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By Pat Pratt
In an annual update posted in late January, a federal assessment of Medicare-certified nursing homes shows ratings for several facilities near Troy.
The Centers for Medicare and Medicaid Services website medicare.gov/care-compare each year assigns nursing homes a star rating, with a five-star rating reflecting much above average performance and a one–star rating reflecting much below average performance. CMS states the information on its is to help families and individuals make informed care choices.
In this article, the Times-Tribune located five nursing homes in the report in the communities we cover – Maryville, Glen Carbon, Collinsville – and summarized the CMS ratings. Troy itself had no facilities listed.
How the ratings work
The overall star rating for each facility is based on three metrics – health and complaint inspections, staffing and quality measures.
The health inspection rating issued by CMS is based on current health inspection and two prior inspections, as well as findings from the most recent three years of complaint inspections and three years of infection control inspections.
Staffing ratings are based on hours worked by different types of staff, are reported by nursing homes, and are used to calculate a ratio of staffing hours per resident per day and the staffing turnover rate.
Quality measures assess nursing home performance in certain areas of care, like if residents have gotten their flu shots, are in pain, or are losing weight and other metrics, according to the CMS website.
Quality measure ratings are also broken down into a number of metrics for both long and short-stay residents. Those include mobility improvements, the amount of psychotropic medications given to residents, number of falls, infections and other measurements.
Meridian Village Care Center
In all three areas which combine to make up the overall rating – health inspections, staffing and quality measures – Meridian Village earned five stars.
In regards to the citation numbers for this facility and others in this report, the ratings take the total number of citations from the most recent standard health inspection and last 12 months of complaint and infection control inspections, according to the CMS website.
The CMS rankings show there was one health citation at Meridian Village in that period – far below the national average of 8.5 and state average of 11.7.
In the past three years, only two complaints were shown to have resulted in a citation.
In 2022, the facility did not see a single complaint inspection.
Staffing at Meridian Village exceeds national and state averages, according to the CMS data. CMS uses the amount of time spent with each resident per day by nurses and aides as the basis of the assessment.
With an average population of 59 residents per day, nurses and aids spent on average 4 hours 37 minutes with residents at the facility. That is above the national average of 3 hours 45 minutes and the state average of 3 hours 22 minutes.
Nursing staff turnover at Meridian Village was 45%, below the national average of 54% and the state average of 52%.
In almost every area of quality measurement, Meridian Village bested state and national averages. Only in the percentage of short-stay residents seeing re-hospitalization after admission or having an outpatient emergency visit, did the facility not perform above average.
Eden Village Care Center
Also located in Glen Carbon, Eden Village saw a four-star rating in the most recent CMS assessment, showing above average ratings in inspections, staffing and quality.
Eden Village also had no complaint inspections in 2022. The facility received four health citations for the year, well below state and national averages. In the past three years, only two complaints resulted in a citation.
With an average of 62 residents per day, staffing levels were rated at four stars in the most recent CMS assessment. Overall number of nursing staff hours per resident per day was 3 hours 38 minutes, slightly below the national average and above the state average.
Eden Village had less staff turnover in 2022 than five-star rated Meridian Village. Total nursing staff turnover there was listed at 32 %.
The facility also scored above average in most quality measures. Residents with new or worsened pressure ulcers/pressure injuries were higher than state and national averages. The number of short-stay residents with improved mobility fell below average, but in most other areas the facility performed above average.
Manor Court of Maryville
No nursing homes in our coverage area were rated at three stars. Manor Court scored three stars in one area of the overall rating, staffing, but saw below average ratings in terms of inspections and quality, earning two stars overall.
Manor Court saw eight health citations within the CMS defined timeframe, about the same as the national average and below the state average of 11.7 citations. The nursing home had two complaint inspections in 2022.
The first, which happened in January 2022, was related to patient transfers. In September of that year, another complaint inspection was initiated following a resident falling.
The average number of residents per day at Manor Court, 98, exceeded both state and national averages. However, nursing staff at the facility spent more time with residents than the higher rated nursing homes in this report – 5 hours and 22 minutes per resident per day.
However, the amount of time registered nurses spend with patients, only 23 minutes per day, fell below both the national average of 40 minutes and state average of 44 minutes.
Registered Nurse hours per resident per day on the weekend also fell below those averages – 18 minutes at the facility, versus 27 minutes nationally and 32 minutes in Illinois.
Those numbers correlate with staff turnover. Overall nursing staff turnover was slightly higher than state and national averages – 59 % at Manor Court versus 54 % nationally and 52 % statewide. However, registered nurse turnover at the facility was at 80%, far above the national average of 52% and state average of 50%.
CMS ratings show Manor Court below average in quality measures overall.
Mobility metrics for both short and long-term residents at Manor Court saw below average ratings. The percentage of short-stay residents who improved in their ability to move around on their own was listed at 65%, about 9% below the national average. The percentage of residents who are at or above an expected ability to move around at discharge was also below the national average – 22% versus 40%. Overall change in residents’ ability to move around was 11.6 % versus the national average of 16.6 %.
