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Re-Inventing the “County” Home

Re-Inventing the “County” Home
If you were starting to look for skilled nursing care for a loved one, would Claremont, the facility owned by Cumberland County, be near the top of your list? A common misperception is that “county” homes are only for low income folks or those that private facilities refuse to admit for whatever reason. In recent years, some counties are questioning whether or not owning a nursing home should be a function of government and are choosing to sell their facilities to private enterprises. Claremont Nursing and Rehabilitation Center would like to challenge these ideas.

Let’s start by discussing care. Claremont was recently awarded a five star rating by the Centers for Medicare & Medicaid Services (CMS). What does this rating mean? CMS initiated a star rating system of health care providers about five years ago to help provide information to consumers who are shopping for health care services. A provider can receive between one (much below average) and five (much above average) stars in the areas of overall functioning, health inspections, staffing, and quality measures. Health inspections by CMS are usually conducted annually and can be done more frequently if complaints are received or if previous inspections indicated poor performance. The surveys are unannounced and the size and professional make-up of the survey team varies based on the size and type of provider being surveyed. Staffing and quality measures ratings are based on self- reported data that facilities submit to CMS, but CMS does evaluate the accuracy of this data during their inspections. Staffing is self-explanatory and the quality measures rating is based on information about various physical and clinical aspects of resident care such as the use of restraints, presence of pressure ulcers and urinary tract infections, frequency of falls, and use of anti-psychotic drugs. The overall rating status is a combination of the ratings for health inspections, staffing, and quality measures. Ratings for local nursing facilities can be found at under Forms, Help, and Resources; then Find Doctors, Hospitals, and Facilities.

Claremont has been working diligently to achieve this five star rating and deserves congratulations for the positive changes that have succeeded in helping them improve from a two star rating several years ago. Karen DeWoody, administrator of Claremont, stated that “it’s a measure of success in today’s long term care industry, but people should look deeper than just what is printed.” She encourages families looking for quality care to view the rating system only as a starting point. Visiting a facility and speaking with staff and current residents can provide valuable insights into whether or not a particular facility is the right choice for an individual. Ms. DeWoody also cautioned that Claremont’s five star rating “does not mean that you are moving to the Ritz Carlton.” While Claremont provides excellent care in a clean and safe environment, the facility is an older building that does not have the updates and fancy décor that might be found in a privately owned nursing home. Claremont has chosen to invest their finite resources in maintaining above average staffing levels and retaining their quality staff members long term.

A discussion about Claremont as a county home would not be complete without discussing finances. Smaller, privately owned nursing facilities can pick and choose their residents to some extent and thus have greater control over their income and expenses. Claremont takes seriously its role as a provider of health care for those individuals with limited resources and extensive health care needs, resulting in 80% of its residents receiving medical assistance. This number may lead Cumberland County taxpayers to be concerned about how the facility can remain solvent. An important fact for taxpayers to be aware of is that CLAREMONT does NOT PRESENTLY RECEIVE A SUBSIDY FROM THE COUNTY. During a time in history when Medicare and Medicaid reimbursements were more attuned to the level of care being provided, the county set aside funds that were collected above the operating costs into a special account for use only towards Claremont’s needs. More recently, federal funding has become more static. Meeting the budget has become more difficult and cost-saving measures aren’t always enough. County officials have been able to responsibly utilize this account to maintain a high quality of service at Claremont without placing an additional burden on taxpayers. This investment in quality care not only assists our elderly citizens who are most vulnerable, but also allows Claremont to attract residents and provide services which will lead to improved financial reimbursement. Claremont will soon be utilizing this special account to begin renovations to an underutilized area of the facility, with a goal of opening a 39 bed short term rehabilitation unit.

The Social Security Act requires that a set of minimum health and safety standards be met by providers who participate in Medicare and Medicaid programs. Claremont will soon be holding a celebration for all of the staff members who, on a daily basis, continue to ensure that care at Claremont far exceeds these minimum standards. The administration is aware that it will be easy to slip from this five star status, and plans to continue to focus on staff education, retention, and recruitment, as well as to follow a strategic plan based on industry standards and evolving health care trends. Claremont is no longer “just the county home.” It is a valuable community resource that is meeting a growing need for quality health care. Stop by and see for yourself.

Karen Kaslow, RN
Elder Care Coordinator