Sunday, January 13, 2013

But But....we are a 4 star rating nursing home.

So what exactly does this mean?

Are we talking hotel here or assisted and skilled nursing?

It means nothing.  This is the image and marketing that the California Armenian Home wants to portray, the outer appearances.lush gardens, statues donated by local artists (except one unnamed Croatian Artist wink wink)  from the outside everything seems OK.  The home guild, ani guild and other groups go through great measures to insure the outside is like a country club, even misuse of new signs complete with valet parking. 

They are trying to hold onto the past glory days of the home and must realize they are over.  The home has no Armenians in adminstrative positions but only in places of menial work ( 3 to be correct )out of over 100+ employees.  Additionally there are currently only 17 Armenians in the facility as either a resident or skilled nursing patient out of 120 beds.  The home wants money from the Armenian community by way of donations but offers nothing in return.  How is it that Armenians become responsible for paying for the care of others and getting nothing in return except for a few meals in Armenian and weekly visits from the Armenian Churches?  That is a high price tag for 17 Armenian residents, there are many many more Armenians at other facilities: Nazerene House, Fairwinds, San Joaquin Gardens, etc.,  Many who were told "we have no room for your family member" by the current Administrator Lubjica.  Smart move Lubjica aka Yuba trying to remove as much Armenian residents and staff as possible. 

Nice going Lubjica, trying to keep Armenian majority out is really paying off in donations (snicker giggles).  Heard you were just at another Armenian funeral that you occasionally make an appearance at.  We must tell you, your not wanted at our Churches sniffing around for donations from families?  This funeral was the aunt of a former board member at CAH who dropped out because of the dirty politics and games you play.  Continue aligning yourself with people who are desperate for a job and see how loyal they are.  The dregs of society can only stay loyal to you for so long and that list of fired ex employees is getting longer and longer. 

Lets go inside and find out what is really going on, compressor that broke down, poor lighting in rooms, shit show of a wall with donors names (90% of which are dead or no longer donate), beautiful dining areas, etc.,  There were even Christmas gifts bestowed on the residence that were country club style (worthless) bathrobes and shower gel.  The bathrobes were stupid as now there will be over 50 people with the same robe and more cross contamination of clothing mixed over.  The shower gel cannot be used at the California Armenian Home as they use a hospital issued soap from their distributors: McKesson, Cardinal, etc.,  But it makes for good appearances.
Take a look deeper at staff, stolen clothing, staff roaming around from their stations, giving oranges to diabetic patients, going freely into the board room, threatening to call police on vistors and family members, texting and photograhy on the floor, visable tattoos and other poor hygiene issues. 

Lets hope the next Administrator at least has a degree in Health Care Administration and understands how to be civil and polite to all members of the Fresno Community.  Instead of ---what is the word one board member uses to describe you ...ah yes "mean".  Good for you Lubrication you managed to have a handful of people who support you, but there are many with deep pockets in places of power that are disgusted with you.  You lack the professionalism, clout, intelligence or communication style to continue.  No amount of face lifts will change that.  In fact, one board member said he didn't notice a difference, but alas those outer appearances are important. 

