Presidential Surgery

Former president Bill Clinton made news this weekend as concern for his health revealed a return to heart bypass surgery which for him was a tuneup to his quadruple coronary. The surgery didn't heal the problem it was a temporary solution to a long term problem. Doctor's revealed the problem wasn't that the former president returned to his bad habits. We initially postulated that it was his failures that brought about the problem. Surgical solutions aren't final solutions and as we continue to promote "couch potato" solutions to health we're gladden by the reports.

But coronary artery disease is a lifetime commitment, Dr. Randal Thomas, director of the Mayo Clinic Cardiovascular Health Clinic and president of the American Association of Cardiovascular and Pulmonary Rehabilitation says. "[Surgery] is a good short-term solution [but] it's temporary; in the long term, the most powerful thing we can do is adjust lifestyle and medication. "Unless we get rid of the underlying problems," he says, the problem will come back.

We searched for local solutions to the bypass surgery and found to our dismay that if we or you needed to have such care the best place to receive it wouldn't be found in the District of Columbia nor even in the traditionally "best hospitals in America." While the places we located were considered by patients and professionals as your best bets for survival and had the lowest infection rates their "quality of care" wasn't equal to the medicine one received. The staff might suck even though the actual surgery and recovery may be the best. We can attest to this from our own anecdotal experiences. While the physician was rude but accurate the nurses were incredibly considerate and attentive.

There are no four or five star facilities in the District of Columbia for Heart Bypass Surgery. There are alternatives in the other local jurisdictions. The Best Hospital for Heart Bypass Surgery in MD -

          1. Saint Joseph Medical Center

The Best Hospitals (4) for Heart Bypass Surgery in NC -

          1. Durham Regional Hospital
          2. Select Specialty Hospital - Durham
          3. Mission Hospitals
          4. Mission Health & Hospital - St. Joseph

The Best Hospital for Heart Bypass Surgery in VA -

          1. Sentara Norfolk General Hospital

Even if you're not an ex-president and we aren't, we can still receive quality care that we can survive if we plan and utilize the best available services from the best available facilities. If we don't, we have only ourselves to blame. If we've got loved ones we can also give them the benefit of our knowledge. We didn't attempt this story until now because of our initial ignorance. We were in disagreement as to whether the problem was a result of President Clinton's lifestyle abuses. It was reassuring to discover it was not (well to some of us).

Dr. Allen Schwartz, the chief of cardiology at the hospital, publicly stated that there was "no evidence of [a] heart attack or [of] damage to [Clinton's] heart," and that what occurred was "not a result of either his lifestyle or diet, both of which have been excellent." (CNN)

Quality Check, our usual source for all things hospital rated was not the most recent source for these local facilities. Becker's Hospital Review magazine names America's 10 Best Hospitals for 2009 none of which made our list. Their choices were, in our area: Duke University Hospital, Durham, NC and John Hopkins Hospital in Baltimore, MD.

While the choices from Health Grades might be your best chances for survival and recovery they aren't the best choices in terms of patient satisfaction. The choices that might be good for you might not be good to you.

They May Excel, But They're the Worst Hospitals for Patient Satisfaction - Patients surveyed give these hospitals, some of America’s best, a poor score overall - Among elite centers in the U.S. News "America's Best Hospitals" rankings that reported patient satisfaction survey results for the year ended December 2008, the 10 percent below were rated worst overall. They had the highest percentages of patients who gave them a 6 or below (10=highest, 0=lowest).

Take, for instance, Virginia's Sentara Norfolk General Hospital which received a patient satisfaction rating of only 16%. While Maryland's John Hopkins considered by many to be one of the best hospital in America received a rating of 75%.

“The fact is, patients are twice as likely to die at low-rated hospitals than at highly rated hospitals for the same diagnoses and procedures,” Dr. Rick May, an author of the HealthGrades study, said in a statement. “With Washington focused on rewarding high-quality hospitals and empowering patients to make more informed health care choices, this information comes at a turning point in the health care debate.” (Seattle Biz Journal)

Our experience reflects that great nurses won't be found with great doctors and great doctors don't necessarily attract great nurses. We loved the nursing staff and care we received but the doctor's attitudes left a lot to be desire. We're they any good? The doctors were incredible. The nursing staff we felt saved our lives. Then again we weren't in for heart bypass surgery either. If we were we'd take rude over sweet but deadly anyday. To use our own anecdotal experiences with Pearlie Mae, her doctor's were the nicest and kindest people we'd ever met. However, the information they gave us wasn't just wrong. It was deadly wrong. We didn't have either access to the information we now have nor any of the rating we're making available to you. If we had, maybe Pearlie Mae would still be with us.

Best Area Nursing Homes?

Though pronounced dead at the hospital which provided her care Pearlie Mae actually died at the nursing home where she for hospice care. The facility did not receive a favorable rating during her "residency." We certainly felt the home was unacceptable for animal care let along the care of a human being. We don't have a high opinion of nursing homes in general. However the ones we do have neutral feelings toward actually didn't score very highly either.

One in five of the nation's 15,700 nursing homes have consistently received poor ratings for overall quality, a USA TODAY analysis of new government data finds. More than a quarter-million patients live in homes given another set of low scores within the past year, according to data released today by Medicare, which first released the star ratings of the nation's nursing homes in late 2008. The ratings are derived from inspections, complaint investigations and other data collected mostly in 2008 and 2009. (USA Today)

It's only because we have experience with many of these local facilities at the time of the ratings that we can support the findings of Medicare. We have from the Medicare site the list for our jurisdictions of the ONLY facilities that you should even consider for housing your recovering or discarded family members. Sorry! That was unnecessarily harsh and we apologize but the subject is still a sensitive one.

