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Annual inspections restart at nursing homes after 2020 pause

Free Press - 5/16/2021

May 16—MANKATO — Recertification inspections are gradually restarting at nursing homes in south-central Minnesota after a pause in 2020 amid more focus on infection control.

A CNHI investigation found about 58% of Minnesota nursing homes didn't have their usual annual inspections in the 18 months leading up to March 2021. Instead, regulators prioritized infection control reviews in response to the COVID-19 pandemic — about 60% of Minnesota's COVID-19 deaths occurred in residents in long-term care or assisted living facilities.

The annual multi-day inspections started back up this year, with some area nursing homes already completing theirs and others anticipating them in the coming months.

"Depending on the state and their schedule, it wouldn't surprise me to see somebody in the next two to three months," said Tom Goeritz, administrator at St. John Lutheran Home in Springfield.

Staff at nursing homes don't know in advance when surveys will take place. Once surveyors arrive, it can be three days of intense work looking at a host of different quality and staffing measures.

Some nursing homes in the region, including Oak Terrace in Gaylord and facilities operated by Monarch Healthcare Management, already had inspections resume. Drew Hood, the administrator for Oak Terrace Senior Living Communities, said the Gaylord facility recently completed its in-person survey.

"Surveys are up and running again, and we welcome a collaborative approach to protect residents," he said.

States and the federal government use the surveys to determine whether nursing homes are measuring up to rules. Based on previous inspections, no nursing homes in Mankato or the surrounding region were deemed to have a history of serious quality issues in CNHI's investigation.

Hood noted nursing homes in the region, and Minnesota overall, perform well overall in quality metrics. Minnesota has placed in the top 10 or 20 among states for nursing home care in rankings over the years.

"We want to do a good job and we want people to point out what we can do better," Hood said.

The federal Centers for Medicare & Medicaid Services uses a five-star rating system for nursing homes, based on measures ranging from inspections to staffing to quality measures.

A five-star rating is considered "much above average," while a one-star rating is "much below average." No nursing homes have one-star ratings within a 25-mile radius of Mankato, while seven of the 11 facilities have either four- or five-star ratings, according to Medicare.gov.

Oak Terrace in Gaylord and St. John Lutheran Home in Springfield aren't within a 25-mile radius of Mankato. Both, though, had five-star ratings.

Five-star facilities in or near Mankato include Pathstone Living in Mankato, Whispering Creek in Janesville, Mapleton Community Home in Mapleton, Living Meadows at Luther in Madelia, and Lakeshore Inn Nursing Home in Waseca.

Apart from the surprise inspections normally done on an annual basis, complaints filed against nursing homes also prompt investigations. At least for the annual surveys for recertifications, usually three or more inspectors visit the nursing home as a team.

They tour the facility, meet with staff and administrators, observe meal and medication services, and interview residents and their families. The results then impact whether nursing homes are licensed to operate in the state.

Nursing homes receive notices if the surveyors determine changes are needed to meet either state or federal regulations. In Minnesota, the health department sets a period of time for nursing homes to develop plans and then correct deficiencies.

The timing depends on how severe the deficiencies are. If the deficiency caused actual and serious harm, for example, it would have to be quickly corrected.

Deficiencies with the potential to cause actual harm, or deficiencies with the potential to only produce minimal harm, would have longer timelines for correction. One example of a deficiency during the pandemic would be residents sitting too close together during a meal.

Fines, legal action or closures can happen if nursing homes fail to correct violations. In the vast majority of cases, facilities make the corrections needed to avoid closures.

Follow Brian Arola @BrianArola

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