White Plains Journal-News

Most Rockland nursing homes prove to be better than average
By KHURRAM SAEED, THE JOURNAL NEWS

Seven of Rockland's 10 nursing homes earned above-average ratings, a Journal
News analysis of federal and state inspection data has found.

The county's three other nursing homes received an average rating, meaning
all of Rockland's facilities fared well in patient-care standards and
regulations examined in four years of surveys.

"That so many are above-average doesn't surprise me at all," said Michael
Fober, head ombudsman of nursing homes for Rockland's Office for the Aging.

By comparison, 70 percent of nursing homes in Westchester and Putnam had
serious patient-care and administrative deficiencies over the past four
years.

Despite the high marks, every licensed nursing home in Rockland experienced
some minor problems. Three were cited for serious deficiencies by the state,
although each was an isolated incident that has been corrected.

Each nursing home also fell short in at least one category that measured how
well a resident was doing at a facility. One measure, for example, counted
the number of residents who had infections.

The study examined inspections done by state regulators, patient well-being
measures and deficiencies of patient-care standards.

As with any study, statistics do not tell the entire story. But the analysis
of federal data provides a snapshot of the state of Rockland's nursing homes
at a time when the county's population is growing older. Rockland's median
age grew to 36 years and 72 days, two years older than in 1990, according to
the 2000 U.S. census.

The information also is valuable because the homes primarily serve the
county's oldest and most frail, said June Molof, director of Rockland's
Office for the Aging.

The homes are expensive, too.

One day in a Rockland nursing home costs an average of $230 if the patient
pays for it personally. That is nearly $84,000 a year, although most
residents' stays are covered by Medicaid or Medicare.

"I think we're doing well," Molof said. "You read about some of the horror
stories that go on in other places, and we have not heard, to date, of these
scandalous situations in Rockland County."

The Journal News analysis was part of a Gannett News Service investigation,
which examined computerized federal government records of the nation's 16,000
nursing homes, covering the period from March 1999 to March 2003. It assigned
a star rating, comparing each home with all other homes in the same state.
The star rating takes into account the seriousness of problems inspectors
found and how much of a threat, if any, they posed to patients.

Using a scale of 1 to 5, with 5 being the best, five Rockland nursing homes
earned the top score.

They were Friedwald Center in New City, Helen Hayes Hospital in West
Haverstraw, Northern Metropolitan in Monsey, Northern Riverview in Haverstraw
and Nyack Manor in Valley Cottage.

The study also looked at several measures of patient quality that are kept by
the federal government. The period reviewed in the GNS survey for those
measures covers July to September 2002, the first time the government has
compiled such statistics.

The measures included the percentage of patients in physical restraints; with
infections; with pressure sores, also called bedsores; with pain; and with
loss of function in daily activities, such as eating.

For example, 24 percent of the more than 200 residents at Northern Manor
Geriatric Center in Nanuet had infections - twice the state average of 12
percent.

Roslyn Hurwitz, Northern Manor's administrator, cautioned against reading too
much into it.

She said the number did not tell the full story, because the home specializes
in caring for people on ventilators. Patients come to the home often after
spending long periods in the hospital, and are debilitated and usually on
large amounts of antibiotics. In other words, Hurwitz said, "they're prime
targets for an infection."

"These indicators are very good," Hurwitz said last week, "but just like
anything else, people who look at these things should not use them as the
only criteria for choosing nursing homes."

Rockland Commissioner of Hospitals Anjan Bhattacharyya agreed that the type
of patient cared for at the nursing home greatly influenced the numbers.

Summit Park Hospital, which is county-operated, sets aside two out of its
nursing home's five floors for Alzheimer's patients. About 60 percent of its
300 residents suffer from minor to severe dementia, Bhattacharyya said.

It's no wonder, he added, that 19 percent of Summit Park's residents lost
some of their ability to do basic tasks by themselves since coming to the
nursing home. The figure was the highest percentage in the county and 6
percent above the state average.

"They've lost their cognitive ability," Bhattacharyya said. "They don't
complete meals because they are easily distracted."

Nurse staffing levels were also examined. Most Rockland facilities ranked
high with the two government owned-hospitals, Summit Park and Helen Hayes,
having the highest number of registered nurses and licensed practical nurses
per nursing home resident.

By comparison, Hillcrest Nursing & Rehabilitation Center in Spring Valley had
the lowest amount of nursing time spent per resident: 49 minutes per day.

Michael Chaiken, Hillcrest Nursing's administrator, said the figures were not
accurate. The state and federal agencies that compiled the statistics last
summer used one week's worth of statistics instead of two, he said.

"That was a glaring error," he said, adding that the information would be
updated.

If the figure were doubled, the for-profit nursing home's level would be
closer to other facilities in Rockland, although still near the lower end of
the spectrum.

Hillcrest Nursing was one of three facilities in the county that had a
serious deficiency last year.

The state Health Department, which regulates nursing homes in New York, found
during a routine inspection that a patient received his medicine at the wrong
time.

The patient was not harmed, and no procedures have been altered, because the
matter was an isolated incident, Chaiken said.

In June, the Tolstoy Foundation Nursing Home in Valley Cottage was cited by
the state Health Department for a significant deficiency. It was an isolated
case detected during a routine inspection.

The facility was told to make sure that residents who take drugs were not
given too many doses or for too long, to make sure drug use was carefully
watched, and to stop or change drugs that caused unwanted effects.

Further details about the circumstances surrounding the deficiency were not
available.

Dorothy Corbett, Tolstoy's administrator, declined to comment last week.

Ramapo Manor Center in Suffern also was cited for two serious deficiencies by
the state last spring after a friend of a resident called to complain. The
facility was notified by the state to give residents enough fluids to keep
them healthy and prevent dehydration.

Marsha Squires, Ramapo Manor's administrator, said the incident was "about
documentation more than anything." The home is responsible for measuring how
much a person drinks during a day, but in this case, the record was not
accurate, she said.

The home has changed its system to ensure the same thing doesn't happen
again, she said.

Lois Morro, a Suffern resident, enrolled her 79-year-old husband, Leonard, in
Ramapo Manor in November because he needed around-the-clock care. She said
she was not concerned about an isolated mistake reported at the home, because
she had been pleased with the service that she has received.

Since her husband has been there, he has been breathing better, he sleeps
through the night, and he is more relaxed, said Morro, 69.

"He's not yelling at me to go home," she said. "That shocks me."

Staff writers Greg Clary and Dwight R. Worley assisted with this story. Reach
Khurram Saeed at ksaeed@thejournalnews.com or 845-578-2412.Staff writers Greg
Clary and Dwight R. Worley assisted with this story. Reach Khurram Saeed at
ksaeed@thejournalnews.com or 845-578-2412.