Quality ratings published Tuesday by the federal government are designed to help ensure better care for nursing home residents across the country.

But the ratings are misleading and don’t give the whole picture, several local nursing home administrators say.

The national survey, published by the Centers for Medicare and Medicaid Services, provides data on all federally recognized nursing homes, including 144 in Oregon. The federal initiative comes in response to increasing concern over instances of abuse and neglect in nursing homes. Assisted living centers, residential care facilities, adult foster homes and other types of long-term care are not included in the survey.

Victor Vander Does, administrator at Pioneer Memorial Hospital in Heppner, said people who are looking for a nursing home for their loved ones might come to the wrong conclusion if they rely only on the ratings information.

“The ratings make us look really good,” he said. “But it’s only a ballpark judgment.”

Hermiston Good Samaritan Center Administrator Lin Cowlinshaw agreed.

“I think the information is inaccurate, and hard for people to really understand,” she said.

The rating information is derived from complaint investigations, inspections and annual surveys performed by state Department of Health representatives who make unannounced visits to nursing homes and gather information on everything from recordkeeping practices and staff background checks to the cleanliness of the facility and residents’ health. The survey’s measurements of quality were developed with input from nursing home industry leaders.

While four local nursing homes were included in the survey, information on Good Samaritan and Pioneer was incomplete. In the case of Pioneer, the facility was too small to be compared with larger ones because, for example, a problem with one resident could skew the numbers in a way that would make a problem seem bigger than it really is, Vander Does said. At Good Samaritan, information was collected in a way inconsistent with the ratings methodology, so it was left out, Cowlinshaw said.

The “quality measures” category looks at how well nursing homes are caring for their residents’ physical and clinical needs and provides data such as the percentage of residents with bed sores, the percentage of residents who are physically restrained, and the percentage of residents who have experienced severe or moderate pain during the past seven days.

The information gathered in the surveys helps nursing home facilities identify and fix problems, Cowlinshaw said.

“In this last survey, we really learned a lot,” she said. “We really want to know if there are problems we need to address.”

Good Samaritan earned a poor rating in one category due to several incidents in which residents suffering from dementia were able to slip out of the facility unnoticed, despite the use of ankle bands that trigger a lock and a buzzing alarm on the main doors when residents attempt to leave. In one case Cowlinshaw described as “poorly handled,” more than an hour went by before staff noticed a female resident was missing. The woman left through a kitchen door that didn’t have the locking feature, Cowlinshaw said.

“She was such a wanderer here, they didn’t notice she was gone,” she said.

Since the incidents, security has been improved and the lock and alarm system has been installed on all doors at the facility, she said.

While the ratings do provide useful information on nursing homes, the best way to evaluate a facility’s quality is to visit.

“You need to do the ‘smell test,'” Vander Does said. “You have to visit us, talk to residents, look around.”

Cowlinshaw said location and convenience is still the main factor families consider when choosing a nursing home.

“We’re the only game in town,” she said. “If people in Hermiston need nursing home care, it’s either here or quite a ways away, like in the Tri-Cities.”

Vander Does said that’s true of Pioneer in Heppner, too.

“It’s location, location, location,” he said. “People often don’t do much to check a place out. But if you’re putting a loved one into a nursing home, you need to look at everything to make a decision.”