Gwen Blodgett, 78, of Skowhegan, is weighing nursing home options for her husband of 60 years, Gerald, who has Alzheimer’s disease.

Gerald is living at an Alzheimer’s care center in Gardiner, but she knows at some point he won’t be able to care for himself.

“You just never know how long it’s going to be,” she said. “That’s why they call it a long goodbye.”

When the time comes, Blodgett said, she is leaning toward Cedar Ridge, a 75-bed home in Skowhegan. She’s comfortable with the staff, who she’s seen care for family members and friends over the years. Others whose opinions she knows and trusts — including her neighbor and her hairdresser — have also reported positive experiences at Cedar Ridge.

Blodgett doesn’t expect perfection from a nursing home and knows that they all have some problems.

“It’s probably unavoidable,” she said.

Ceder Ridge is one of five central Maine nursing homes that show no serious deficiencies in a batch of reports recently released on Medicare’s website. The most recent batch of reports, which are published periodically, cover about 40 of Maine’s 107 nursing homes, including five in central Maine.

The five central Maine nursing homes, in Augusta, Hartland, Pittsfield and Waterville, had deficiencies, but they were less serious than those found in other areas of the state.

The ability to track nursing home problems became easier in July 2012 under a provision in the Affordable Care Act, which requires the Center for Medicare and Medicaid Services to publish the full report of each federal nursing home inspection on its website, Nursing Home Compare.

The reports help consumers learn which residences have the highest quality healthcare and can also lead to improvements, according to Courtney Jenkins, a spokeswoman for the federal center.

With Cedar Ridge’s inspections and ratings online, Blodgett can see what problems have been documented.

The most recent inspection found two deficiencies, neither categorized as serious.

The first was for having separated seams in the floor of the whirlpool room, while the second was for having a freezer that allowed condensation to drip and freeze on items including sealed bags of frozen Brussels sprouts.

Overall, Cedar Ridge gets four of five possible stars from the government, a quality rating of above average.

As it turns out, Blodgett’s positive impressions of Cedar Ridge match its positive rating, but that’s not always the case.

Causing harm

About 40 reports documenting inspector visits between March and August were recently published online by Pro Publica, a journalism and public advocacy organization. The results are published and analyzed under Nursing Home Inspect on Pro Publica’s website.

Some are minor, such as a failure to record the temperature of food or a missing thermostat cover.

Of about 1,600 deficiencies documented during the last three years, the large majority resulted in no actual harm. Industry leaders say the transparency is welcome, but deficiencies should be put in the proper context.

Maine’s rate of serious deficiencies, 0.06 per nursing home, is 10th lowest in the nation, according to a data analysis by Pro Publica.

One Waterville administrator said Maine’s good record is the result of effective state oversight and programs that allow residents to take more control over their environment. Federal inspectors visit each of Maine’s 107 nursing homes annually to document deficiencies, categorized into different levels of severity, depending on the level of harm caused. Nursing homes typically respond with a correction plan.

The most serious violations documented in the state during that inspection period were at Narraguagus Bay Health Care Facility in Milbridge and Mercy Home in Eagle Lake, two nursing homes rated below average by the federal government, with two of five stars. 

At Narraguagus Bay, a 35-bed home, a March 20 inspection documented three deficiencies in which harm occurred.

According to the report, in November a doctor ordered that one resident walk only with a rolling walker and the assistance of two staff members, because of a high risk of falls. The doctor’s orders were not followed, which resulted in the resident falling in December and again in January. The first fall resulted in bruises and severe pain, while the second resulted in a fractured hip, according to the report.

Attempts to contact Narraguagus Bay administrators for comment were unsuccessful.

At Mercy Home, a 40-bed residence, an April 17 inspection documented the case of a resident who twisted an ankle on Feb. 5. The next day, when the resident complained of pain, a doctor ordered an X-ray, but one wasn’t made for nine days. The resident complained of high pain levels every day, refused to do a range of motion exercise with the foot, and was only given Tylenol by staff.

When an X-ray was finally done on Feb. 14, it showed the resident had a bone fracture, according to the report.

A message left for Denise Raymond, Mercy’s administrator, was not immediately returned.

Central Maine shines

None of the five recently inspected central Maine nursing homes had serious deficiencies.

Mary Ford, owner of the 57-bed nursing home Pittsfield Rehab, said Maine’s nursing homes try to avoid serious deficiencies because they know the state response will be swift.

“I think Maine has been regulated heavily for a long time, so compliance has been good in our state,” she said.

Pittsfield Rehab gets five of five stars from the government, a rating of much above average.

A July 12 inspection documented two nonserious deficiencies, for not giving patients showers according to their preferences and not communicating a medication order from a resident’s doctor to that resident’s pharmacist.

Ford said the state accepted a correction plan and that the facility is now in full compliance.

Sara Sylvester, administrator at Waterville’s 90-bed Oak Grove Center, said there haven’t been any serious deficiencies because comments from an active resident council allow residents to have more control over their lives.

In addition to organizing outings and choosing meals, the residents voice concerns about problems with the staff and the home.

“If they’re not being treated correctly, if a nurse or an aide is curt with them, those people have to go home,” Sylvester said, “and an investigation has to happen immediately.”

The most recent inspection at Oak Grove, on May 9, found five non-serious violations, including a urine odor in one area, a failure to best manage each patient’s drug regimen and failure to cycle out expired calcium vitamins.

Sylvester said the state approved a correction plan and Oak Grove, rated above average with four of five stars, is now in full compliance.

The Augusta Center for Health and Rehabilitation in Augusta, a 72-bed residence, is also rated above average, with four of five stars.

During a May 16 visit, inspectors documented five non-serious violations at the center, including separated bathroom floor seams, failure to update a patient’s care plan to reflect a worsening pressure ulcer and failure to keep an ice machine clean.

Administrator Cathleen O’Connor said the state accepted a correction plan and the center is now in full compliance.

At Augusta’s MaineGeneral Rehab & Nursing at Graybirch, a May 14 inspection uncovered four non-serious deficiencies, all related to an incident in which a resident left the building and was missing for hours before being brought back by family members.

Graybirch has three of five stars from the government, a rating of average.

Connie McDonald, Graybirch’s administrator, did not immediately return a call for comment.

At Sanfield Rehab & Nursing Center in Hartland, inspectors found four non-serious violations on April 4, including failure to notify a resident’s family about the expiration of a particular Medicare benefit; stains in the kitchen; and failure to update a resident’s medication orders.

The federal government rates Sanfield as much above average, with five of five stars.

Administrator Sheila Beasley referred questions to Sanfield Rehab’s owner, North Country Associates, but a call to North Country’s chief operating officer, Mary Richards, was not immediately returned.

Transparency

The nursing home industry welcomes the added transparency, according to Nadine Grosso, vice president of the Maine Health Care Association, which represents nearly every nursing home in the state.

She said prospective residents should pay attention to the scope and severity of deficiencies, rather than the number.

“For example, if a person in the kitchen forgot to wear a hairnet, is that a big deal in the scheme of things?” she said.

Grosso said serious or recurring deficiencies should be taken into account, and the information should be one component of a larger information-gathering strategy.

“If they’re looking at a particular facility and they look at a deficiency report and they see something that they now have a question about, it would be really good to go talk to the facility about that,” Grosso said.

Matt Hongoltz-Hetling — 861-9287
mhhetling@centralmaine.com