The facility also saw above average rates of short-stay residents who were re-hospitalized after admission and who had outpatient emergency department visits. Those figures show 29.9 % of Manor Court short-stay residents re-hospitalized versus 22 % nationally and 15.1 % visiting an emergency room versus 11.8 % nationally.
Elmwood Nursing and Rehab Center
Located in Maryville, Elmwood Nursing and Rehab Center was issued 27 health citations in the time-frame used in the CMS ratings. That number is more than three times the national average of 8.5 and more than double the state average of 11.7.
Elmwood saw seven complaint inspections in 2022.
One of those complaint inspections found a resident was transported to the hospital after his pain medication was cut by 66 % due to an error by a nurse. In another, staff failed repeatedly to address self-harm prevention for a resident with mental-health issues. Issues regarding safe transfers and missing resident property are also listed in the complaint inspection reports.
Staffing hours at the center, which saw an average population of 85 residents per day, fell far below state and national averages, according to the CMS findings. Total number of nurse staff hours per resident per day was 2 hours and 26 minutes, more than an hour per resident below the national average and almost an hour below the average for the state. On weekends, the time nursing staff spent with residents was even less, about 2 hours and 7 minutes per resident.
Nursing staff turnover at Elmwood was not available, as it was either not submitted or did not meet CMS criteria.
Elmwood Nursing and Rehab Center saw a two-star rating in the quality measures rating for short-stay residents. Short-stay residents who were re-hospitalized after admission was listed at 6%, well below the national average of 22.1 and state average of 24.6 %. The CMS rating also shows that 100% of short-stay residents had their functional abilities assessed and their goals included in their treatment plans.
Other short-stay resident metrics listed for the facility fell far below state and national averages.
While the national average of short-stay residents who got antipsychotic medication for the first time was 1.7%, at Elmwood the figure was 7.6%. Only 8.7% of short-stay residents got a flu shot, whereas the national average is 75 % and the state average is 62%. Pneumonia vaccines for short-stay residents at the facility were listed at only 1.6 %, with a national average of 79 % and a state average of 65%.
Metrics for long-stay residents at Elmwood saw similar below average numbers. Long-stay flu shots were listed at 40 % at the facility, less than half the state average of 91% and national average of 94 %. Smaller numbers were reported for long-stay resident pneumonia vaccines – 23.4 % at Elmwood versus 92% nationally and 85% in Illinois.
Long-stay residents receiving antipsychotic medication doubled the national average – 31.6% at Elmwood versus 14.5% nationally. Statewide the percentage of long-stay residents receiving antipsychotic medication was 17.8%.
For long-stay residents who had signs of depression, the rate at Elmwood of 27.7% was nearly 20 percentage points above the national average of 7.9%, but below the state average of 32.1%, according to the CMS website data.
The facility saw some positives in long-stay resident quality measures. No residents were reported to be physically restrained. Less than 1% of long-stay residents were reported to have weight loss, far below the national and state averages of about 6%.
Collinsville Rehab and Health CC
Collinsville Rehab and Health CC ratings were a mixed bag, with the facility receiving a one-star rating in the health inspection category, a two-star rating in staffing and a four-star rating in quality measures.
In the health inspections category, 19 health citations were reported. Three complaint inspections were reported in 2022. One of those was for not providing residents at least weekly showers. In another, the facility failed to ensure a method to communicate to staff resident’s treatment wishes regarding code status and emergency treatment. The third was related to fall prevention measures.
In the staffing metric, Collinsville Rehab and Health earned a two-star rating. The facility had an average population of about 60 and nursing staff spent about 3 hours 15 minutes per day with residents, just minutes below the state average and about one-half hour below the national average.
However, of that time period, only 14 minutes of time spent with residents was by registered nurses. The national average there is 40 minutes and the state average 44 minutes.
Total nursing staff was reported to be 56, just a few percentage points away from national and state averages. A breakdown of registered nurse turnover was not available in the CMS reports.
While Collinsville Rehab and Health fell below average in the two aforementioned areas, it earned a four-star rating in quality measures.
Those are divided into short and long stay residents, but the facility had too few short-stay residents to provide data in most categories, the CMS website shows.
For long-stay residents, flu and pneumonia prevention measures both exceeded state and national averages. Weight loss among residents was also better than those averages, as was the percentage of residents experiencing bowel or bladder control loss.
Mobility issues were also better than average at Collinsville Rehab and Health. Only 3.1 percent of long-stay residents reported their ability to move independently worsened. That is far below the national average of 16.2% and state average of 15.7%. Fewer residents here also saw their need for help with daily activities increase – only 2.7% compared to 14.8% nationally and 13.8% statewide.
Urinary tract infections, however, were significantly higher than state or national averages, with 22.2% of residents seeing infections compared to 2.3 nationally and 2.6% statewide.
The number of long-stay residents who got an antipsychotic medication at 30 was double the national average and almost double the state. Numbers for residents receiving anti anxiety or hypnotic medication 34.5% were also higher than state averages 18.8% and national averages of 19.4%.
The number of long-stay residents who have symptoms of depression was lower than state and national averages at Collinsville Rehab and Health. Only 3.8% percent of residents there reported those symptoms, compared to 7.9% nationally and 32.1% in Illinois.