiencies found during annual state inspections, staffing ratios, and a range of quality measures, like percentage of residents hurt in falls or physically restrained. (Find the Nursing Home Compare site here.)
“When residents and their families are faced with important decisions about care, they need an easy, transparent way to figure out which facility is the best fit for them or their loved ones,” Dr. Patrick Conway, the agency’s deputy administrator and chief medical officer, said in a statement. “With this update, star ratings will provide an even more accurate reflection of the services that nursing homes provide.”
Nursing homes across the state and across the nation are more likely to have a 5-star rating than nursing homes in the area, and are less likely to have a 1-star rating.
Twenty-four percent of the 600-plus nursing homes in the state have a 5-star rating – twice the proportion of 5-star facilities in Western New York.
On the lowest end of the scoring scale, 17 percent of homes nationally have a 1-star rating – half the 35-percent-share of homes in this region with a 1-star rating.
Slightly more than half of Western New York’s nursing homes received a 1- or 2-star rating. Two years ago, 30 percent of the area facilities received such scores.
Keep in mind, even 1-star facilities deliver care and meet the basic requirements of their licenses, said Richard Herrick, president and CEO of the New York State Health Facilities Association.
More 1-star homes
Area nursing home administrators say they are at a loss as to explain why so many homes in the region have a below-average rating.
Some administrators contend state inspectors in this area are more apt to cite nursing homes for deficiencies than those who inspect facilities downstate, said Patricia O’Connor, administrator of Catholic Health’s Mercy Nursing Facility at Our Lady of Victory.
Representatives of area nursing homes met with Department of Health staff several weeks ago to raise their concern, O’Connor said.
“They did agree to look at it,” she said.
A Health Department spokesman did not respond to a request for comment.
Nonprofits rate higher
The Kaiser Family Foundation found, on average, nonprofit nursing homes receive higher star ratings than for-profit nursing homes, based on its analysis of the federal data from February 2015.
Two of the larger for-profit companies in the region received notably different ratings for their homes.
Absolut Care’s nine facilities recorded an average star rating of 1.4, while Elderwood’s seven facilities had a 3.3 average star rating.
The 26 nursing homes in the region with a 1-star rating include 11 facilities that carried over a 1-star rating from February 2015, but they also include 14 homes that fell one, two or three stars from past reports.
Two nursing homes fell from 4 stars to 1 star.
Comprehensive at Williamsville, a 142-bed skilled nursing and subacute-care facility, registered such a drop. Its star rating dropped after its sale by the non-profit Catholic Health System, which operated the home as St. Francis of Williamsville, to the for-profit Comprehensive Healthcare Management Services of Long Island.
Comprehensive executives declined to comment.
The other local nursing home whose rating dropped by three stars is the Jennie B. Richmond Nursing Home, a nonprofit 80-bed facility next to Bertrand Chaffee Hospital in Springville.
Soricelli, the nursing home’s administrator, attributes the rating decline to an injury to a resident last winter. The nursing home reported the incident to the Health Department, which investigated the incident.
“We don’t believe it could have been prevented,” Soricelli said.
Staff administered the proper treatment to the resident, he said. But the Health Department determined the patient’s treatment was delayed. The home took steps to prevent a similar incident in the future, Soricelli said.
Four homes saw their scores improve by two stars, and nine others gained one star.
Mercy Nursing Facility at Our Lady of Victory, an 84-bed nursing home in Lackawanna, earned four stars in April 2015 and five stars last October.
O’Connor, the administrator, said officials focused relentlessly on quality, using internally generated data and federal data to point them toward areas where improvement was needed. For example, system officials recognized they are seeing sicker residents, who are closer to the end of their lives and stay for a shorter time.
“Those types of residents need more hands-on care,” so the system hired more workers, ensuring a high staffing ratio score, O’Connor said.
Erie County Medical Center’s Terrace View Long-Term Care Facility rose from one star to three stars. The 390-bed facility serves residents with an average age of 57, most of whom have suffered a disabling injury of some kind, such as to the brain or spinal cord. So it’s a different patient mix than the typical nursing home, said Thomas J. Quatroche Jr., ECMC’s president and CEO.
The improvement required documentation of the care delivered, and came thanks to an investment in electronic medical records, and a high level of engagement from staff, said Charlene Ludlow, chief safety officer.
“It’s a validation and an affirmation of the care being delivered at our home,” Quatroche said.
A one-year fluctuation in a home’s rating may reflect a change in how the rating system is scored, nursing home administrators say. But a home that consistently receives the same high – or low – star rating over time reveals a pattern that consumers can judge.
Nursing home operators say consumers should use the star ratings only as one part of the decision on where to place a loved one.
But they’re only one tool to use and they aren’t a substitute for in-person visits and discussions with staff and current residents and their families.
“So it’s not the be all and end all; it’s imperfect. But it’s the best we’ve got,” said Soricelli, the Jennie B. Richmond administrator.