Jan. 10--DANVILLE -- Four of Danville's five nursing homes rank at the bottom of a new Medicare-sponsored rating system and local administrators are crying "foul."

The "Five Star" system was unveiled late last year by the Centers of Medicare and Medicaid Services as a way to help families choose the best facility. It uses a mix of data rating nursing homes from one to five stars, with five being best. Rankings are divided into the categories of state health inspections, staffing and quality measures.

According to updated rankings on the Five Star Web page, four Danville facilities -- North Logan, Danville Care, Hawthorne Inn and Vermilion Manor -- rate one star. A facility in Covington, Ind., The Waters, rated two stars.

Just two Vermilion County nursing homes received more than two stars -- Colonial Manor, which had a perfect rating of five stars, followed by Hoopeston Community Hospital's facility with four stars.

"It was upsetting to me," said Lisa Miller, administrator at Hawthorne Inn, 3222 Independence Drive. "I'm very competitive, so I'm not happy at all. I would consider my building a five-star building."

Miller, like most administrators contacted for this story, was perplexed by the low ranking and couldn't explain why individual scores were so low. They say state surveys have not pointed out major deficiencies -- and when weaknesses are highlighted, they are corrected quickly.

She said polls show residents at her facility, which has 64 beds, are pleased with the service they receive.

Miller said the Illinois Department of Public Health is known for being one of the strictest in the country with its health-inspection surveys. She believes the facility might have been knocked for a recent survey that showed some individual resident decline.

That doesn't mean the decline wasn't met head-on or indicative of a system failure, just that the outcome may not have been positive.

"Sometimes people do have declines, no matter what you do," she said. "That's why they come to a nursing home.

"But if you had a bad survey, it can stick with you for three years (under the five-star system). The year before, we had a deficiency-free survey."

Many factors

Melanie Arnold, a spokeswoman for the IDPH, said state officials take their part of the ranking seriously, but inspections make up only a small portion of the total ranking.

"We look at a lot of different things," she said. "We kind of enforce that (federal) certification in the state of Illinois."

The process includes the annual inspection as well as investigation of any complaints a facility might incur. The inspection includes general quality of care, life-safety issues, and staffing and nursing levels.

Arnold said her office has received several complaints about the new federal ranking system.

"We typically don't hear from the nursing homes," she said, "but some of the lower-ranked ones have complained. As far as we're concerned, we don't ultimately do that ranking. We can't do anything about it."

Nursing homes are required to display survey results for prospective residents and their families and Miller recommends they tour several facilities as well to get a "feel" for them before choosing.

"You just need to get out there, eat the food and join in on some activities before you make your decision," she said. "Usually, they end up right back here."

Subjective system

"We couldn't believe it," Claire Matheny, administrator for North Logan Health Care Center, 801 N. Logan St., said of the one-star rating. "We run a good, clean facility."

Matheny said she could only recall two deficiencies pointed out in the last inspection survey -- one was an individual skin issue and one was an instance of a diabetic patient receiving too large a piece of cake -- but nothing that would lead to such a low ranking for the 108-bed facility.

"Of the last three surveys, two have been exceptional and one was not so great," she said. "It's an extremely subjective system that doesn't reflect the quality of care here. I know a lot of people are getting low scores."

She also suggested visual inspection over Web site ratings.

"Everything's there for the public to see," she said. "Come in and look at the surveys and talk to people. The (rating system) is not going to affect how we care for people. We pride ourselves on that."

'Just a snapshot'

Joan Darr, administrator for Vermilion Manor, 14792 Catlin-Tilton Road, a 237-bed facility, said managers were not happy with the rating and believe past deficiencies carry too much weight -- but they are working to improve their score just the same.

"The problem is, if you made improvements, that's not going to show up on (the ranking system) very quickly," she said. "There's all kinds of things we do to improve, from staff training to purchasing new equipment."

She said several factors lead to difficulties for area nursing homes, including the fact many facilities don't turn away low-income residents.

She said the ranking system is misleading because it doesn't give credit for corrected deficiencies, "picks and chooses" certain criteria to highlight, re-lists prior complaints even if they were unfounded or addressed, and only ranks a predetermined percentage of nursing homes at each "star" level (for example, only 10 percent of "five-star" homes may be ranked in a particular state).

"I don't think it provides a good picture of the home," she said. "It doesn't include every category, so you may be exceptional in one area and it's not even listed. It's just a snapshot and not a very good one."

Starting point

Mark Black, administrator for 83-bed Colonial Manor, 620 Warrington Ave., said while his facility's ranking is deserved, the "five-star" system should only be a starting point for prospective residents.

"It isn't perfect by any stretch of the imagination," he said. "The star rating is just a tool. I wouldn't say the tool in and of itself is what I would use to determine where to admit someone in a nursing home. It's a start."

Black said the longevity of service among his staff is what makes Colonial stand out, though other nursing home administrators in this story mentioned that fact as well.

"I think I've got great people who have been with me for a long time," he said. "We try to give them resources and we try to keep frustration levels down. I'm probably the least most important person here."

He said greater worries loom on the horizon for nursing home operators, including the low levels of federal reimbursement.

"We all have concerns about health care reform and where reimbursement rates are going," he said. "We're all asking, 'What will that mean to us?'"

The administrator for 200-bed Danville Care Center, 1701 N. Bowman, declined requests for an interview.

ON THE WEB

To find national nursing home rankings, go to the U.S. Health and Human Services Web site http://www.cms.hhs.gov. Type 5-star into the search engine at the top of the page, which will lead you to a link entitled, "Five-Star Quality Rating System Certification & Compliance." Click it. At the bottom of this page is a link entitled "Nursing Home Compare," under the heading, "Related Links Inside CMS." This leads to a page with prompts for a ZIP code search.

You can find state inspection survey results for individual Illinois nursing homes at http://www.idph.state.il.us/webapp/LTCApp/ltc.jsp.

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