Valley nursing facilities screening visitors

A sign forbidding routine visits was posted outside the entrance of Nottingham Village in Northumberland on March 11, 2020.

Just one nursing home out of 13 in the Valley hasn’t undergone a federal inspection in at least 18 months but has been surveyed by state inspectors 13 times within that timeframe.

Nottingham Village in Northumberland, a 3-star facility as rated on www.medicare.gov, last underwent a survey by Centers for Medicare and Medicaid Services (CMS) in July 2019. The state surveys were completed by the Pennsylvania Department of Health, with the latest inspection results available from February.

A team of statehouse reporters with CNHI, The Daily Item’s parent company, scrutinized a lack of federally mandated in-person site inspections of nursing homes over at least 18 months. The review found that more than half of nursing homes in the U.S. that receive Medicare or Medicaid reimbursements were at least that far behind in required annual survey inspections.

The reporting found that even prior to the global spread of COVID-19, the review system struggled to keep pace with required oversight in many states — and that many surveys are largely reactionary, relying heavily on complaints from residents’ family members or facility staffers.

That lack of federal site surveys doesn’t apply in the Valley. These completed visits coupled with those by state inspectors confirm or, in some cases, absolve the facilities of reported deficiencies.

CMS created its Five-Star Quality Rating System to help consumers, families, caregivers compare nursing homes. A five-star rating is considered much above average quality and one-star is much below average quality. Each home has one overall rating and a separate rating for each of three other categories, health inspections, staffing and quality measures.

The health inspection rating uses the three most recent health inspections and investigations due to complaints. Staffing rates nursing homes on the number of hours of care provided on average to each resident each day by nursing staff. The quality measures rating is based on 15 different physical and clinical measures for residents.

The overall rating combines the other ratings into one “snapshot,” according to CMS

Nottingham Village is one of five Valley nursing homes with a 3-star rating or higher. Even with that standing in the CMS facility metrics, it isn’t without deficiencies as identified in the federal site-visit survey. and without a follow-up survey, potential remedies haven’t been documented.

Nottingham’s nursing home administrator, Sue Wert, declined comment, citing confidentiality and privacy concerns.

According to the CMS survey, the facility had 10 deficiencies. All but one was cited in a prior survey. The deficiencies were limited to “few” or “some” residents, such as a failure to update one patient’s do-not-resuscitate directive, not implementing measures to reduce the fall risk for two residents, failing to assess and monitor nutritional parameters for two others, and a lack of activities on evenings and weekends to meet several residents’ specific needs.

The survey notes that in one case, “many” residents were at risk of harm due to failures to abide by professional food service standards. The kitchen deficiencies were largely a lack of record-keeping of rinse/wash temperatures for dirty dishes but also dust buildup in two kitchens and a lack of labeling to identify and date food stored in a freezer.

Kitchen deficiencies were cited in February during a state inspection including failure to label a thickening agent as well as the buildup of debris on surfaces.

CMS, which falls within the Department of Health and Human Services, ranks facilities on a 5-star system. It’s based, in part, on data provided on Minimum Data Set (MDS) forms: a standardized, primary screening and assessment used to track patient health status and also used in Medicare and Medicaid reimbursement. Valley nursing homes and their individual star rankings: ManorCare Health Services, Sunbury, 2 stars, last inspection on Dec. 20, 2019; Milton Nursing and Rehabilitation Center, Milton, 2 stars, last inspection on Dec. 4, 2020; Mount Carmel Nursing and Rehabilitation Center, Mount Carmel, 3 stars, last inspection on Feb. 6, 2020; Mountain View: A Nursing and Rehabilitation Center, Coal Township, 1 star, last inspection on Nov. 8, 2019; Nottingham Village, Northumberland, 3 stars, last inspection on July 25, 2019; Nursing and Rehabilitation at the Mansion, Sunbury, 3 stars, last inspection on Jan. 8, 2021; Watsontown Nursing and Rehabilitation Center, Watsontown, 1 star, last inspection on Nov. 6, 2020; Emmanuel Center for Nursing and Rehabilitation at Maria Joseph Manor, Danville, 2 stars, last inspection on Dec. 20, 2019; Grandview Nursing and Rehabilitation, Danville, 3 stars, last inspection on Jan. 22, 2021; The Manor at Penn Village, Selinsgrove, 2 stars, last inspection on Jan. 15, 2021; Buffalo Valley Lutheran Village, Lewisburg, 3 stars, last inspection on Sept. 18, 2020; RiverWoods, Lewisburg, 1 star, last inspection on Sept. 25, 2020; Rolling Hills Healthcare and Rehabilitation Center, Millmont, 4 stars, last inspection on Oct. 2, 2020.

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