Residents get a voice in inspection of state’s 956 nursing homes



During an Ohio Health Department inspection of a nursing home on the North Side of Youngstown, a resident placed her hand on an inspector’s arm and began to cry.

“Help me find her,” she said.

This incident led to one of the nine code citations found during that Aug. 5 visit to Campus Health Care Center, 196 Colonial Drive. These ranged from employing staff under investigation of abuse to failing to get counseling for the woman who couldn’t find her sister, and who had been moved to another facility by her family. Ultimately, a licensed social worker determined that the facility didn’t offer appropriate counseling because “she fell through the cracks.”

Greg Roof, administrator at Campus Health, did not return phone calls for a response.

The nursing home did respond to the state, pledging to correct all problems, however. These responses are not published online alongside the citations — a fact that has at least one area nursing-home official questioning the fairness of this practice.

As chief of the Bureau of Long-term Care for the health department, it is Dustin Ellinger’s job to make sure the voices of nursing home residents are heard by his staff during inspections.

His staff of roughly 130 surveyors travels to nursing homes each week to conduct surprise inspections. It takes a team of three or four surveyors a week to complete one site inspection. There are 956 nursing homes in the state and 78,221 residents.

“Before hiring, we inform them that they will be working long hours, traveling often, staying overnight, and working at a fast pace,” Ellinger said.

Each surveyor, who must be a registered nurse, must undergo a rigorous one-year testing and training process. Salaries range from $52,000 to $72,000 a year.

Surveyors gather data by interviewing nursing-home residents and jotting answers on tablet computers. Every aspect of resident care and the facility environment is scrutinized under a rigidly developed set of standards.

Theresa Sebastiano, director of nursing at Maplecrest Care Center in Struthers, said people can find the state inspection reports online at various websites, including, but that they cannot find the home’s responses and plans of correction there.

“That doesn’t seem fair,” she said.

The inspection reports are part of what officials, including Ellinger, say people should examine before placing a loved one in a home.

“It’s not a decision to be made lightly,” Ellinger said.

A spokesman for the Ohio Department of Health said responses from the nursing homes are not posted online because they don’t exist electronically — yet.

That was expected to change in November, when a new Web-based system will replace the paper-based system now in use, said Tess Pollock, a representative for the health department.

“This will allow nursing homes to submit their plans of correction electronically,” she said. “All the information will then be available in the same place.”

Though inspectors follow a “prescriptive” set of guidelines, no voice is louder than that of the residents.

“We are really focused on talking with the residents,” Ellinger said, noting that interviews will often center on a particular issue. “If even one resident says, ‘The staff treats me badly,’ we’re going to focus on abuse.”

Also, the facilities are graded on a scale from A to L, with L having the most-severe issues. Inspectors also conduct complaint surveys and follow-up surveys. Complaint surveys are similar to annual surveys, except they focus more attention on specific complaints, such as pressure sores.

If a complaint or annual survey results in a grade of a D or below, or if a situation is labeled as “immediate jeopardy,” then a follow-up survey is scheduled within 30 days of the initial visit. The surveyors must document the facility’s progress since the last visit. If there is no change, then the facility faces losing funding and Medicare programs.

Though all surveys are unannounced, Ellinger said inspections can and should be expected.

“If we haven’t been there in 13 or 14 months, they know that we’re required to come every 15 months. People might say they can expect us,” Ellinger said.

To avoid a predictable visit, Ellinger staggers nursing home surveys by alternating the time or date of the visit. Arriving to a nursing home at 5 a.m., 7 p.m. or even on the weekends allows for a more-accurate assessment of the home. is a collaborative effort among the Youngstown State University journalism program, Kent State University, University of Akron and professional media outlets including The Vindicator, The Beacon Journal and Rubber City Radio, both of Akron.

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