North Carolina
What’s the best way to pick a nursing home for a loved one?
By Thomas Goldsmith
When the time comes close to to decide on a nursing dwelling for a beloved one, the best path is to go to a number of services and speak with directors, employees, and residents, in response to folks conversant in this transition.
However for a lot of households, the necessity for a nursing house is an pressing one, precipitated by a fall or a catastrophic sickness that has all of the sudden rendered a beloved one unable to manage at dwelling.
A number of on-line assets may also help people who find themselves in search of the absolute best care. It’s in style to “do your individual analysis” on decisions comparable to this, however it may be troublesome to seek out the time and experience to look into nursing houses, particularly since many individuals enter the long-term care system in disaster.
Public and nonprofit specialists helped North Carolina Well being Information compile a listing of some sources of details about expert nursing services throughout the state.
That is the final of three tales on a brand new report from the Nationwide Academies of Science, Engineering and Drugs.
The sweeping new report on nursing houses created by a blue-ribbon committee of the Nationwide Academies accommodates broad criticism on the present state of look after older folks and people with disabilities.
The assembled knowledgeable members of the committee that produced the report, “The Nationwide Crucial to Enhance Nursing House High quality,” included specialists from the fields of nursing, veterans affairs, well being economics, household medication, geriatrics, well being care coverage, vaccines, public well being and most cancers analysis.
Dr. Philip Sloane is a professor of household medication and geriatrics at UNC-Chapel Hill and a member of the panel that created the report. Every of the specialists gave a stamp of approval to every of the panel’s conclusions, Sloane stated.
So, if the establishment of nursing houses wants enchancment, what particular steps does the report suggest to make possession and operations extra clear for the general public?
In a single proposal sure to obtain pushback from business, the committee recommends that the federal Facilities for Medicare and Medicaid Companies ought to have full entry to Inside Income Service tax returns of firms that play a job in a nursing dwelling’s operation.
In lots of instances, the individual or company in possession of a nursing dwelling additionally owns firms that offer enterprise administration, pharmacy providers, meals preparation, safety and different must the ability. That can lead to a convoluted construction that’s laborious to evaluate and that makes any authorized motion towards the nursing dwelling laborious to pursue.
The presence of legally separate companies owned by the nursing houses guardian company could be utilized by Medicare and Medicaid in an annual audit of a facility’s dwelling workplace and associated firms, in response to the committee’s advice.
Moreover the committee recommends that:
- Potential house owners of a talented nursing facility needs to be prevented by new rules from shopping for, operating or managing new services if information present they’ve a historical past as house owners of working different houses, in any state, that chronically had low staffing or poor high quality.
- Enforcement of legal guidelines and guidelines on nursing houses ought to transcend the extensively used civil financial penalty. These efforts ought to make extra use of treatments that embody having company chains enter integrity agreements, disallowing new residents, mandated programs of correction, set up of short-term managers, and ending contracts with Medicare and Medicaid.
- A brand new Early Detection Job Power made up of federal and state regulators, folks from the Facilities for Illness Management and prevention and the U.S. Justice Division ought to maintain a unbroken eye on nursing houses’ efficiency based mostly on information collected on staffing ranges, a file of time spent by a facility’s medical director, inspection applications and the federal justice division’s assessments. The duty power would be capable to ship “strike groups” into nursing houses with particularly pressing issues. An identical follow was utilized in western North Carolina early within the COVID pandemic.
As well as, the report says folks ought to be capable to search info on the Nursing House Evaluate website not solely by a facility’s identify, but in addition by any chain or widespread possession.
Learn Half 1 of our sequence right here, and Half 2 right here.
Look to the celebs
For these starting the method, the five-star score system provided by the Facilities for Medicare and Medicaid Companies, or CMS, is price consulting however needs to be supplemented from different sources, stated Invoice Lamb, a board member of the advocacy group FOR, or Buddies of Residents in Lengthy Time period Care.
“A five-star score means you continue to want to have a look at extra info,” Lamb stated in a cellphone interview. “However if you happen to’ve acquired a two-star or one-star or particular focus facility, there’s one thing happening there.”
