New York State oversight of nursing homes clearly needs an overhaul if the ongoing saga of Medford MultiCare Center for Living is any indication of how the system works.
Imagine families, looking for a place for mom, dad or another family member, coming upon the home's four-out-of-five-star state ranking in health inspections and quality of care last year.
That ought to have provided significant guidance -- and perhaps even some degree of comfort -- during an incredibly stressful time.
But then families learn about a state attorney general's lawsuit alleging a decade -- a decade! -- of patient mistreatment or neglect.
Among the AG's allegations, which a lawyer for the home disputes, is that the 320-bed, for-profit facility cut resident food allowances. And that workers were told to change adult diapers not more than once every eight hours.
The most disturbing allegation -- that a 72-year-old woman died because she was not attached to a ventilator machine -- led the attorney general's office to file criminal charges against nine facility employees.
A Newsday report on Sunday included the Department of Health -- which answered only via email rather than put an official on the telephone -- defending the state's rating.
But a deeper look into the Newsday story demonstrates why that assertion shouldn't be enough for consumers -- especially families looking to New York State for guidance in choosing a nursing home.
New York State, for example, issues fewer deficiency findings after inspecting nursing homes than other states.
And on Long Island, according to a 2006 study using 2004 statistics, the state determined that 23 percent of local nursing homes had no deficiencies at all.
The local data, even at a decade old, remain disturbing -- especially for a region with a skyrocketing population of elderly residents.
But the state, which feeds nursing home data into a federal website for consumers, relies on more than site inspections.
It also looks for information on how much staff each nursing home employs; and on quality-of-care measures, from how many falls patients had to numbers of bed sores.
But there's a problem.
New York, like other states, relies on nursing homes themselves to compile those reports -- and their information is not audited.
Charlene Harrington, a professor of nursing at the University of California, San Francisco, and author of several studies on nursing homes, put the problem simply.
"The rating system is based on three things: First, deficiencies: If those aren't issued properly, then you can't rely on that. Second, staffing: Nursing homes can gin up those numbers when they suspect surveyors are coming. Third, they can falsify quality measures."
A part of the Affordable Care Act was supposed to fix some of that by requiring nursing homes to provide payroll and other verifiable records -- but there's no funding to put it in place.
So, what are families -- who often feel boxed in by finances, or the need for, say, specific items like ventilator beds -- supposed to do?
Having some information on nursing homes is better than having no information at all.
But unless the gap between state rankings and reality can better be bridged, it can't be enough.