Carson nursing home among worst in report

WASHINGTON - Fifty-four nursing homes, including Evergreen Mountain View Health and Rehabilitation Center in Carson City, are being told by the government that they're among the worst in their states in an effort to goad them into improving patient care.

Lawmakers and advocacy groups have been pushing the Bush administration to make it easier for consumers to identify poorly performing nursing homes. They complain that too many facilities get cited for serious deficiencies but don't make adequate improvement, or do so only temporarily.

The administration agreed, and the Centers for Medicare and Medicaid Services will list the homes on its Web site today.

"Very, very poor quality nursing homes do not deserve to be left untouched or unnoticed," said Sen. Herb Kohl, D-Wis., chairman of the Senate Special Committee on Aging. "This is not to be punitive. That's not our goal. Our goal is to see to it that the people in these nursing homes get better quality care or that they get the opportunity to move somewhere else."

The homes in question are among more than 120 designated as "special focus facilities." CMS began using the designation about a decade ago to identify homes that merit more oversight. For these homes, states conduct inspections at six month intervals rather than annually.

The homes on the list got not only the special focus designation, but also registered a lack of improvement in a subsequent survey.

Dan Barber, appointed three months ago as administrator of Evergreen Mountain View Health and Rehabilitation Center in Carson City, said the CMS survey for his facility that's listed in the report was done last April, and a new survey done in October shows improvements.

As for the facility's national listing, Barber added, "I don't think anybody deserves to be on that. This is a very hard industry and our No. 1 priority is to take care of the elderly and make sure they are given excellent care. ... I do believe that the staff here has done a great job."

About 1.5 million elderly and disabled people live in nursing homes. Taxpayers spend about $72.5 billion a year to subsidize the cost of nursing home care.

Every nursing home receiving federal payments undergoes inspections about once a year. In such inspections, surveyors assess whether the facility meets standards focused on safety and quality of care. Among the things inspectors look for are giving residents the proper medicine, assisting them with daily living activities such as bathing, and assisting them with their medical needs and diet, as well as the prevention of accidents and infections.

Typically, homes that get the special focus designation do show improvement. Federal data indicate that about half the special focus homes improve their quality of care significantly within 24-30 months.

However, about 16 percent are terminated from Medicare and Medicaid.

Kerry Weems, acting administrator at the Centers for Medicare and Medicaid Services, said states pick from a list submitted by CMS when determining those that get the special focus designation. He said that because of regional differences, a home that makes the list in one state may actually provide better care than a home that's not listed in another state.

"I'm careful in saying they're not the worst performers, but they are chronic underperformers," Weems said.

Weems said he hopes that naming the homes makes it easier for them to improve.

"We're hopeful making this disclosure will put the right kind of pressure, helpful pressure, on the facilities to move to the path of improvement rather than the path to termination," Weems said.

The AARP also applauded the administration's action.

More information

• Medicare officials said families with relatives in a special focus nursing home should visit the home and talk to staff and residents. They can also review the survey history for the home on Medicare's Web site called Nursing Home Compare (

• Another source of information about a home is the state's nursing home ombudsman.


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