Particular focus services are nursing houses with information that present they’ve fallen brief in caring correctly for residents throughout lengthy durations. If federal regulators make that willpower, the middle in query can discover itself going through extra frequent inspections, ponying as much as pay fines inside a wide range, and dropping reimbursement from each Medicare and Medicaid.
A brand new report analyzing the state of the U.S.’s nursing houses from the Nationwide Academies of Science, Engineering and Drugs, “The Nationwide Crucial to Enhance Nursing House High quality,” raises questions in regards to the worth of the federal star score system, obtainable on the Nursing House Evaluate web site.
“Though the five-star composite measure appears to have face validity and predictive validity on the extremes, the proof is blended as as to if the star rankings are useful to shoppers selecting amongst nursing houses which are nearer to common,” the report says, citing tutorial research that increase typically provocative questions in regards to the system.
There’s the unlucky risk that facility house owners with data of the system would possibly put together info designed to provide a selected score.
“A part of the problem of the present score system is that each staffing and high quality measures are based mostly on self-reported information from nursing houses, which may permit for ‘gaming’ the place nursing houses may falsify their information or use questionable methods to enhance scores,” the report says.
In different phrases, well-ranked houses are seemingly good, whereas poorly-ranked houses ought to seemingly be prevented. For houses ranked in the course of the pack, the standard will be laborious to find out.
See for your self
Lamb and different specialists throughout the board emphasize the significance of in-person visits.
“Making an appointment to go to nursing houses and speaking to employees and residents can also be necessary,” stated spokeswoman Summer time Tonizzo from the North Carolina Division of Well being and Human Companies.
Adam Sholar, CEO of the nursing dwelling commerce group North Carolina Well being Care Services Affiliation, is on the identical web page.
“Personally, I’d suggest that households make an appointment to go to close by nursing services to allow them to see first-hand what sort of care is being supplied,” Sholar stated. “Private visits will let you know much more in regards to the employees, the services, and the tradition than anything.”
Nevertheless, folks conversant in the business warning guests to not place a lot significance on facilities such because the well-appointed foyer of a nursing dwelling. The day-to-day remedy of residents takes place out of sight of any such trappings.
Take a deeper dive into the information
The location information.medicare.gov, maintained by CMS, is probably going probably the most informative software, however may also be probably the most troublesome to make use of. Its spreadsheet information can provide shoppers with particulars a few facility’s stage of staffing at specified jobs, charge of turnover, inhabitants, deaths from COVID-19 and far more. These unfamiliar with Excel or different spreadsheet software program might want to learn to use it by themselves, or get assist with it.
Nursing House Evaluate lets guests test attainable locations towards competing services. It’s run by the federal Facilities for Medicare and Medicaid Companies and points the 1 to five star rankings for services.
This website focuses on seeing how one facility stacks up towards one other, or with just a few, so it’s not all the time the best place to get info. Nevertheless, as famous within the Nationwide Academies report, the star score system is a helpful solution to decide a basic stage of high quality, particularly within the decrease and 4 to five star ranges.
The state NC DHHS’s Division of Well being Service Regulation Nursing House Licensure and Certification Part net web page permits shoppers to seek the advice of inspection stories for services within the state, together with statements of deficiencies which are generated when there’s an issue and the corresponding plans of correction. A no-frills checklist of services is on the DHHS website — click on on “nursing houses, transportable doc type.”
There are additionally common postings of the facilities with “deficiencies.”
Return in time
Amongst different assets, the state nursing dwelling licensure and certification part, which receives about 2,000 nursing dwelling complaints a yr, maintains a listing of facilities which have been cited for deficiencies in care.
These concerned with a selected nursing dwelling can study information from the close to previous or going again a number of years. For instance, somebody trying into the Citadel Salisbury would discover that regulators cited the nursing dwelling in March for failing to guard a feminine resident who complained {that a} male resident had repeatedly provided her cash for intercourse.
Residents or caregivers can file complaints about incidents which have occurred up to now yr and that contain issues recognized in state or federal rules. Different types of considerations might be dealt with by one other company.
Though nursing houses are licensed and function below federal rules, when there’s a criticism, it’s state DHHS and native county workers who perform inspections that type the chief foundation of citations and penalties from the Facilities for Medicare and Medicaid Companies.
