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Six of Guilford County’s 24 nursing homes received the lowest rating, “much below average,” in the federal government’s new five-star rating system for these homes.

Statewide, more than a quarter of 419 homes received the lowest rating, one star, and 16 percent rated below average, receiving two stars.

The system assigns ratings of one to five stars based on three major groups of criteria: health inspection results, staffing and quality measures.

One of the six lowest-rated Guilford County homes was Guilford Health Care Center. But administrator Ashley Sculley pointed out that some of the data are more than a year old.

For example, she said, nursing staffing, for which the home lost points, is now above the state average for registered nurses and at the state average for certified nursing assistants.

In its most recent state inspection, Oct. 2, the home received no deficiencies, an unusually high score.

Greensboro’s Evergreens Senior Healthcare System also received one star. Executive Director Fred Soule said the center lost points because evaluators thought the center was improperly restraining a patient. He said the center now handles such patients differently.

He also said that because his center is operated for Guilford County, “we tend to take those folks that may be more difficult to place and therefore a little more difficult to take care of.”

Some of the patients have multiple disabilities, which is not the case in all nursing homes.

Guilford’s other Evergreens nursing home, in High Point, has fewer patients with such complex needs, Soule said. It scored four stars out of five.

Another Guilford nursing home with one star, Heartland Living and Rehabilitation, is operated by Century Care Management, whose president, Bob Gilliam, said the rating is misleading.

“We are disturbed … by the one-star rating,” he said. “That’s because we had our latest annual survey on Aug. 20, 2008, and we were deficiency-free.”

Most centers are rated based on information collected in late 2007 or early 2008, though the timing varies from center to center.
The system rates the homes on a number of criteria under each of the three major headings.

For example, under “quality measures,” the site lists 14 criteria, such as percentage of long-term patients who developed bladder infections.

The site includes links to explanations of the criteria.

The Centers for Medicare and Medicaid Services encourage comparisons between homes in the same state only, because of variations from state to state in how inspections are carried out.

Medicare cautions that the ratings are only a starting point for choosing a nursing home. It encourages people to visit homes and talk with staff when choosing a home.

Medicare also rates hospitals on a one- to five-star scale.

The Associated Press contributed to this report.