Government website marks 25 Florida nursing homes with abuse, neglect warning icon

The federal government has marked 25 Florida nursing homes with a warning icon for failing to protect residents from being abused, neglected or exploited.

The Nursing Home Compare website, which lists 697 facilities in Florida, marked the nursing homes Wednesday with a symbol showing a bright red circle around an  upraised hand in the "halt" position. It was the first day the new warning system went into effect.

The website is operated by the Center for Medicare and Medicaid Service. Administrator Seema Verma said in an email that the icon was assigned to nursing homes with "severe citations of abuse" and that it would give nursing homes incentive "to compete on quality."

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People in the nursing home business have argued that the icon would cause concern for current residents and their families and deter potential residents from considering a facility that might best suit their needs. And some even suggested that the threat of getting the icon might deter nursing homes from reporting incidents of abuse or neglect.

"To be clear, intentional harm, abuse and poor quality care cannot be tolerated," Katie Smith Sloan, president and CEO of LeadingAge, an association of nonprofit nursing homes and senior care providers, wrote in a guest opinion column for McKnight's Long-Term News. "However, mistakes sometimes are made, whether in nursing homes, in hospitals or other care settings. Yet under the terms of this new initiative, the icon will be identical, even if the problem was not." 

The icon designation will remain for about 12 months after the abuse violation is cited even if the incident was a one-time occurrence or a correction has since been made. Serious abuse or neglect violations will usually involve a death or injury. But less serious violations, if they are repeated, can also lead to the designation if a nursing home is cited two years in a row. And the abuse icon can remain up to 24 months if there are repeated violations.  

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The nursing homes that received the icon Wednesday were cited with a violation in which a patient was harmed between Oct. 1, 2018 and Sept. 30, 2019. They could have also received an icon if they had "potential harm" violations during that time and another between Oct. 1, 2017 and Sept. 30, 2018. 

The site also provides a one-to-five star rating of nursing homes in four categories: health inspection reports, staffing, quality measures and overall quality.

But the star rating is also not without criticism by some in the industry.

Martin Goetz, chief executive of River Garden Senior Services, whose nursing home facility received Medicare's five-star rating in every category, is no fan of the system. 

"I do not believe the government should be in the business of ranking nursing homes and hospitals," Goetz said. "The government should be saying this (facility) meets our standards and is acceptable for licensure." 

Two Southwest Florida nursing homes are designated with the abuse icon. But it's not their only problem. ManorCare Health Services in Fort Myers and Lakeside Pavilion in Naples are rated two-stars, indicating that they are "below average." Both are on Florida's nursing home "watch list" of troubled homes and both received citations in 2018 for not protecting a patient from being abused.

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Lakeside failed to perform CPR on a patient who was in cardiac arrest but didn't have a do-not-resuscitate order.

And an aid at ManorCare continued giving food to a patient who wasn't swallowing. The woman died the next day after developing respiratory problems.

Because the violations were cited in surveys last October, the icon will likely be removed next month if the homes have no similar violations. And within the next few weeks, both homes are slated to be removed from the watch list.

A call to Lakeside was not returned. A spokeswoman for HCR ManorCare, the Toledo-based company of ManorCare nursing home, provided a statement that can be read here. 

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