Nursing homes with
unblemished records are rare
Gannett News Service
ROCKVILLE, Md. — Spring has delivered a perfect day to the
National Lutheran Home.
Big clumps of white azaleas and delicate pink dogwoods decorate
the landscape like cotton candy. An elderly man wearing a tidy straw
hat and leaning on a sturdy cane makes his way through the front
doors of the nursing home.
Inside, the comfortable lobby is a crossroads of activity.
A receptionist answers the phones and makes periodic announcements
on the public address system. A visitor with an armful of flowers
encounters an old friend, and the two hug. A petite woman with white
hair dozes softly in an upholstered chair. A bag of lemon drops
sits opened in the little cloth carrying case hanging from her walker.
Two women, probably in their 80s, guide their electric scooters
past the open chapel doors on their way to an exercise class.
“Good morning ladies,” says a man whose voice rings
strong and deep. “It looks like you have quite a parade going.”
The women chuckle and glide off toward the activity room.
The voice belongs to the Rev. Richard Reichard, executive director
of the National Lutheran Home. Reichard is an unusual man.
He is as comfortable in a pulpit speaking about the Gospel of Matthew
as he is behind his broad desk fretting over the minutiae of state
and federal nursing home regulations.
The nursing home he directs is even more unusual.
The 300-bed center, located on a quiet two-lane road not far from
one of the region’s busiest superhighways, is among a fraction
of nursing homes nationwide that has not been cited for a single
violation of government patient care standards in the last four
In an industry still struggling to overcome a reputation for abuse
and neglect, the National Lutheran Home is an oasis.
The key is staff, said Reichard, 65, a tall man who speaks with
a powerful preacher’s baritone.
“This is serious stuff,” he said. “Our board of
trustees is tuned to the times and knows that excellent and well-trained
people don’t come cheaply.”
Of 16,437 Medicare and Medicaid certified nursing homes nationwide,
just 314 — fewer than 2 percent — have been violation
free for the last four years, according to a Gannett News Service
analysis of federal inspection and complaint investigation reports.
To participate in the Medicare and Medicaid programs, nursing homes
must submit to periodic surveys about every 12 months. They also
must open their doors and records to investigators whenever a patient
or family lodges a complaint with the state-run survey and certification
Inspectors can cite hundreds of so-called deficiencies, ranging
from making sure that residents have enough food and proper vitamins
to performing criminal background checks on staff.
Examples of more severe deficiencies include nursing home-wide patterns
that fail to protect residents from mistreatment, abuse or neglect.
Among the most common: failing to protect residents from accidents
and properly treat pressure sores.
Each year, the number of violation-free nursing homes has ranged
from 19 percent in 1998 to 14 percent in 2001, according to a study
from the University of California at San Francisco.
The men and women who live at the National Lutheran Home appear
content with their surroundings and the level of care.
Howard Lynch, 82 and his wife, Catherine, 78, live in one of the
small independent-living cottages that surround the three-story
nursing home. They know that when their health deteriorates to the
point they need assistance, they have a good place to go.
“When you get older you have to plan for the future,”
said Lynch, a former salesman for a trucking company. “This
is without a doubt the best move we ever made.”
Lynch’s mother-in-law spent her last years in the home. His
brother-in-law and sister-in-law are also residents there.
“Our neighbor’s husband was in the nursing home, and
the care he got was just tremendous,” Lynch said. “The
patients really come first here. There is nothing that gets shortchanged,
and the staff is really interested and caring.”
The National Lutheran Home has been without problems for four years
because it can afford to offer its employees better wages, benefits
and working conditions than other nursing homes, Reichard said.
“We’re part of a church, and the church cares. And we’re
nonprofit, and people send us money and leave us bequests,”
Federal records show that National Lutheran Home provides its residents
with 3.03 nursing staff hours per resident per day, slightly below
the national average of 3.9 hours a day.
Since 1995, the annual retention rate for the 185-member nursing
staff has hovered around 90 percent, said Norma Spinella, the director
“People come here, and they want to work here, and they stay
for years,” said Spinella, now in her 22nd year at the nursing
home founded more than a century ago at a church member’s
farm in Washington.
National Lutheran’s retention rate contrasts with many other
nursing homes, which have suffered because of chronically low wages.
Yet the nursing home’s perfect record soon will have a blemish.
Reichard said it recently concluded a dispute with the son of a
former patient who complained to Maryland’s nursing home survey
agency about the treatment his mother received.
The agency, the Maryland Office of Healthcare Quality, cited National
Lutheran for failing to follow up on results of a skin cancer test.
The low-level deficiency is not yet visible to the public on the
federal government’s Nursing Home Compare Web site because
the information has not been updated yet.
“We have loved our unblemished record,” Reichard said.
“We’re exposed to probably 100,000 potential events
or incidents a year here. In the arena in which we function every
day, one deficiency is pretty good. We can live with that.”
(Contributing: Robert Benincasa, GNS)
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