Different info sources:
- The Kaiser Household Basis has reams of details about expert nursing services, from nurse staffing to personal and nonprofit possession. A latest difficulty temporary sums up what states have performed to handle shortages in nurses at expert nursing services.
- The nationwide non-profit investigative newsroom ProPublica additionally has particularly sturdy info and prides itself on retaining its itemizing updated. Their information website Nursing House Examine additionally combines info from completely different ranges of companies. For instance, a ProPublica itemizing reveals two North Carolina nursing houses as among the many most closely fined nationally throughout a three-year interval. They’re Citadel Salisbury with $700,000 in fines and the Carolina Rehab Middle of Cumberland, with $604,000.
Republish our articles free of charge, on-line or in print, below a Artistic Commons license.
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By Jane Doe
North Carolina Well being Information
North Carolina Well being Information is an impartial, non-partisan, not-for-profit, statewide information group devoted to masking all issues well being care in North Carolina. Go to NCHN at northcarolinahealthnews.org. (on the internet, this may be hyperlinked)
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North Carolina
4-generation N.C. winery aims for visitors to leave ‘feeling like a part of our family’
Part of the reason for publishing these travel pieces is to help spread the word about quality wineries worth visiting to those who do hit the road and explore.
The other part is to find good stories up and down the East Coast of individuals and families who are operating wineries and/or cideries.
A story on Parker-Binns Vineyard in Mill Spring, North Carolina, around 85 miles west of Charlotte and 45 miles southeast of Ashville in the foothills of the Blue Ridge Mountains. It operates on 40 acres.
Dan McLaughlin, a member of North Carolina Fine Wines and a familiar figure in the state’s wine industry, noted in an email that “if Jimmy Buffet had a vineyard, it would be like Parker-Binns. It has four generations there (on the weekends, the great-grandson of the owner is there helping his dad in the vineyard.) They have a restaurant that is very relaxed and great food at reasonable prices. … Their vibe is very chill, but classy. Everything is spa-like in perfection. Just a place to enjoy the view and enjoy excellent wines. James Suckling gave them five 90+ scores this past year.”
Parker-Binns Vineyard is open noon to 6 p.m. Wednesday and Thursday and noon to 7 p.m. Friday through Sunday.
Prices for its canned ciders and bottled wines are in the $20s, with a few exceptions. You can see the full list at this link, although the 2021 Loco Lulu Red should be mentioned because $1 of every bottle sold goes to the local pet adoption organization.
The Relish Kitchen is open noon to 5:30 on Thursday and noon to 6:30 on Friday through Sunday. Here’s a link to the menu.
Parker-Binns Vineyard in western North Carolina opened in 2010. Several wines including this one, feature Lulu (their 4-legged greeter) on the label.Parker-Binns Vineyard
There’s a full section on the history of the place, founded by Karen and Bob Binns.
Per the website:
After spending twenty-five years in the food and beverage industry on the Jersey Shore, we headed to South Florida where we purchased raw land, north of the Everglades, just east of the Great Cypress Swamp. After months of clearing jungle-like conditions, we planted a tree farm and established a plant nursery. After twenty years of a very successful business, the Government approached us to acquire the land for a project to restore and save the Everglades. The timing was right, it was a good reason to sell, and we thought we could retire!!
After only a couple of years of retirement, we were bored and needed inspiration. With our background in the food and beverage industry, we decided that we wanted to be part of the emerging East Coast wine industry. We searched up and down the region and finally found what we felt was the perfect parcel, 10 acres in the Tryon Foothills of the Blue Ridge Mountains.
Polk County, North Carolina had a rich history of growing and selling grapes in the late 1800’s. Now with the area having over 20 vineyards and 3 wineries, we knew this was the place to begin. And begin we did…clearing the trees and thickets, preparing the soil and planting over 4000 grape vines. Although we were familiar with this, we made an outstanding discovery … we’re 31 years older (ouch!) and yet another adventure begins!!!
The business, which opened in 2010, eventually welcomed daughter Kelly Binns and grandson Cory Lillberg and his family.
Justin Taylor makes wine for Parker-Binns Vineyard as well as Marked Tree Vineyard down the road in Hendersonville.
Karen died in April. Her obituary includes this line: “Leave a mark, dance like no one’s watching, and love hardest.” She said it, and lived it.”
