DETROIT – Local 4 Defender Karen Drew went digging through inspection reports of Metro Detroit Medicare nursing homes, and some of the findings were a surprise.
Many nursing home patients are sick and elderly and rely on others because they can't speak or walk.
While many of our parents and grandparents are receiving quality care, there are others reporting abuse and neglect. What's really going on at the facilities? The Defenders spent months scouring inspection reports.
Medicare nursing homes are rated with a star system, with five stars indicating an outstanding facility and one star signaling serious problems that need to be corrected for the health and well-being of residents.
Some nursing homes around Metro Detroit have very low ratings, according to the federal inspection reports.
"When I walk into the facility, the last thing I want to smell is the smell of urine," Kenneth White said.
White's mother was recently being cared for at the Cambridge South Healthcare Center in Beverly Hills.
"I kind of feel like I got hoodwinked, so to speak, because that's not what I saw when I came to visit," White said. "I saw everything was clean. I mean, all the employees, they spoke, they were nice, and after being there a minute, and a couple of months, it kind of went 360."
White said that he took his mother out of the center. Its rating has since improved, but there are many Medicare facilities with low ratings that potentially put residents in danger.
Oakland County
In Oakland County, the Defenders found 46 Medicare facilities, and two had one-star ratings. They are:
- Medilodge of Farmington
- Clarkston Specialty Healthcare Center
At Medilodge of Farmington, the inspection report states that the facility "failed to provide timely incontinence care."
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Federal inspection reports show that, at Clarkston Specialty Healthcare Center, the facility "failed to respond to resident and family grievances." The concern was about "multiple undocumented falls, poor attitudes from the nurse aides and the residents being left in soiled incontinence briefs."
Clarkston Specialty Heathcare Center released the following statement:
"Clarkston Specialty Healthcare Center has worked diligently to improve their overall Star Rating.
"Unfortunately, the survey results are only updated once a year during the annual survey. The staff continues to work to improve the quality of care for those individuals we have the privilege of serving. We appreciate the staff's commitment and we thank the community for their ongoing support."
Macomb County
In Macomb County, the Defenders found four of the 29 Medicare facilities had a one-star rating. They are:
- Advantage Living Center -- Roseville
- Father Murray Nursing and Rehab Centre -- Center Line
- Warren Woods Health and Rehab Center -- Warren
- Lakeside Manor Nursing and Rehab Center -- Sterling Heights
At Advantage Living Center in Roseville, reports show staff members "failed to respond to call lights in a timely manner" in seven of seven instances.
At the Lakeside Manor Nursing and Rehab Center, inspection reports state the facility "failed to report when a resident's head was entrapped between enabler bar and mattress." A nurses note states that the "resident was found on the floor, head between the assist bar and mattress, knees on the floor."
Karen Drew asked Michael Karson, the president and CEO of the Area Agency on Aging 1-B, about his reaction to the findings.
"I think that anyone can make a report, so family members or patients in a nursing home can make a report, and sometimes they're very valid," Karson said. "Other times, you might have an employee that leaves that's very disgruntled that might call and make a report that might not be factual."
Lakeside Manor released the following statement:
"Lakeside Manor is committed to maintaining a safe environment for our residents.The resident involved was not seriously injured, and specific measures were taken to resolve the factors that contributed to the incident.
"In addition, our interdisciplinary team initiated a quality improvement initiative to review, improve, and monitor our processes to prevent future occurrences. We appreciate the opportunity to make a statement."
Wayne County
The Defenders also found some disturbing reports in Wayne County, where there were six Medicare facilities with one star out of 71 total.
The Wayne County one-star Medicare facilities are:
- Hope Healthcare Center -- Westland
- Heartland Health Care Center -- Livonia
- Advantage Living Center -- Wayne
- St. Joseph's Healthcare Center -- Hamtramck
- Wellspring Lutheran Services -- Livonia
- Westwood Nursing Center -- Detroit
"The services are horrible," said one man with a relative inside a one-star facility. "They only come in there when we're in there."
He doesn't want to show his face because he's worried about his grandmother's care. He said he's trying to find a new place for her.
"The government needs to do their job and come up here and see what's going on instead of just giving this money out," he said.
Federal inspection reports show Heartland Health Care Center in Livonia "failed to ensure adequate supervision" during a lift transfer, "resulting in major injury."
Reports cite Advantage Living Center in Wayne had a resident say, during a lift transfer, "I fell on my head. I looked up and they were already starting to lift me without the strap in place."
Inspection reports state at Wellspring Lutheran Services in Livonia, staff "failed to properly administer medication." Findings include "eight medication errors in 30 opportunities observed," resulting in "an error rate of 26.6 percent."
At Westwood Nursing Center in Detroit, a resident reported, "nobody will cut my nails." The report said she took off her socks and showed "one-half-inch toenails, which were fungal and curled under the toes."
Heartland Livonia released the following statement:
"Heartland provides high quality of care which is not reflected on the five- star rating report. The report only displays a snap shot in time and does not reflect our continuous quality of care provided to our patients year round. Our employees are committed to providing quality care to the patients they serve and the well-being of our patients and residents is of utmost concern to us. As dedicated caregivers, we work diligently to provide quality care in a caring environment.
