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Tuesday, September 26 News

Health Check: Of 41 nursing homes in Fairfield County, four garner a single star from Medicare

In Fairfield County, more nursing homes rate above average than below. But while 15 have five stars in a government rating system, four have just one and qualify as much below average.

Picking a nursing home can be a complicated process and a common one, especially for Connecticut residents where a doctor noted a “demographic tsunami” triggering growing need. Nearly 10 years ago, Medicare tried to make the nursing home choice a little easier with a searchable online ratings system where facilities can garner one to five yellow stars — like a TripAdvisor for nursing homes but based on compiled self-reported and inspection data. All Medicare- or Medicaid-certified facilities get a rating.

“Consumers are much more savvy now,” said Dr. Gerard Kerins, a geriatrics specialist at Yale New Haven Hospital’s Saint Raphael Campus and geriatrics professor at the Yale School of Medicine.

Along with more awareness, he has seen the ratings help facilities to self-evaluate and make it more difficult for them to hide information. While Kerins believes patients or families are reluctant to select a facility with a 1-star rating, he sees most still primarily base their choice on their doctor’s recommendation.

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Fairfield County nursing homes’ Medicare ratings

15 have a 5-star (much above average) rating

Four have a 4-star (above average) rating

Seven have a 3-star (average) rating

11 have a 2-star (below average) rating

Four have a 1-star (much below average) rating

What’s in town?

Cambridge Health and Rehabilitation Center, Fairfield — 4 stars

Carolton Chronic and Convalescent Hospital, Fairfield — 5 stars

Fairview Healthcare Center of Fairfield, Southport — 1 star

Ludlowe Center for Health and Rehabilitation, Fairfield — 5 stars

What’s in town?

Cambridge Health and Rehabilitation Center, Fairfield — 4 stars

Carolton Chronic and Convalescent Hospital, Fairfield — 5 stars

Fairview Healthcare Center of Fairfield, Southport — 1 star

Ludlowe Center for Health and Rehabilitation, Fairfield — 5 stars

Waveny Care Center, New Canaan — 5 stars

Westport Rehabilitation Complex, Westport — 3 stars

For his own patients, Kerins would recommend a facility with three to five stars.

Medicare’s ratings are calculated using annual state inspection results, staffing levels, Registered Nurse staffing levels and quality measures. Kerins tabbed the quality measures as most important, covering self-reported data on infection and fall rates, untreated patient pain, if patients need more help after a stay than when they first arrived and more.

Because the star ratings are based on the average nursing home, only a certain percent can get the top 5-star designation. The stars range from one to five, representing much below to much above average status. Kerins warned not every 5-star facility is deserving of that high status, though most are good facilities.

Medicare’s system is not without its criticisms. Both staffing and quality measures are based off self-reported data and health inspection results vary by state, making the comparison most accurate within state lines. While Kerins said the self-reported information Medicare uses is not likely to be perfectly accurate, he believes most facilities attempt honesty.

“In total, most people strive to be honest because they want to improve,” he said.

Forty-one Fairfield County nursing homes currently appear in Nursing Home Compare, Medicare’s tool to search its assessments. Of those facilities, only two have the highest possible markings — an overall 5-star designation as well as five stars for the three assessment categories: health inspections, staffing and quality measures.

The two top-ranking facilities are Waveny Care Center, located at 3 Farm Road in New Canaan, and Lourdes Health Care Center, located at 345 Belden Hill Road in Wilton. Both have under 100 beds and non-profit ownership.

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Four, however, ranked much below average: Fairview Healthcare Center of Fairfield, Cassena Care at Norwalk, Laurel Ridge Health Care Center and RegalCare at Greenwich. All four facilities had below or much below average health inspection ratings and were under for-profit corporation ownership. Located at 930 Mill Hill Terrace in Southport, the former Fairview facility is now RegalCare at Southport. It received more than twice the average number of health deficiencies during health inspections last year, including an August finding that the nursing home area was not free from accident hazards and risks or not enough supervision was offered to prevent avoidable accidents. Fixed in early October, that deficiency is designated as having potential for “actual harm.”

RegalCare at Southport did not return a call requesting comment. Under the same current ownership, RegalCare at Greenwich is the only Fairfield County facility currently flagged on Medicare’s site as a Special Focus Facility. That means government inspection teams have found “a history of persistent poor quality of care” and that it could eventually lose its Medicare and Medicaid eligibility.

The 1188 King St. facility is among seven RegalCare Management currently operates, all in Connecticut. Medicare deems two average, two below average and two much below average — not including the 1-star former Fairview.

While not familiar with the Southport facility, Kerins said for-profit facilities that frequently change names — usually indicating they are being bought and sold to different corporations — tend to struggle more often to perform well because of corporate pressure to turn a profit. He noted there are quality for-profit nursing homes that offer average and above care.

Facilities run by local health systems or as nonprofits tend to struggle less to provide high-quality care, Kerins reported, based on what he’s observed in the greater New Haven area. Carolton Chronic and Convalescent Hospital, a rehabilitation and long-term care facility at 400 Mill Plain Road in Fairfield, is among five-star awardees. Medicare gives the 229-bed for-profit facility much above average staffing and quality measures ratings and an above average health inspection rating.

“We’re very happy with our 5-star rating, and we feel we deserve it because we provide excellent care,” Administrator Dennis Kretzmer said. He said the Medicare ratings system didn’t impact Carolton’s care, and its staff have always been motivated by doing their best for patients rather than a high rating.

Carolton’s President and CEO, however, explained he wants potential patients or residents and their families to look beyond the stars.

“I think it’s very important that families do not just look at the five-star rating,” Carmen Tortora said. “It really doesn’t tell you the whole story of the facility.”

He urged families visit, get a sense for a nursing home’s atmosphere and see its care as they themselves walk around and observe if a location can meet their family member’s needs. Five-star facilities can have deficiencies, Tortora added, and 3-star facilities could provide good care.

“You have to have people go and see the communities and compare,” Tortora said.

Kerins suggested family members drop in unannounced and said the family of a resident needs to stay actively involved with ensuring good care. Most facilities offer good care for a vulnerable population in need by his assessment, but Kerins cautioned, “consumer be aware.”

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