Thanks to Lillberg for responding to PennLive’s questions with answers that cover plenty of ground for the latest in the “Grape Escape ‘24″ series.
Q, I want to include the history of how Bob and Karen wound up starting the winery. Pretty fascinating. Just because of our proximity, what did the two do while they were on the Jersey Shore early in their careers? And when did the winery open?
A, They spent their time on the Jersey Shore operating “The Fairview,” a rock ‘n’ roll bar that my grandfather owned and operated from Memorial Day to Labor Day each year from 1957-90. My grandmother wasn’t in the picture until 1979 when they started managing that business as a team. Eventually, they would live in South Florida year-round once they sold the business in 1990. They met and worked together first at my grandfather’s restaurant and bar in Fort Lauderdale called “Maggie Mae’s.”
The view from the tasting room at Parker-Binns Vineyard in Mill Spring, North Carolina.Parker-Binns Vineyard
Once they sold that business, they then started their next adventure, which was growing a plant and tree nursery in the Fort Lauderdale area. They operated “B.J Binns Plants and Trees” for over 20 years. They grew tropical hardwoods, palms, shrubs, hedges and flowering bushes on over 100 acres of South Florida farmland. The tree farm has since been viewed as the birth of their passion for agriculture. Fast forward to 2006 when they sold the tree farm and began looking for their next adventure. At the ripe age of 73, the old man decided that he would plant a small vineyard as a passion project to leave the heat of Florida for the summer. After finding the 10-acre lot in North Carolina’s Polk County, he and my grandmother cleared the land, dug the holes, pounded the posts, planted the vines, and took care of them until their first fruit came in 2011. They had intended on selling most of the fruit to the Biltmore estate as our neighborhood vineyards had already been supplementing The Biltmore’s estate vineyard in Asheville for years. Upon finding out the Biltmore house was not looking for more contracts, a decision had to be made. Drop the fruit or make wine? Ultimately, they decided to each make their own wine in order to figure out who had the better mind for winemaking. Admittedly, my grandmother kicked my grandfather’s @$$ and she became the winemaker while he tended to the vines. Fast forward to today and the vineyard and winery have grown to 40 acres of estate and are officially our “hobby out of control” as my late grandmother would say. Their passion for what they started is what made this business successful from the beginning even without the intent.
Q, Four generations working at the winery now? What roles do everyone play there?
A, We do have 4 generations working the farm and in many capacities. Bob Binns, Kelly Binns, myself, and my soon-to-be 10-year-old son Hunter Lillberg round out the four generations respectively. At nearly 90 years young, my grandfather is more of an overseer these days. However, he does still make appearances in the tasting room regularly as well as being our resident flower man. He makes sure to get himself out to water, feed and maintain our rose and English gardens with some regularity during the growing season. While his body may be slowing down a bit, his cognitive prowess is as strong as ever. Kelly is our tasting room manager and bookkeeper. She also books our music schedule for the year as well as being an integral piece of executing our many events over the calendar year. As for myself, I have assumed the responsibilities of vineyard manager, winemaker (alongside Justin Taylor), and server (on the weekends). Essentially, I have assumed all of my grandparents’ primary responsibilities. My son, Hunter, helps on every level and in every arena that this business possesses. He is hard-working, motivated and eager to help always. He has given tours to families, helps out on the weekend with appropriate taskings around the tasting room and has also started learning operations in the vineyard and winery. As the only one of us to grow up in this business, I envision him becoming the best of all of us with an already evident passion for what we do as an estate vineyard and wine producer.
There’s plenty of seating at Parker-Binns Vineyard, open Wednesday through Sunday.Parker-Binns Vineyard
Q, For someone who has never visited, how would you describe the vibe there?
A. For someone who has never visited, I would simply say that anyone who walks in our doors leaves feeling like a part of our family. We extend an unrivaled level of customer service and care in an aesthetically stunning environment that defies pretension and a “snooty” atmosphere. Wine should be fun, and we try VERY hard to harness that fun, light-hearted approach to wine, with a family-centric experience like vineyards of the Old World.
Q, Are you sourcing your own vineyard (s) or others in the area? What are some of the grapes that thrive down there?
