Starship KCNH
By Mike Kroll
1/29/09
Earlier
this month the Register-Mail ran a story about a federal report released in
December regarding the Knox County Nursing Home (KCNH) that began:
“The Knox
County Nursing Home has been given the lowest possible rating by a new federal
inspection system for nursing homes. Federal Centers for Medicare and Medicaid
Services inspectors gave the Knox County Nursing Home 1 out of a possible 5
stars in the new rating system, which was launched this month and covers almost
16,000 nursing homes nationwide. Knox County Nursing Home administrator
Marianne Wiesen has criticized the report, which she said does not present an
accurate picture of the publicly-funded facility.”
Three
days following the January 2nd publication of that news story the
same Federal agency released a new report on KCNH which raised its star rating
to two-stars for overall quality. The Register-Mail ran a second story on
January 24th recognizing this latest monthly rating of KCHN:
“CMS
spokesperson Cinthia Michel said the rating system is updated monthly, and,
based on new information, the county nursing home has now been awarded a second
star. In an interview Friday, Michel could not provide specific details about
why the score had been upgraded. ...The county nursing home’s administrator,
Marianne Wiesen, declined to comment for this story.”
Wiesen
declined to comment because she believed that the Register-Mail had failed to
gather the complete story the first time around and it amazed her that no one
from the Register-Mail would take her up on her invitation to visit the nursing
home and see for themselves the quality of care.
“We have
had only a single new admission this month since that original Register-Mail
story was published and we don't feel that this scoring system is an accurate
reflection of the quality of our facility,” said Wiesen. “I am confident that
if someone from the paper had only taken the time to visit the nursing home and
meet my patients and staff that they could not possibly leave believing anything
at all was substandard regardless of the star rating.”
At the
present time there are nine nursing homes rated in Knox County. None have
received five-stars; one (Cottage Hospital Skilled Nursing Unit) received
four-stars; three received three-stars; four (including KCNH) received
two-stars and one received a single star and another critical article in the
Register-Mail.
This new
five-star rating system is very controversial within the nursing home industry.
Paul Langevin Jr., President of the Health Care Association of New Jersey wrote
earlier this month, “Five-Star is not simple or consumer-friendly. Its release
(both haphazard and premature) has generated as much confusion about which
facilities are really 'quality facilities' as any previous rating system
developed. ...we have all come to expect that 5-star restaurants and hotels
will be far superior to their 3-star counterparts. In the case of nursing homes
and this system, that’s not necessarily so.”
In a rating
system designed to foster accountability and transparency for consumers the
methodology of the five-star system
actually discourages nursing homes from reporting incidents because even
a isolated incident report can have a dramatic negative effect on a nursing
home's five-star rating. It was a self-reported incident at KCNH that resulted
in that initial one-star rating according to Wiesen. Not unlike a restaurant
health inspection where a “critical problem” that significantly lowers a
facility's score can be easily and quickly resolved this five-star rating
system appears unduly sensitive to occassional issues that many knowledgeable
people would see as part and parcel of nursing home care.
Wiesen is
especially displeased that nowhere in the five-star rating is there are
reflection of the satisfaction of patients or their families with the nursing
home and its level of care. Langevin agrees and wrote: “Perhaps the most
disturbing thing about CMS’ Five-Star rating system is the fact that it has no
accommodation to include resident, family or other consumer satisfaction
measures. This is not a mere oversight but, in HCANJ’s opinion, a fatal flaw.
Shouldn’t we care about what those who currently use nursing home services
think about the quality of care that they receive? Isn’t word of mouth and
consumer input part of the decision that we make about every other service that
we purchase?”
A clearly
frustrated Wiesen is concerned about the public perception of KCNH and worried
that too much has been made of this new rating system. “We run a very good and
caring nursing home at Knox County and I wouldn't have it any other way. The health and safety and
comfort of my clients is the only priority at the Knox County Nursing Home.
Just as I offered the Register-Mail the opportunity to come visit us and see
for themselves I make that same offer to anyone in the public. I am exceedingly
proud of this nursing home and my staff and I am confident that my patients and
their families feel the same way.”