Monroe County nursing home report card

May 22--People are living longer. On average, U.S. citizens now live at least another 19 years after reaching 65, according to the Centers for Disease Control. Patty Fretz, director of the Monroe County Area Agency on Aging, said her department's referral totals continue to increase as more people live longer and require more care.

The agency provides services that try to allow elderly residents to live comfortably at home for as long as possible. For most residents, a nursing home relocation doesn't come until it's absolutely needed -- leaving the comfort of home for personal care is considered more a necessity than a choice.

Recent statistics and inspection results show an issue with Monroe County nursing homes.

Through ratings based on the Pennsylvania Department of Health's inspection results, the Centers for Medicare and Medicaid Service provides statistical analysis for facilities that participate in their healthcare service. On average, the four Monroe County nursing homes included in the ratings are below state and national averages for quality, according to the statistics available on the Medicare website.

Whitestone, Golden Living Center in Stroud Township, Pleasant Valley Manor and Brookmont Healthcare received an average score of 1.75 out of 5 in Overall Rating from inspections in the past three years, according to Medicare.gov.

Additionally, the four Monroe County facilities have accumulated 294 total health deficiencies from 2013 to 2015, according to information provided by the state Department of Health. The average of over 73 health deficiencies per facility over that three-year span is the most of any county in the state -- with the second-most being Columbia County at 43 per facility.

According to the CMS website, three of the four facilities also drew more than 10 complaints and facility-reported incidents in the past three years -- Whitestone had the most at 25. Compared to eight participating non-Monroe County facilities within 25 miles of Stroudsburg, the rate of complaints and incidents is exceptionally high. The eight facilities, which range from Phillipsburg, N.J., to the Lehigh Valley, did not amass 10 total complaints and incidents combined.

For categories ranked from one to five, the four nursing homes each scored highest in Quality Measures, which indicates "how well the nursing home cares for residents' needs." The Monroe County facilities averaged a score of four. Their lowest score was in Health Inspections -- each scored a one.

Whitestone is the only one of the four facilities to be marked as a Special Focus Facility due to a "history of persistent poor quality of care" that has resulted in more frequent inspections, according to the website. The facility also received a federal fine of more than $123,000 in July 2015. Pleasant Valley Manor was the only other facility listed in the 25-mile radius of Stroudsburg to have received a federal fine in recent years.

Whitestone is also facing multiple medical liability lawsuits from the past three years. Monroe County affidavits detail instances of a resident being transferred by ambulance to Pocono Medical Center after a two-month stay, and another resident allegedly breaking at least two vertebrae after falling seven different times. Other lawsuits link the facility to residents' deaths.

Gregory Nicoluzakis, General Counsel for Whitestone's corporate parent Saber Healthcare Group, wrote in an email in response to questions for this story that in all times the facility acts "in the best interests of the health, safety and welfare of its residents."

"A unitary star rating determined by folks who may not have ever visited Whitestone does not accurately reflect the quality of care the facility provides to its residents and the number of positive outcomes encountered by their families," Nicoluzakis wrote.

The county agency on aging also provides its own surveillance of nursing home issues, Fretz said. When it is needed, the agency has ombudsmen -- one paid and the rest volunteer -- who oversee facilities and speak for its residents.

"They meet with residents and try to enable them to speak for themselves to ensure their rights are not being violated," Fretz said.

Fretz could not comment on the inspection results because they fall under the regulation of the Department of Health. However, she did say the agency provides its own protective and investigative services for nursing home residents through the state Department of Aging. It's her intent to resolve issues before they worsen.

"I would want to reassure the public their loved ones are being taken care of," Fretz said.

Drew Lutton, administrator for Pleasant Valley Manor, said he disagrees with the CMS ratings. He said he was informed the service would be updating its rating system to add more categories this year, which would "properly more reflect how it's been going."

"It may end up being more reflective of how a nursing home's doing," Lutton said.

Michelle Metzger, director of communications for Golden Living Center, wrote in an email that they have the utmost regard for the ratings and inspection system, but insists the numbers only offer a "snapshot" of the nursing home's day-to-day operations. She added the categories by which the rating system is created are fluid in nature.

"Therefore, a commitment to constant quality improvement remains a goal for all of our teams," Metzger wrote. "When we have deficiencies, our team moves swiftly to work with the DOH on a plan of correction, which we follow to move back into compliance."

The Department of Health has also been more frequently investigating facilities based on anonymous complaints, Lutton said. He believes complaints from an anonymous source are difficult to evaluate, due to a person's ability to have lied to the state department about having already brought the complaint to facility managers such as Lutton. And because the complaint is anonymous, Lutton is never sure what the complaint was, and what could have been done prior to an investigation.

"We don't really have any idea of knowing if it's something that's been approached to the facility or not," Lutton said.

The state department also implemented a Nursing Home Quality Improvement Task Force, director of marketing Yasmin Coleman said in an email.

"This task force includes nationally recognized experts in long-term care management who are charged with identifying ways the department can advance quality improvement in Pennsylvania's long-term care facilities," Coleman wrote. "The task force meets monthly and will issue a comprehensive report with findings and recommendations this summer."

Lutton's frustration doesn't extend to the state and CMS regulators, and he hopes a change to the rating system will correct what he calls their "flaws in the past."

"This staff really gives a darn about its residents," Lutton said. "It can be a little frustrating when it looks like we're barely treading water."

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