The data on 17,000 nursing homes that the federal government put on the Internet last week provide only a starting point for selecting homes and may not accurately measure their quality, say health-care administrators and watchdogs in Ventura County.
The new Web site, accessible at www.medicare.gov, is like a guide to picking a college or buying a car.
"It's a good piece in the chain of making a decision. I don't think it's the only piece," said Sylvia Taylor, executive director of Long Term Care Services of Ventura County, a nonprofit organization that counsels families and inspects nursing homes.
Ventura County has 170 facilities that offer various levels of long-term health care, Taylor said. But the U.S. Department of Health and Human Services compares online only 22 that provide skilled nursing care.
On average, compared to all California nursing homes, inspectors found fewer deficiencies at Ventura County facilities. But the typical county nursing home had slightly more problems than the national average.
California nursing home residents are more likely to have bedsores and be physically restrained, according to the survey. In Ventura County, 21% of residents were restrained -- more than twice the national average.
Residents in the county and state receive more nursing attention than those in the rest of the country. On average, nurses and their aides are able to spend about four hours with each resident each day.
Last week's Web launch, with an accompanying phone number (800-633-4227), is part of an initiative to improve the quality of nursing homes. The initiative includes government-funded training for nursing home personnel. Data on home health agencies, hospitals and doctors may follow.
Jerry Wells, Beverly Healthcare's operations director for Victoria Care Center in Ventura and Maywood Healthcare Center in Oxnard, said he welcomes the release of the information but cautions consumers against using it to rank nursing homes.
For example, the Web site compares homes by the number of residents with acute confusion or delirium. Many consumers might prefer a low number, while those looking to place a loved one who has those problems might prefer a facility skilled in handling them. Such a home would naturally have a higher number in that category.
"It doesn't mean that they're worse than another facility," Wells said. "Facilities accept different kinds of patients."
California has two other Web sites that compare the state's 1,400 nursing homes: www.nursinghomeguide.org and www.calnhs.org.
"I don't know how much the public will actually use [the sites]," Wells said. "A lot of our customers, obviously, do not surf the Net a lot."
After the Health and Human Services Department rolled out its new directory last week, Congress' investigative arm said the report-card system was released prematurely and might confuse consumers. The U.S. General Accounting Office has questioned the validity of the data.
Taylor, whose office functions as county ombudsman, said she has similar questions, having only scanned the Web site since its unveiling.
"My concern is, where is all the information coming from?" she said. The federal government receives data on nursing homes from a variety of sources, including state agencies and the homes themselves.
Inspections of nursing homes offer just a snapshot of their care and may occur as infrequently as once a year. Staff turnover is high among the industry's caregivers, so the quality can change daily, Taylor said.
"To get the latest, up-to-the-minute information in our county, they need to call the local ombudsman office," she said.
Volunteers in Ventura County's ombudsman program visit nursing homes every week for several hours. "We knock on every door, and we visit with every resident we are able to visit with," she said.
Inspectors report evidence of gross abuse and neglect but otherwise try to resolve residents' complaints at the nursing home.
Prospective residents and their families should always do their own inspections, Taylor said.
"Just go in," she suggested, "and use all your senses to see how you really feel about placing a loved one in this facility."