"Whenever we identify a patient care issue or if state surveyors have a concern, we aggressively address the matter in a plan of correction, training or other measures to ensure patient comfort and safety. We have staff training in place, conduct self-inspections and work with patients and families to ensure we are meeting their needs.
"Patients come to us with multiple care issues requiring complex skilled medical and rehabilitation services. We are proud that patients choose Heartland skilled nursing and rehabilitation centers for their care and are satisfied with the level of care and services provided by our staff. The residents who reside in our facilities remain our top priority."
Hope Healthcare Center released the following statement:
"Hope Healthcare Center is currently in compliance and is focusing on its survey results to assist with improving it overall Star Rating. Staff has been diligent with following its clinical guidelines and improving the quality of the care we provide for our residents. We expect that the survey results will continue to improve during their next annual survey. We appreciate the support of our residents and their families."
Advantage Living Centers Wayne and Roseville released the following statement:
"Advantage Living Centers Wayne and Roseville strive to provide a high quality of care for our residents at all times. We address any citation aggressively to assure the issue is corrected, our staff is educated and supervisors are empowered to ensure an issue is not repeated.
"For our facilities, one issue is one too many. That said, the survey portion of the five star system does not lead to the best possible information for families. It often distorts what is happening in a facility and reflects old information that is not longer accurate or relevant. A better measure of the status of a facility lies in the Quality Measure component of 5 star which represents current resident populations and the care they are actually receiving. Both of these facilities are at a 3 Star in Quality Measures with the goal of achieving 5 star status."
How to choose a nursing home
What should a family do when looking for a nursing home facility for a loved one? Karson suggests families check out the star rating and do their homework.
"It's important to meet the director of nursing," Karson said. "It's important to meet the administrator. Take a tour to talk to some of the residents or families that are there, but also to go on off hours. Go during off hours and see if you are getting the same feel if you stopped by at 8 o'clock at night as you did when it was 11 o'clock and it was a very set tour and all the admission and marketing people were in the facility."
Karson said to always make surprise visits.
"If this were your parent, if this was your mom or your dad, how would you want them to be treated?" he said.
Click here to visit the Michigan Association of Nursing Home Administration's website.
Community-based options for long-term care
The Area Agency on Aging 1-B provided the following statement about community-based options for long-term care.
"Receiving care at home is an alternative option to consider for nursing home placement. Home care services can be a critical piece in helping seniors and people with disabilities continue to live safely in a home setting. These services provide assistance with those activities of daily life a senior might have trouble doing for themselves—things like bathing, dressing, meal preparation or housekeeping.
"Your local Area Agency on Aging in Michigan may have several programs that offer direct care for older adults and/or adults with a disability. Some of our programs receive government funding, so people must meet eligibility requirements to qualify. All Area Agencies on Aging also provide an information and assistance telephone line that can help guide you in understanding what programs or services are available to help you or the loved one you are caring for -- whether that is a program provided directly by the Area Agency on Aging or a program offered by another local organization.
"Below is the contact information for the three Area Agencies on Aging serving Southeast Michigan. Area Agencies on Aging are trusted sources for information on long term care options. Call us today, we can help."
Area Agency on Aging 1-B:
Serving Livingston, Macomb, Monroe, Oakland, St. Clair and Washtenaw counties
800-852-7795
aaa1b.org
Detroit Area Agency on Aging:
Serving Detroit, the five Grosse Pointes, Hamtramck, Harper Woods and Highland Park
313-446-4444
detroitseniorsolution.org
The Senior Alliance:
Serving Southern and Western Wayne County
800-815-1112
aaa1c.org
"Area Agencies on Aging are funded under the federal Older Americans Act to plan and coordinate various social and health service programs for persons 60 years of age or more across the United States. The national network of Area Agencies on Aging consists of more than 600 organizations. To find your local Area Agency on Aging visit www.eldercare.gov or call 1-800-677-1116."
Michigan long-term care ombudsman program
The Area Agency on Aging 1-B shared the following information about a program called the Michigan Long Term Care Ombudsman Program.
"Since 1972, the Michigan Long Term Care Ombudsman Program has striven to improve the quality of care and quality of life experienced by residents who reside in licensed long term care facilities.
"Licensed long term care facilities are nursing homes, homes for the aged, and adult foster care homes.
"Ombudsmen advocate for the resident in the facilities, guided by the wishes of the resident. All services are provided under strict confidentiality. Ombudsmen cannot share information about the resident or the resident’s concerns without the resident’s permission.
"The program also aims to improve the long term care system, speaking for passage of laws, regulations and policies benefiting over 100,000 Michigan long term care residents.
"The Michigan Long Term Care Ombudsman Program is funded by federal and state government. There is no cost to residents or families for ombudsman services. You can contact the program directly by calling 866-485-9393 or for more information, click here."
The Area Agency on Aging 1-B said the following documents should help families know what to consider when looking for a nursing home and questions to ask when hiring health care companies to provide services.
When searching for a nursing home:
Questions to ask when hiring a home care agency: