Not By The Numbers

From Bodies
To Minds

Medicare report tells only a partial story about care at Danto, says administrator.

Loewenstein of Gleaners
is joining Cranbrook.

HARRY KIRS BAUM
Staff Writer

T

he public release of nursing
home information on the
Medicare Web page has
focused attention on the
Marvin and Betty Danto Family
Health Care Center in West
Bloomfield.
The report states that 33 percent of
Danto's 96 residents suffer from infec-
tions, one of the highest rates in metro-
politan Detroit. The Medicare Web site is
vvwvv.medicate.gov/NHCompare/Home.asp
The report, which lists 10 "quality
measures" to rank more than 17,000
nursing facilities nationwide, does not
take certain facts into consideration, said
Anthony Abela, Danto administrator.
The tabulation, taken from the
Minimum Data Set (MDS), a
required nine-page assessment form
taken for each new patient within 14
days • of arrival, might be correct, but it
isn't reflective of the care provided by
Danto, Abela said. "It's not saying that
33 percent of our residents acquired
infections here. On the contrary, it's
probably 90 percent were admitted
with infections."
Most Danto residents are admitted
directly from the hospital for short-
term rehabilitative stays, Abela said.
Danto admits about 75 new patients a
month and about 95 percent go back
home or into assisted living facilities.
a nursing facility that
"If we
mostly provided long-term care to res-
idents and did very few admissions a
month, those percentages would be
very low," he said. "We have a lot of
people in the community who benefit
from rehabilitation and that's what
we've worked to focus on. "
The Danto nursing staff enters
patient information into a computer
system that the Center for Medicare-
Medicaid Services in the State of
Michigan and the Michigan
Department of Consumer and
Industry Services are able to access.
"What we look at in the community
is the center-acquired infections,
which most of the time are colds or
upper respiratory infections or urinary
tract infections," said Sharon
Dulmage, director of nursing at
7 17. Danto. "We do a lot of intravenous •

11/29
2002

18

SHARON LUCKERMAN
Sheryl Madson-Campbell, the new
administrator of Menorah House in
StqffWriter
Southfield, said she feels the same way.
bout to embark on a new
"[The ranking] is very confusing to
challenge, Richard
people," said Madson-Campbell. The
Loewenstein, 42, of West
Medicare report states that 19 percent
Bloomfield is leaving a rich
of the facility's 178 residents suffer
legacy behind at Gleaners Community
from infections.
Food Bank in Detroit, where he was
Menorah House averages about 40
president for the past five years.
short-term patients, does a lot of
Effective Sunday, Dec. 1, he begins
intravenous therapy and has a wound
his new job as chief advancement officer
physician on staff, which allows the
for Cranbrook Educational Community
nursing home to admit patients with
in Bloomfield Hills. Loewenstein says
"skin breakdown" and other infec-
tions. Those infections skew results on he will be responsible for leading a team
effort to raise $300 million over the
the Medicare ranking, she said.
next seven years for Cranbrook. Its
"They need to have a little para-
institutions include three independent,
graph that explains in some facilities
college-preparatory schools, grades pre-
one should anticipate to see higher
K-12; institute of science; academy of
rates of these problems," she said.
art; and art museum.
"There is always room for improve-
Loewenstein, a
ment, but those statistics really don't
Cranbrook Schools grad-
reflect accurately what's going on."
uate, is chairman of its
Carol Rosenberg, associate director
of Jewish Home and Aging Services in alumni association and a
bciard member.
West Bloomfield, said the agency
"We distributed 14 .
maintains a close relationship with
Loewenstein
million pounds of food
Abela and Madson-Campbell.
when I started at Gleaners," he said,
"We are the community liaison, and
looking back over his time there.
we provide religious, cultural and spir-
"Now we're up to 25 million. We've
itual support for Jewish older adult
provided
65,000 meals a day to metro
care for these two facilities," she said.
Detroit
hungry
people."
JHAS, a Jewish Federation of
He said what he would miss most at
Metropolitan Detroit agency, under-
the food bank are the people -- 40
stands the nature of the residents in
employees and up to 7,000 volunteers.
both nursing homes.
At first, Loewenstein said, his new chal-
"They're in the highest percentage
lenge
seemed like traversing two differ-
of frail elderly and usually those peo-
ent worlds, but now he sees similarities.
ple are very ill," Rosenberg said. "In
"I'm going from nourishing bodies
my experience, Danto has outstanding
to nourishing minds," he said. "And
rehabilitation services, and their sur-
vey history has only gotten better each when you look at a person holistically,
as a whole, you need both to make a
year." ❑
Whole person."
Another similarity, he says, is that
he'll be working to educate the public
and fight stereotypes. At Gleaners, he
learned that 51 percent of the hungry
Residents
Residents
Residents
are children and over 40 percent are
With
With Pressure In Physical
working
people. From Cranbrook, he
Infections
Restraints
Sores
knows that tuition doesn't cover the
n/a
10%
8%
cost of educating a child there.
"It's not necessarily a rich person's
15%
7%
8%
institute, but a valuable gem that
needs community support," he said.
2%
33%
16%
Loewenstein and his family, which
9%
includes three children, are members
19%
0%
of Temple Beth El in Bloomfield
Township. ❑

antibiotics here, and [those infections
are] coming from hospitals."
Infection control reports that separate
whether a patient had a center-acquired
infections or whether they were admit-
ted on antibiotics are required by
Medicare, but that distinction is left
out of the Web ranking, she said.
When new information is posted
like this, Dulmage said the question
shouldn't be, "Do we want that
patient if they're going to skew the
numbers?
"Our first question is, 'Can we meet
the needs of the patient?"' she said.
"We do IV antibiotics. If the patient
needs it for six weeks, we do it."
Abela cites the three deficiencies —
two minor deficiencies and one
regarding the comfort of a resident —
for Danto in the 2002 Medicare annu-
al survey taken in August as "the best
it's been since the building opened
seven years ago.
"We've gone from gone from 19
deficiencies three years ago to seven
last year to three," he said. "The infec-
tion percentage is really not a true
indicator of the patient population."
Vicki Boyle, project manager,
Michigan Peer Review organization, a
Medicare contractor that has been try-
ing to help nursing homes improve
quality, said the Minimum Data Set
groups so many infections together
that it makes it a tough area to gauge.
"We know there are facilities that
are doing a much better job than oth-
ers or that there are variations," she
said. "But just because [Danto]
appears to have a high rate in this one
area doesn't mean [Danto's] not capa-
ble or able to provide good care."

Residents

U.S. Average

88.2

Michigan Average

96.1

Danto

96

178

Menorah House

•

.

•

. .

A

.

XAMINAMOIMINVAMMVS ME AMIMMIME

Source: Medicare Web sire