A, We are currently producing fruit on 10 acres of vineyard with another 3 acres coming online over the next 2 seasons at the estate. We will certainly bring grapes in from other local facilities around North Carolina as needed in a pinch, usually in lieu of a cold event in the vineyard. We grow 10 different varities including Chardonnay, Muscat, Petit Manseng and Vidal Blanc for white varieties. Our reds include Merlot, Cab Franc, Chambourcin, Malbec, Tannat and Petit Verdot. To keep things simple, I would say that the Petit Manseng and Merlot are my favorite white/red performers in the vineyard and winery respectively. Our 2021 Merlot won the “Best Red” category in our 2024 state competition.
Q, Wines mostly dry? Looks like a wide mix of red and white still wines? Anything new on the horizon?
A, We are currently producing a wine portfolio that is mostly dry. However, we do have a tier of off-dry labels that feature a mild sweetness and approachability as well as some dessert-style wines made from both our fruit and that of other local growers. Our blackberries are sourced from a family operation in the Henderson County area. We also produce a line-up of 4 seasonal hard ciders! The fruit for that project comes from the same neighborhood in Henderson county. From A-Z, we like to think anyone can find a wine or drink they enjoy in our tasting room. Our newest project we are working on is a Piquette that we intend on serving on tap at the tasting room. It is a low-alcohol, lightly carbonated, Muscat-derived sparkling wine that we hope appeals to a future generation of “consumption-conscious” patrons.
Looking out toward the mountains at Parker-Binns Vineyard.Parker-Binns Vineyard
Q, For those traveling into town, is that list you have on the website up to date?
A, Our website is up to date for those who would like to order wine online or stop in for a tasting. www.Parkerbinnsvineyard.com
Q, Is Relish the restaurant? Open Thursday through Sunday?
Q, Relish is open Thursday-Sunday during our busy season (Apr-Oct) and Fri-Sun the other half of the year. They were a successful food truck in the Lake Lure area for many years and we joined forces in the winter of 2022. They have brought an incredible menu to bolster an already breathtaking winery experience.
Finally, a look at the place with a full house. Parker-Binns Vineyard is open until 7 on Friday through Sunday.Parker-Binns Vineyard
Q, Finally, tell me about the Hippie Bash in September. How long have you been doing that?
A, With my grandmother passing in April of this year, we decided to “rebrand” our harvest festival into a celebration of our deeply missed matriarch. She was a hippie at heart, and it was glaringly obvious to anyone who met her. We will be celebrating her with the inaugural event this year on Sept. 14 and every year forward. We will celebrate her legacy and the harvest that she cared so deeply for with music all day, yard games, food trucks, Relish restaurant, event-specific tie-dye shirts and local craft vendors to help us make the day extra special. 12-7p.
YANCEY COUNTY, N.C. (WTVD) — A tree-trimming crew in North Carolina had a harrowing encounter when a man with a criminal record opened fire on them.
This happened near Murphytown in the Green Mountain area of Yancey County. According to a statement from the Yancey County Sheriff’s Office, 36-year-old Lucas Wilson Murphy shot three tree workers while they were clearing trees for a power company.
All three sustained serious injuries. They were taken to a hospital for treatment.
31-year-old Shelby Teague, whose husband Brandon Teague, 32, was part of the five-member crew, is still grappling with the incident. The couple have three children together.
“To have somebody crazy running through the woods is not a risk that you would think about,” she told ABC affiliate WLOS
She is thankful her husband wasn’t hurt, but three of his colleagues were.
“I’m trying not to be angry,” Shelby said. “We could have lost a bunch of good men.”
Authorities said during the exchange, an officer-involved shooting happened. Murphy was injured and taken to a hospital.
Murphy is charged with nine felony counts detailing that he assaulted five crew members with a long rifle with intent to kill.
Previous Criminal History
Shelby is angry Murphy was not in jail for previous charges.
Murphy’s misdemeanors, dating back to 2013, carry little to no jail time. This includes resisting public officers, driving while intoxicated and carrying a concealed weapon.
In 2021, the most serious case where he went to trial involved a charge that he shot and tried to kill his brother.
A law enforcement source who spoke anonymously told WLOS that Murphy’s brother refused to cooperate and minimized what happened.
Because of this, the jury could only find him guilty of assault.
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