Former Frazier co-star David Hyde Pierce had a different opinion and take on the issue when interviewed for the for PBS Series Life (Part 2) stating:

"...[T]hey found a great assisted living place 7 miles from their house, moved him there. It turned out to be the best thing in the world. We usually think of that as a bad second choice. In this case, it was a wonderful choice because instead of being in a house where there were very few people around, 'cause people had to work or be in school, he was constantly surrounded by people. He flourished in a social environment. He was always a very social person. Because of the demographics, he was one of the few men among many women, so that was lovely. And he continued to decline. He never went as far as my grandfather did. My grandfather went the whole route of the disease. My dad was, as we think, mercifully, stricken with the flu and got very sick, and my brother called us all. We were all able to come up there and we were all with him and he still knew us when he passed away." (Science of Happiness, Episode 10)

It took us a few days to analysis the data and find the best of the "poor." These should be the only facilities that you'd even consider for care, however, knowing how a facility fails can help you in either your choice or your lawsuit. The choice to know the devil the government knows or to know what you need to watch out for can also be a great boon to their care.

The Five-Star Quality Rating System was created to help consumers, their families, and caregivers compare nursing homes more easily and help identify areas about which you may want to ask questions. This rating system is based on continued efforts as a result of the Omnibus Reconciliation Act of 1987 (OBRA '87), a nursing home reform law, and more recent quality improvement campaigns such as the Advancing Excellence in America’s Nursing Homes, a coalition of consumers, health care providers, and nursing home professionals. Nursing home ratings are taken from the following three sources of data: Health Inspections, Staffing and Quality Measures. We provide a star rating for each of these three sources, in case some areas are more important to you than others. Then, these three ratings are combined to calculate an overall rating. (MEDICARE)

DC 3 choices (though we only found two (2) worthy of use and our choices are below):

1.  Jeanne Jugan Residence, NE  Stars 5/5/5/2 Medicaid, Non Profit, (40)
2.  The Methodist Home, NW   Stars 5/5/4/4 Medicare and Medicaid, Non Profit, (50)

MD 36 choices (though we only found seven (7) worthy of use and our choices are below):

1. Maria Health Care Center, Baltimore  Stars 5/5/5/5 M and M, Non profit, (60)
2. Crawford Retreat, Baltimore  Stars 5/5/4/5 Medicaid, For Profit, (20)
3. Sacred Heart Home, Hyattsville, Stars 5/5/4/5 Medicaid, Non profit, (102)
4. St. Vincent Care Center, Emmitsburg, Stars 5/5/5/4 M and M, Non profit (46)
5. Garrett County Subacute Unit, Oakland, Stars 5/5/5/3 M and M, Government (10)
6. Hartley Hall Nursing Home, Pocomoke City, Stars 5/5/3/5 M and M, Non profit (70)
7. St. Joseph's Nursing Home, Catonsville, Stars 5/5/3/5 Medicaid, Non profit (44)

NC 47 choices (though we only found four (4) worthy of use and our choices are below):

1.  Chowan Hosp-Snf, Edenton, Stars 5/5/5/5 M and M, Non Profit (40)
2.  Mayview Convalescent Center, Raleigh, Stars 5/5/5/5 M and M, For Profit (51)
3.  Pungo District Hosp Ventilator Unit, Belhaven, Stars 5/5/5/U M and M, For Profit (10)
4.  Wakemed Fuquay Varina Outpatient & Snf, Fuquay Varina, Stars 5/5/5/3 M and M, Non Profit (36)

VA 35 choices (though we only found seven (7) worthy of use and our choices are below):

1. Central Virginia Training Cent, Lynchburg, Stars 5/5/5/5 M and M, Government (104)
2. Little Sisters Of The Poor, Richmond, Stars 5/5/5/5 Medicaid, Non Profit (22)
3. Shenandoah Vly Westminster-Canterbury, Stars 5/5/5/5 M and M, Non Profit (40) 
4. Snyder Nursing Home, Salem, Stars 5/5/5/4 Medicaid, Non Profit (45)
5. Summit Square, Waynesboro, Stars 5/5/5/4 Medicaid, Non Profit (18)
6. Lake Prince Woods, Sufflok, Stars 5/4/5/5 Medicare, Non Profit (40) 
7. Southside Regional Medical Ctr, Petersburg, Stars 5/4/5/5 M and M, For Profit (20) 

• Stars (Overall / Inspections / Staff / Quality Measures) (# of Beds in the facility)

The best nursing home in the District of Columbia can't equal the best Maryland, North Carolina or Virginia facilities according to the Medicare government data. In choosing a better nursing home in the area size matters and the smaller the better - however smaller means fewer available beds. When your loved ones are in need the need from a hospital is immediate. Like David Hyde Pierce whose family interred their Grandfather and then their father in a nursing home while proclaiming the sites good for their relatives. You know if you're a nursing home person.

For us the question is would we want this for ourselves. We certainly wouldn't want to be burden on our families nor bankrupt them financially either. But to quote Mr. Pierce, speaking about his grandfather, on the PBS Series Life (Part 2) episode 10 entitled "Seeking Happiness:"

"The last time I saw him he was in a nursing home in New York State. He was in a wheelchair with his arms tied with straps to the arms of the wheelchair looking at cutout pictures in a construction paper book that some helpful volunteer had put together of flowers. Just sort of happily staring kind of blankly at this thing." (VIEW)

That's not the kind of life or death we'd like for ourselves but that's just us! We say live the kind of life you'd like to die living. For us it's not something we'd like to do alone with strangers but that's how we were raised. If you're raised differently stay in contact with the best places which can transport your loved ones to a facility for specialized care and then return them to the home to convalesce. Beds are few are far between - people are dying to get in.