Transitional Care at Good Samaritan

5601 LOCH RAVEN BOULEVARD
BALTIMORE, MD 21239
(443) 444-4070

• Located in Baltimore City, Maryland
• Nonprofit Corporation
• Certified Beds: 30
• Last Medicare Rating: 5 Stars

Transitional Care at Good Samaritan in practice is a unit of MedStar Good Samaritan Hospital in Baltimore. This unit provides transitional care (also known as sub-acute or extended care) for post-surgery patients, cardiology and respiratory care, wound care, stroke recovery, and physical and occupational therapies. Its total of only 30 certified beds makes it one of the smallest nursing facilities in Baltimore.

It is very unusual in our experience to come across a nursing facility that gets an overall 5-star rating from Medicare - along with a 2-star rating for quality measures, which are numerical measures of the types and amounts of care residents receive. Yet that is the case with Transitional Care at Good Samaritan - rated very highly in general, but below average on one critical metric. It's an odd contradiction.

Before we dig deeper into this paradox, let's look at some of the competitors in the area.

Transitional Care is really an extension of the hospital, so it does not have competitors in the same way that other nursing homes do. But almost every patient has options for short-term nursing care. Here are some of nursing homes in the area.

• GSNH Operator, LLC: Probably better known now as FutureCare at Good Samaritan, this Baltimore facility gets lower scores than its rival Good Samaritan in all four main Medicare rating categories. To add to the confusion of their similar names, these two facilities are close to being next-door neighbors.
• FutureCare Cold Spring: Another FutureCare facility located close to Transitional Care in Baltimore, FutureCare Cold Spring earned very odd Medicare ratings: terrific 5-star ratings for staffing and quality measures (where it equaled or exceeded Transitional Care) and a lowly 2-star rating overall (versus Transitional Care's five stars).
• Long Green Center: Here is a Baltimore facility that competes with almost nobody - certainly not Transitional Care at Good Samaritan. Long Green gets dismal 1-star ratings in three of four main Medicare categories (while Transitional gets 4 or 5 stars).
• Homewood Center: Homewood Center gets slightly better Medicare scores than Long Green Center, but this Baltimore facility still does not come even close to Transitional Care's overall 5-star rating.
• Holly Hill Nursing and Rehabilitation Center: This Baltimore facility's Medicare scores are lower than those of Transitional Care in three categories, equal in one. Its overall 2-star rating can't compete with Transitional Care's five stars.

Listed by Medicare as joint owners of Transitional Care are the Good Samaritan Hospital of Maryland (since 1996) and MedStar Health (since 1998). MedStar Health owns Good Samaritan Hospital.

MedStar Health describes itself as "the largest healthcare provider in Maryland and the Washington D.C. region," with ten hospitals, a variety of other health organizations, and some 6,000 affiliated physicians.

MedStar describes its Good Samaritan Hospital as a 246-bed adult care community teaching hospital providing primary care, intensive care, surgery, and other services. MedStar notes that this hospital has the advantage of being part of a larger MedStar network that helps it "advance health through medical education, research, subsidized health services," and other means. Transitional Care at Good Samaritan, in turn, is a unit of MedStar Good Samaritan Hospital; and it is located inside the hospital.

Given so extensive a support system, it is hardly surprising that Transitional Care should have earned an overall 5-star rating (tops) based on the most recent standard Medicare inspection in February 2016.

In other respects, Transitional Care was more average. Its most recent health inspection turned up a total of 8 deficiencies, placing this facility in between the Maryland and U.S. averages of 11.4 and 7.1 deficiencies, respectively. Transitional Care got a 4-star Medicare rating for that inspection.

As we said, Transitional Care does depart very much from the average in terms of size. This Good Samaritan unit has only 30 certified beds, of which only 25 were occupied at the last official count. Its total of 25 residents were less than a quarter of the Maryland average (107.5) and under a third of the national average (86.2).

