When you're judging a nursing home, the raw numbers can tell you only so much. Some of the most important factors are harder to quantify. "Two homes with roughly the same staffing and same reimbursement rates can have vastly different track records," says Iris Freeman, founder of Advocacy Strategy, a consulting firm in Minneapolis. "Leadership has something to do with it."
When our reporter visited Greenhurst Nursing Center in Charleston, Ark., she saw what Freeman meant. Greenhurst, which sits on a grassy campus near the Boston Mountains, did not quite make our list of the homes most likely to offer good care. It is one of those homes in the middle of the pack, the kind of place most people shopping for a nursing home would be fortunate to find.
That's clear when a visitor walks through the door. It is almost lunchtime, and staff members are sitting and chatting with residents. One is holding a woman's hand. Another offers a resident a cup of coffee while a colleague places a book in front of a woman who has memory problems. The book reminds her of her favorite color. Kriss Schaffer, who owns Greenhurst with his brother, Fred, asks 91-year-old Mima Dunn if she's a Democrat or Republican and whether she voted for his uncle, former U.S. Senator Dale Bumpers.
All of the women are dressed for the day, wearing jewelry and makeup. The men are clean-shaven. Schaffer doesn't like seeing chin whiskers or nose hairs on men. He doesn't like diapers either. No resident wears them unless the family insists. "It's degrading and promotes lazy care," Schaffer says.
Prominently posted in the kitchen is a list of residents' food allergies and another noting their likes and dislikes--seven don't like Brussels sprouts, two don't like raw tomatoes. The chicken with green beans and mashed potatoes that's served for lunch is as tasty as you'd get in most restaurants.
Greenhurst is an independently owned, for-profit facility, but Schaffer says money doesn't drive the care. Most of the residents are on Medicaid. He says the facility could make more money if it took Medicare patients, since Medicare pays more for the few nursing services it covers, but he sees no reason to do that. "We do comfortably. We don't drive Porsches. I am not a real popular fellow with the industry. The bottom line is making people happy," he says.
Like most nursing homes, Greenhurst has employee turnover, but some key staff members have been there a long time. The director of nursing has worked at Greenhurst for 24 years, the beautician for 10.
One-third of Greenhurst's 97 residents came from other nursing homes. 23-year-old Jordan Smith, for example, became a quadriplegic after a BB gun accident and had been at other facilities before his mother, Connie, put him on a waiting list for Greenhurst. "I liked the way the residents looked," she says. "They've taken him off almost all medication, and he is more alert. They have enough staff to watch him. The CNAs [certified nursing assistants] work together to make it fun."
Once she saw the CNAs jumping on the bed to amuse him. When he turned 21, Schaffer put a drop of beer on Jordan's lips--coming of age in a nursing home. "There's something that works here," Connie Smith says.
