Last month, the official U.S. website for Medicare (Medicare.gov) significantly
altered the scoring method used for measuring ratings of the nation's
nursing homes in its vast online database and comparison tool,
Nursing Home Compare.
Following the changes of the scoring model rolled out in February of 2015,
more than 60% of nursing homes saw their overall quality score decrease,
though in most instances, not dramatically. However, a full 28% of those
facilities who were adversely affected by the scoring changes saw their
overall quality score lowered by a one full star.
Nursing Home Compare is website run by Medicare.gov that keeps up-to-date
quality of care information on every single Medicare and Medicaid-certified
nursing home in the nation. If you're concerned about avoiding the risk of
nursing home abuse or neglect occuring, it's a great asset to use. The website calculates quality
of care scores for more than 15,000 facilities in all 50 states, and is
accessed by 1.5 million visitors a year.
How Nursing Home Compare scores are calculated
The website employs a 5-star scaled scoring system to calculate an overall
quality score for every nursing home in the county that participates in
Medicare or Medicaid. Each nursing home is scored based on three different
areas that affect the level of care the facility provides: health inspections,
quality measures, and staffing.
According to Federal officials, the changes incorporated are:
- Introduced a quality measure tied to the rate of newly-prescribed anti-psychotic
drugs and treatments to short-stay patients
- Increased the number of points required to get an overall quality score
higher than 2 stars
- Increased the requirements to achieve a higher score in the level of care
category for staffing, a critical component of the overall quality score
The worst nursing homes in Palm Beach County, according to Nursing Home
There are 55 nursing home facilities in Palm Beach County that are ranked
in Nursing Home Compare. Last year, we wrote an article on
Avante at Boca Raton being the worst nursing home in Palm Beach County. Avante is a skilled nursing facility which received the lowest score
in the county by the Nursing Home Inspections Ranker, a similar tool used
to compare nursing homes run by the Agency for Health Care Administration, or AHCA.
According to Nursing Home Compare, Avante does not boast the lowest quality
scores – but they are far from the top. With an overall quality
score of 2 stars, Avante scores in the bottom 30% of the score range for
all Palm Beach County facilities. Nearly 45% of all Palm Beach County
nursing homes achieved an overall rating of 4 stars or more, following
last month's scoring system updates.
To Avante of Boca Raton's credit, the facility achieved a 4-star rating
in the care category of staffing, and a 5-star rating in the category
of quality control, which are two very important categories, according
to the page on the website that explains how the scoring system works.
Remember, one of the changes the website rolled out to its scoring system
was giving more leverage to the care category of staffing to influence
overall quality score.
Digging deeper into the database, two facilities stand-out as having the
worst scores in both overall quality and each category. They are Glades
Health Care Center in Pahokee, and Heartland Health Care and Rehabilitation
Center in Boca Raton (see screenshot below).
In the care categories of health inspections, both facilities received
only one star. For the category of staffing, Glades has not been scored
– the algorithm hasn't gleaned enough data from the facility
to process a score. Heartland received two stars.
Both facilities received only two stars for quality measures, and both
facilities represent two of only three facilities in Palm Beach County
to receive one-star ratings for their overall quality score.
Glades and Heartland are strikingly similar – both have 120 beds,
both participated in Medicare and Medicaid, and they are both independent
care facilities. According to Medicare data, Glades Health Care Center
is non-profit; Heartland Health Care is for-profit. Heartland was fined
by Federal authorities only once in the last three years, in the amount
In the area of health and safety inspections, in the last year, the total
number of deficiencies discovered by officials at Heartland was 11, compared
with 7 at Glades, and 5.7 as the average number of deficiencies for all
facilities in the state of Florida.
Heartland also received more than four times the number of complaints to
Medicare that were filed against Glades. When it comes to fire deficiencies,
Glades was cited with three times as many deficiencies than Heartland.
The best nursing homes in Palm Beach County, according to Nursing Home
Of the 55 nursing homes in Palm Beach County that are ranked on Nursing
Home Compare, 27% carry an overall quality score of 5 stars. Of those
15 facilities, only two facilities carry 5-stars on every scoring level
– overall quality score, health inspections, staffing, and quality measures.
Those facilities are Harbours Edge in Delray Beach, and Joseph L Morse
Geriatric Center in West Palm Beach. Both facilities are non-profit, and
both received a total number of health deficiencies that were well below
the average for Florida in the last year. Harbours Edge did receive a
fire safety inspection report in 2013 that cited the facility for seven
deficiencies, more than those reported in the same year at Glades and
Interestingly, Harbours Edge and Joseph Morse are credited with a smaller
percentage of short-stay patients who were newly prescribed with antipsychotic
medications by the facility. In fact, both facilities prescribed antipsychotic
medications to only .5% and 1.4% of their short-term newly-admitted patients,
respectively, compared with 3% for the average of all Florida facilities
and 2.4% nationally.
The greater weight placed on the measure of how many newly-admitted short-term
patients receive antipsychotic medication was one of the recent key changes
to the scoring system, according to a release by Medicare.
The takeaway from this article is that the newly incorporated changes to
how Medicare and Nursing Home Compare scores the nation's facilities
has, on average, lowered the overall quality score for many facilities.
In Palm Beach County, many overall scores were lowered among facilities
that already suffered from a low overall score, as expected. But some
facilities were rewarded with a higher overall score, and in the three
quality of care categories.
If you or someone you know has been a patient or resident of Glades Health
Care Center or Heartland Health Care and Rehab Center, and you they have
been subjected to
nursing home abuse or neglect, please give our office a call immediately at 561-444-4440. You or your
loved one or friend, or their family, may be entitled to compensation
related to damages suffered. We may be able to help. The call and a consultation
is free – 561-444-4440.