That small residential population got the benefit of an almost phenomenal amount of nursing attention. Transitional Care is hugely superior to the state and national averages in terms of total nurse time per resident per day: four hours and 17 minutes - well over twice the averages for Maryland and the U.S. (both a bit under two hours).

At three hours and five minutes per day, residents here got more than three times the amount of RN time as the Maryland and U.S. averages. As for LPNs and LVNs (licensed practical nurses, licensed vocational nurses), again this facility beat both the state and national averages for total time per day, by about 20 minutes. Residents here also got about an hour more per day with certified nursing assistants than the Maryland and U.S. averages.

In perhaps the most astonishing statistic, residents here got 58 minutes a day with physical therapists. The Maryland average is 9 minutes; the U.S. average, 6 minutes. Hardly any facility we have seen gives residents much more than the average amount of time, and many give less. The comparison is a little bit apples to oranges - short term care is always going to have more PT time. Still, there seems to be a high level of care even for a short stay nursing home.

Since Medicare apparently rates staffing based on the amount of time staffers spend, Transitional Care ought to get, say, six stars on this metric. But it had to settle for Medicare's top 5-star ratings both for registered nurses and for staffing overall.

Then we come to quality measures -- statistical measures of the types and amounts of care residents receive. Medicare tallies caregiving statistics for both short-stay and long-stay residents.

Transitional Care got an overall 2-star rating for quality measures, which we think in this case may be a misleading figure. First, this facility had almost no data on long-stay residents - probably because it doesn't have any such residents. Medicare noted that for 14 of 15 categories for long-stay residents, data were "NOT AVAILABLE." So Medicare based its quality measures score on only half the usual amount of data.

(Oddly, this facility did have exactly one stat for long-stay residents: 100 percent of these residents got a flu shot. We suspect that this facility gave a shot to exactly one resident who somehow qualified as a long-stayer.)

Transitional Care scored better than the Maryland and U.S. averages in five of the nine Medicare categories for short-stay residents; so why didn't it get at least a 3-star rating on this metric?

Its good scores included handily beating the state and national averages on giving flu and pneumonia vaccinations (this facility gave more of them), and on distributing antipsychotic meds (this facility gave less of them). The number of short-stay residents here who reported having serious pain was only 3.2 percent - versus state and national averages that were four to five times higher.

There were four points on the negative side. This facility's short-stay residents were a bit more prone to contract pressure sores. They were slightly more likely than average to require rehospitalization after discharge (although they were less likely to need an ER visit).

Two stats may have hurt this facility the most. With respect to improving residents' functionality, Transitional Care's 31.3 percent success rate was less than half the state and U.S. averages. Its rate of successful discharges was 44.9 percent - significantly lower than the Maryland and U.S. averages of 59.3 percent and 56.9 percent, respectively. Is this because the Medicare ratings just do not work for some short-term facilities? We have to say "some" because some short-term facilities like this do have much better numbers. But it could depend on so many different variables like the type of patients that are directed to the facility.

Still, the amount of nursing time per resident is so extraordinarily high here, compared with the Maryland and national averages, this facility's below-average rating on quality measures are baffling. With so much nursing time, why did so few residents show improvement in functionality? How did any resident manage to contract a pressure ulcer? This contradicts the whole "oh, it is skewed short stay statistics" thesis. There could be some other factors at play here that the Medicare stats do not reflect. The numbers, by themselves, never tell the whole story.

Has someone you love suffered needlessly at Transitional Care at Good Samaritan or other Baltimore nursing home that made a terrible mistake? Call our nursing home attorneys at Miller & Zois today at (800) 553-8082. We will help you explore your options. You can also get a FREE no obligation, confidential case review online.

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• This nursing home, like many nursing homes, has had a problem dealing with pressure sores. These are probably the leading source of successful nursing home lawsuits in Baltimore. Get sample settlement and verdicts in pressure ulcer cases.
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1 Vital Statistics

Number of Beds: 30 certified beds

Beds in the nursing home that have been approved by the federal government to participate in Medicare or Medicaid.

