The Dolton HealthCare and Rehabilitation Center did what no other black Illinois nursing home accomplished. In May, it was the only facility in the state that had a majority of black residents to get the government’s highest quality rating in the federal ranking system Nursing Home Compare.

By the time this story was going to print, the Dolton facility no longer held that distinction, but still was ranked among the best majority black facilities in Illinois.

Now, nine states have majority black nursing homes with no excellent ratings–”Arkansas, Connecticut, Illinois, Indiana, Kansas, Kentucky, Oklahoma, South Carolina and Wisconsin.

The key elements in Dolton’s high rating were high amounts of staff time with residents, high percentage of licensed staff care provided by registered nurses rather than licensed practical nurses, and an approach to resident care that emphasizes residents’ wants in addition to their medical treatment, according to an analysis by The Chicago Reporter and the home’s acting administrator.

“There’s no question that the staffing levels are very closely associated with higher outcomes for nursing homes patients; that’s been in the literature for years,” said Susan Reed, a professor and urban health policy researcher at DePaul University’s School for New Learning.
Residents at the Dolton facility get more than four hours of care per day. That is the second highest total of Illinois’ 46 black nursing homes for which data were available. The median daily staff time spent with residents among Illinois’ black nursing homes was about 2.5 hours.

At 66 percent, the Dolton facility also had the second highest percentage of licensed care provided by registered nurses, the highest skilled nurses, among the state’s black nursing homes.

The facility received its top mark with residents who could not afford expensive care–”more than 85 percent of resident days last year were paid for by Medicaid, a federal program that provides health care to low-income people.

Dolton Administrator Lee Moriarty said her facility focuses on quality of life in addition to quality of care. Residents have control over when they eat, bathe and get out of bed, rather than having to follow a schedule.

The home does this because that is how people live in their own home, said Moriarty, who has worked at Dolton since May 2009.

Muriel Gillick, a clinical professor at Harvard Medical School and author of The Denial of Aging, said that the focus of nursing home care during the past few decades has prioritized clinical treatment over the residents’ needs for dignity and control over their choices.

Dolton is part of a statewide and national movement called the Illinois Pioneer Coalition, a group created to help long-term care facilities feel more like a home to their residents.Coalition members ascribe to a holistic view of care in which the resident, rather than the medical treatment, is the primary focus.

The coalition is not membership based, and does not track the ratings of the facilities that participate, said President Becky Haldorson. Each home defines success on an individual basis, she added.

Haldorson said that the number of homes participating in the coalition has grown, but could not say by how much. She said that in February 2009 the coalition hired a director who will track membership and other information for the group.

“We are empowering the people who live here to be the decision makers because it’s their home,” Moriarty said. “That’s the way it needs to be because it’s their lives.”

Jeff is the founder and executive director of the Center for Collaborative Investigative Journalism (CCIJ) and the Padnos/Sarosik Endowed Professor of Civil Discourse at Grand Valley State University....