Leahi Hospital rates poorly in federal agency survey

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The Centers for Medicaid and Medicare Service has given Leahi Hospital a poor performance score as one of 54 nursing care facilities in the nation identified as needing more thorough federal oversight.

Leahi, which has 179 long-term care patients, is operated by the Hawaii Health Systems Corp., a quasi-public agency that administers 12 state hospitals.

Hospital spokesman Miles Takaaze said no evidence of direct harm to patients was identified in a January survey by the federal agency, and the staff has worked to correct deficiencies. He said leadership felt the issue was mostly about documentation of services.

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WASHINGTON » Fifty-four nursing homes are being told by the government that they are among the worst in their states, in an effort to goad them into improving patient care.

Leahi Hospital, a 105-year-old state hospital behind Diamond Head, is among them.

The facilities were listed by the Centers for Medicare and Medicaid Services on its Web site today.

Leahi, which houses 179 long-term care patients, is operated by Hawaii Health Systems Corp., a quasi-public agency with oversight of 12 state hospitals.

What federal officials found unsatisfactory in a January survey here was "mostly about documentation," said Miles Takaaze, spokesman for Hawaii Health Systems Corp. "Whatever came up in January, we are confident that significant progress has been made. The staff is looking forward to the upcoming survey" to show that deficiencies were addressed, he said.

The routine oversight for facilities that serve Medicare patients amounts to "a snapshot of the comprehensive long-term care we provide. If a patient was there and we provided a service but it wasn't documented, that would be recorded as a deficiency."

Takaaze said, "There was no evidence of direct harm to patients. If there was direct harm, there would have been penalties; they would have stopped admissions and stopped Medicare payments."

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 do not make adequate improvement or do so only temporarily.

"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 54 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.

The nursing homes to be cited come from 33 states and the District of Columbia, according to a list obtained by the Associated Press. There are about 16,400 nursing homes nationwide.

Nursing home administrators have concerns that homes showing significant improvements will still show up on the Medicare Web site.

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 inspection about once a year. In such inspections, surveyors assess whether the facility meets standards on safety and quality of care.

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 might actually provide better care than a home that is not listed in another state.

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