Virginia’s Self-Inflicted Nursing Home Crisis – Part 4 – the Worst Facilities in Virginia

by James C. Sherlock

Today we are going to take a look today at a snapshot of Virginia’s worst nursing homes as rated by the Centers for Medicare/Medicaid services.

Medicare rates 54 of the total of 386 nursing facilities in Virginia as overall one star out of five.  By definition of the way that Medicare compiles records and assigns scores, they have been bad for a long time.

Don’t use them. If you have any friend or loved one in one of these places encourage them to re-locate if they can. Either way, visit them often. It helps.

The ratings are established in considerable part by the inspections conducted by the Virginia Department of Health Office of Licensure and Inspection.

I have praised the professionalism of those inspectors and regretted the major shortage of personnel in that office. It has both rendered them unable to meet statutory requirements for frequency of inspections and caused big personnel turnover because of overwork and frustration.

See the first three installments of this series here, here and here.

First thing to know is that the data presented here is a snapshot. Please look at the dates on the top of each column. Read the footnotes for explanations that will help you understand the meaning of the data.

As for the rankings, I personally put a lot of stock in them for two reasons.

  1. CMS works this system to death to make sure its rankings are meaningful; and
  2. There is no other source that is based on the breadth and depth of objective data available to CMS.

The overall star rating is a composite of the three individual star rating dimensions. The core of the overall rating is the health inspection rating, which is adjusted up if the facility receives very high staffing or QM ratings, and is adjusted down for low staffing or QM ratings.

The rankings themselves change, but not very quickly because they look back something like three inspections and quarterly reports of staffing to give a broader picture. The medical care quality data are calculated from CMS data on Medicare and Medicaid patients.

I have sorted the nursing facility 1-star overall rankings both by region of the state and by chain ownership.

Both results are newsworthy and we will make some news here.

Worst Virginia nursing homes sorted by region

When you open the spreadsheet, you can see that there is a great deal of information, all of it from CMS.

Nearly all of what I am showing you and a great deal of additional information can be found at Medicare’s Healthcare Provider Compare page. I searched it for nursing homes across the entire state. You will enter your or your loved one’s zip code and adjust the distance for what you can live with.

The first thing we see is that there are only two one-star facilities in all of Northern Virginia. Three possible take aways:

  1. Competition works:
  2. More patients might pay with private insurance of self-pay, raising profitability:
  3. Good hospitals, making patients less susceptible to medical problems when sent to nursing homes.
  4. Some of all three.

Not sure what Henrico County did to deserve its six different one-star facilities out of twelve total in the county.

As for South Hampton Roads, not good.  Fourteen one-star facilities out of a total of 34 in this area.

The three one-star nursing homes in Portsmouth happen to be all the nursing homes in Portsmouth. The three in Chesapeake are out of a total of four nursing homes in Chesapeake.

Petersburg, Hopewell and Emporia have a total of eight nursing homes. Five of them are one-star rated.

The Worst Virginia Chains

If you are looking for villains, look no farther than a few select chains. The numbers below are number of one star nursing homes of the listed chains in Virginia vs. the total nursing homes of that chain in Virginia:

  • Consulate – nine of 21
  • Saber – Nine of 32
  • Accordius – six of 18
  • Trio – four of nine
  • ProMedica – three of six
  • Communicare – three of five

Why would a chain have so many bad facilities? Is it because understaffing is perhaps the easiest way to raise profits?

As for the non-profits on this list, they will have to explain their own corporate issues.

It would be interesting to know if the Health Commissioner has ever considered denying additional licenses to those chains.

Saber, for example, recently bought several to add to its stable.

There is one interesting case.

Four of six of Virginia Care Holco LLC’s homes are rated one star, but that organization has controlled its facilities in Virginia for only a couple of years maximum. Perhaps the owners think they can turn them around.

We’ll see.

That has proven a very difficult thing to do. And there is a shortage of available qualified staff nearly everywhere.

Next

In upcoming reports. I’ll look at:

  1. the best facilities in the state. In most regions there are plenty of excellent ones. No need to use the bad ones; and
  2. all facilities by region.