Best Nursing Homes 2012: Behind the Rankings
Health-inspection results, adequacy of nursing staffing, and quality of medical care determined each home’s star ratings
February 7, 2012 RSS Feed Print
One in seven Americans age 65 and older will spend time in one of the nation's 16,000 nursing homes this year and for those 85 and older, the chances are more than one in five. The numbers add up to about 3.3 million Americans. How will those millions of people and their families find a source of good care?
To help them out, U.S. News displays data about nearly every nursing facility in the United States, updating the information every quarter and using it to rate and rank the homes. The 2012 Honor Roll also lists 39 homes that received perfect five-star ratings for four consecutive quarters.
The U.S. News rankings are built on data from Nursing Home Compare, a consumer web site run by the federal Centers for Medicare and Medicaid Services. CMS sets and enforces standards for all nursing homes enrolled in Medicare or Medicaid. (For government purposes, a nursing home is defined as a Medicare or Medicaid facility that provides 24-hour nursing care and other medical services. We don't rank retirement or assisted-living communities, which aren't covered by Medicare or Medicaid.) The data for Nursing Home Compare come from regular health inspections carried out by state agencies and from the homes themselves. Based on that information, CMS assigns an overall ratings of one to five stars to all nursing homes other than a few too new for meaningful data to be available. Homes are also given one to five stars in how well they do in the health inspections, in providing enough nurses, and providing a high level of quality of care. 
At Nursing Home Compare, you can search for a specific home or for all homes in a particular state or within a certain distance of your city or ZIP code. But you can't assume that all homes that got five stars overall, or those with three or four stars, are of the same quality. There are so many homes at each level—2,486 overall five-star homes alone at the start of 2012—that the range of performance even within a single group is bound to be wide. Searching Nursing Home Compare also poses problems. Search terms cannot be combined, so if, say, you want only five-star homes within 50 miles of a specific city, you're out of luck.
Best Nursing Homes addresses these and other issues. Homes are presented in tiers within each star category, based on their total stars across the three major rating elements of health inspections, nurse staffing, and quality of care. The topmost tier, for example, consists of homes that not only got five stars overall, but five stars in each of the three underlying elements—a perfect 15. The next tier down is five-star homes that ran up 14 stars in the ratings categories, and so on. Within each tier, homes are listed alphabetically. 
If you're hunting for a home by state, region, city, or ZIP code and turn up too many to be practical, Best Nursing Homes lets you combine search terms to narrow the field. You can choose homes that are religiously affiliated, for example, or homes that accept Medicare residents. Or you can launch a multipronged search, perhaps for five-star religiously affiliated Medicare homes within 50 miles of a particular city. 
All homes listed in Nursing Home Compare that are in the 50 states and the District of Columbia also are included in the U.S. News rankings. A small number that take only private-pay residents cannot be evaluated by CMS and likewise are omitted from Best Nursing Homes. 
Here are more details about the CMS standards that determine a home's rating: 
Health inspections. Because almost all nursing homes accept Medicare or Medicaid residents, they are regulated by the federal government as well as by the states in which they operate. State survey teams conduct health inspections on behalf of CMS about every 12 to 15 months. They also investigate health-related complaints from residents, their families, and other members of the public. "Health" is broadly defined, as the checklist of 180-some items shows. Besides such matters as safety of food preparation and adequacy of infection control, the list covers such issues as medication management, residents' rights and quality of life, and proper skin care. A home's rating is based on the number of deficiencies, their seriousness, and their scope, meaning the relative number of residents who were or could have been affected. Deficiencies are counted that were identified during the three most recent health inspections and in investigations of public complaints in that time frame. State inspectors also check for compliance with fire safety rules, although their findings do not factor into the CMS ratings. Best Nursing Homes displays the full range of health and fire inspection results online.
Nurse staffing. Even first-rate nursing care falls short if there isn't enough of it because of too few nurses who can spend time with residents, so CMS determines average nursing time per patient per day. Homes report the average number of registered nurses, licensed practical nurses, licensed vocational nurses, and certified nurse aides who were on the payroll (agency temps are not counted) during the two weeks prior to the most recent health inspection and their number of hours worked. The information is compared with the average number of residents during the same period and crunched to determine the average number of minutes of nursing time residents got per day. To receive five stars in the latest CMS ratings, nurses and aides had to provide slightly more than four hours of care a day to each resident, including 33 minutes from registered nurses. The time provided by each home is shown in the rankings.
Quality measures. CMS requires nursing homes have to submit clinical data for the most recent three quarters detailing the status of each individual Medicare and Medicaid resident in 19 indicators, such as the percentage of residents who had urinary tract infections or who were physically restrained to keep from falling from a bed or a chair. The Best Nursing Homes rankings and Nursing Home Compare display data for each home on all 19. The ratings, however, are based on 10 that are considered the most valid and reliable, such as the two above and measures related to pain, bedsores, and mobility.
Good ratings or bad, CMS is adamant in cautioning that they are just a starting point. Nothing substitutes for in-depth visits. You can ask questions, observe residents and their families and caregivers, and get a feel of a home that stars can't communicate. "There are many satisfied residents and families of residents in nursing the one-star level," states an FAQ posted on the CMS website. Moreover, "no resident should be moved solely on the basis of a nursing home's ratings.... [Transferring] your loved one to a facility that has a higher rating should be balanced with the possible challenges of adjusting to a new nursing home." That is one of many hard truths about finding a home where a parent, or anyone you hold dear, can find good care.

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