A nursing home’s ‘secret’ to making list of ‘Best Nursing Homes’

U.S. News & World Report yesterday released its annual Best Nursing Home Ratings. Top ranked facilities are based on the Centers for Medicare & Medicaid Services’ Five-Star Quality Rating System.

Say what you will about what critics consider a flawed survey system, those SNFs that made the “Honor Roll” are doing something right. Out of 15,000 nursing homes reviewed by U.S. News, only 39 were recognized for receiving four straight quarters of perfect five-star ratings from CMS in the areas of health inspections, nurse staffing and quality of care.

I spoke yesterday with the CEO/administrator of one of the honorees, Sister Jacquelyn McCarthy, CSJ, of Bethany Health Care Center, Framingham, Mass. Bethany is a 101-bed non-profit operated by the Sisters of St. Joseph of Boston. I asked McCarthy about the honor and how her community has managed to attain the achievement not once—but three times.

It’s all about the staff, she insists. “They deserve the accolades. First off, we have ongoing staff development, adequate staffing and we make it a priority,” McCarthy says. “We do the same thing every single day to the best of our ability. Our philosophy is if you do your best every day, you will be successful. I think that has been the secret to our success.

“We do have high standards, but we also have longevity among our staff,” McCarthy says. “We have people here as long as 30 years [including McCarthy]. When people feel they’re treated fairly and that they’re known and they’re called by name—and not just another face in the building—then they feel valued, and no matter what they’re asked to do they’ll do it because they know they’re appreciated.”

Regularly recognizing staff for the great work they do is a priority at Bethany. “It’s a pretty simple formula,” McCarthy says. “Longevity with employees is a key to quality resident care. There’s a bond between residents and staff that develops.”

McCarthy and her team face the same challenges other LTC operators face, number one on her list being reimbursement. She’s also gearing up for ACOs (accountable care organizations). “We’re working closely with our local hospital. We have a zero percent rehospitalization rate,” she notes proudly. “We attribute that to having a physician who comes every day and visits those who need to be seen. Because of that we’re really ahead of the curve because he takes care of things as they happen so we don’t have to send people back to the hospital.”

It’s only recently, McCarthy notes, that this model has received more attention in the LTC industry. “The funny thing is we’ve done this for 27 years and I’ve talked about this model of care since 1999, but nobody wanted to listen,” McCarthy says. And she suggests the added cost of physician services is offset by the benefits of low readmission rates.

As for the ratings process itself, “It’s based on very objective criteria so it’s hard to dispute,” McCarthy says. “Either you get a good survey or you don’t. Either you have enough staff or you don’t. Some surveyors are pickier than others but you don’t have the same surveyor every year—at least I don’t.

“I’m just so pleased that my staff is wonderful and that they work hard and really care," McCarthy says. "[The U.S. News ranking] gives everyone a good feeling about what they do here every day.”

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