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Patrick Springer, Published December 20 2008

Bethany Homes earns 1 out of 5 stars in new nursing home rating system

Bethany Homes of Fargo received one star in a new five-star quality rating system the federal government developed as a consumer guide.

The rating system, released this week, is the latest in an evolving effort by the Centers for Medicare & Medicaid Services to provide information to the public to evaluate health providers.

Grant Richardson, director of development at Bethany Homes in Fargo, said the rating system doesn’t adequately account for the complexity of health care.

“I don’t think it’s an accurate reflection of the quality of care we deliver,” he said. Bethany Homes has a 70-year history of providing good care, and many of its residents come after consulting friends, doctors or social workers, Richardson added.

“We have people that are waiting to get into Bethany,” he said, and its 192 nursing beds are usually full. That wouldn’t be the case, Richardson said, if people didn’t have confidence in the care provided.

Jon Riewer, president of Eventide Lutheran Home, had similar criticisms of the limitations of the government’s new rating system, although his nursing home scored four stars, or above average, in its overall rating.

“Even though I probably should be out there tooting our horn and saying this is great, I don’t think that’s the case,” he said.

The five-star rating system, partly based on health inspection surveys, oversimplifies the care residents receive and relies too much on subjective measures that vary not only between states but among evaluators, Riewer said.

That complaint was common among nursing home administrators in Fargo-Moorhead contacted about the new Medicare rating system. The nursing homes were not given an opportunity to challenge the ratings.

Federal officials say the new measures give health consumers “unprecedented” quality comparison information for the nation’s 15,800 nursing homes that participate in Medicare or Medicaid.

“Our goal in developing this unprecedented quality rating system is to provide families a straightforward assessment of nursing home quality, with meaningful distinctions between high- and low-performing homes,” said Kerry Weems, acting administrator for the Center for Medicare & Medicaid Services.

Nationally, about 12 percent of nursing homes received a top score of five stars, while

22 percent ranked at the low end with one star. The results are posted online at the government’s Nursing Home Compare Web site, www.


Eventide, which has facilities in Moorhead and West Fargo, deals with inspectors from Minnesota and North Dakota who have different inspection programs, Riewer said.

He and other local nursing home administrators said the government’s quality guide is just one factor residents and families should consult in deciding where to place loved ones.

More meaningful measures, Riewer said, come from actually visiting a home, talking to staff and family members of residents, as well as consulting health providers and social workers.

Manor Care Health Services in Fargo, which is a rehabilitation center and not a traditional nursing home, was given an overall score of one star.

“We’re in the process of reviewing the data,” said Tony Keelin, administrator at Manor Care.

A spokeswoman for KCR ManorCare, the Fargo center’s owner, said the quality indicators are more suited to conventional nursing homes than rehabilitation centers.

“The system does not recognize that providers such as HCR ManorCare, that provide a very high level of comprehensive medical and intensive rehabilitation, should be rated on different criteria than centers who provide a less complex level of care or who operate more as residential caretakers,” said Julie Beckert, the company’s assistant vice president for marketing.

Federal health care officials agree that the new quality rating system is just one measure to use in evaluating nursing homes. Also, results are a “snapshot” that can change. Ratings will be updated monthly.

Readers can reach Forum reporter Patrick Springer at (701) 241-5522