Accepts: Medicare and Medicaid

Shows if the nursing home participates in the Medicare, Medicaid, or both.

2 Key Ratings

Star Rating Summary
Overall Rating A rating of 1 to 5 stars based on the health inspection, staffing, and quality measures ratings combined into one. More stars are better.		Much Above Average
Health Inspection A rating of 1 to 5 stars based on the nursing home’s health inspection results. More stars are better.		Above Average
Staffing A rating of 1 to 5 stars based on the nursing home’s staffing hours for Registered Nurses (RNs), Licensed Practical Nurses (LPNs), Licensed Vocational Nurses (LVNs), and Certified Nursing Assistants (CNAs). More stars are better.		Much Above Average
RN Staffing A rating of 1 to 5 stars based on the amount of time Registered Nurses (RNs) spend with residents as reported by the nursing home. More stars are better.		Much Above Average
Quality Measures A rating of 1 to 5 stars based on resident assessment data that show how well the nursing home cares for residents’ needs. More stars are better.		Average

3 Key Short Stay Statistics

Description	Transitional Care at Good Samaritan	MD Average
Percent of short-stay residents who self-report moderate to severe pain. Lower percentages are better.	2.7%	14.2%
Percent of short-stay residents with pressure ulcers that are new or worsened. Lower percentages are better.	1.1%	1.3%
Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine. Higher percentages are better.	90.8%	82.5%
Percent of short-stay residents assessed and given, appropriately, the pneumococcal vaccine. Higher percentages are better.	98.4%	81.2%
Percent of short-stay residents who newly received an antipsychotic medication. Lower percentages are better.	0.2%	2.2%

4 Key Long Stay Statistics

Description	Transitional Care at Good Samaritan	MD Average
Percentage of long-stay residents experiencing one or more falls with major injury. Lower percentages are better.	0.0%	2.9%
Percentage of long-stay residents with a urinary tract infection. Lower percentages are better.	NOT AVAILABLE	4.5%
Percentage of long-stay residents who self-report moderate to severe pain. Lower percentages are better.	NOT AVAILABLE	6.4%
Percentage of long-stay high-risk residents with pressure ulcers. Lower percentages are better.	NOT AVAILABLE	6.8%
Percentage of long-stay low-risk residents who lose control of their bowels or bladder. Lower percentages are better.	NOT AVAILABLE	58.0%
Percentage of long-stay residents who have/had a catheter inserted and left in their bladder. Lower percentages are better.	NOT AVAILABLE	2.5%
Percentage of long-stay residents who were physically restrained. Lower percentages are better.	0.0%	0.6%
Percentage of long-stay residents whose ability to move independently worsened. Lower percentages are better.	NOT AVAILABLE	22.3%
Percentage of long-stay residents whose need for help with daily activities has increased. Lower percentages are better.	NOT AVAILABLE	18.7%
Percentage of long-stay residents who lose too much weight. Lower percentages are better.	NOT AVAILABLE	6.3%
Percentage of long-stay residents who have depressive symptoms. Lower percentages are better.	0.0%	4.8%
Percentage of long-stay residents who received an antianxiety or hypnotic medication. Lower percentages are better.	7.1%	18.3%
Percentage of long-stay residents assessed and given, appropriately, the seasonal influenza vaccine. Higher percentages are better.	100.0%	95.0%
Percentage of long-stay residents assessed and given, appropriately, the pneumococcal vaccine. Higher percentages are better.	95.2%	92.2%
Percentage of long-stay residents who received an antipsychotic medication. Lower percentages are better.	4.8%	14.1%

5 Inspection Summary

Date of standard health inspection: 02/25/2016
Total number of health deficiencies: 8
Average number of health deficiencies in MD: 11.0