You’d think it would go without saying. You’d think a nursing home could function day to day without a written policy that begins, “It is the policy of SJR (Saint Joseph’s Manor) that no resident should ever be infested with larvae.”

“Do we think we’ll ever have to use it again? I certainly hope not,” said David Hamlin, administrator of Saint Joseph’s Manor, in an interview Thursday.

If ever there was a story to make all of Maine shudder, it was last month’s revelation that a dying patient at Saint Joseph’s Manor on Washington Avenue in Portland was found infested with hundreds of maggots early on Aug. 8.

For the 121-bed nursing home, it was (and still is) a public relations nightmare of the highest order.

For anyone with a loved one in or en route to a nursing home, it should be nothing short of a wake-up call.

The Saint Joseph’s crisis erupted when four unnamed people, presumably upset staffers at the nursing home, called the Maine Department of Health and Human Services’ division of Licensing and Regulatory Services on Aug. 9 to report the discovery of maggots throughout the bedridden patient’s groin area.

Soon thereafter, the DHHS slapped Saint Joseph’s with a dreaded “J-tag” — industry speak for a finding that a patient has been put in “immediate jeopardy” by neglect on the part of his or her caregivers.

Last week, the state followed up with a “statement of deficiencies” against Saint Joseph’s. It asserts, among other shortcomings, that the nursing home took four days to adequately treat the patient, who has since died of causes unrelated to the maggots.

In yet another finely crafted statement of the obvious, the DHHS report said, “The facility’s failure to prevent neglect by not treating this dying resident for the elimination of ‘maggots’ resulted in an environment that did not enhance the dying resident’s quality of life.”

The story is far from over. On Sept. 9, Hamlin and other Saint Joseph’s officials will meet with the DHHS for an informal dispute resolution, at which they will challenge the state’s finding that their patient’s infestation went untreated for four days.

“That was not the case,” Hamlin said. “This was discovered and rectified immediately.”

The appeal will center not on whether Saint Joseph’s did anything about the problem — the record already is clear that the staff washed the man (and everything else in sight) repeatedly with soap and water until finally, after 37½ hours, the maggots disappeared for good.

Rather, Saint Joseph’s will challenge the state’s claim that soap and water were not the appropriate strategy. Citing “current literature,” the DHHS maintains the treatment should have included “an application of lice shampoo, lice bedding spray or hair spray.”

In short, it’s too soon to tell whether this is the horror story we all thought it was when it broke on the 6 o’clock news, or if it’s an unfortunate chain of events (dying patient, hot and humid conditions, one or more fertile house flies in the wrong place at the wrong time) made infinitely worse by what Hamlin calls the “sensationalism” it spawned among some media outlets.

Either way, who hasn’t looked at what happened at Saint Joseph’s and wondered, “Is there some sort of road map to tell us what to look for when choosing a nursing home for grandma or grandpa, mom or dad, or (gulp) ourselves?”

Fortunately, there is.

Go to and you’ll find a state-by-state ranking of every licensed nursing home in the country.

Follow the prompts to Maine and you’ll get a complete list of licensed nursing homes from Kittery to Fort Kent, complete with a five-star ranking system that separates the “much above average” (five stars) from the “average” (three stars) to the “much below average” (one star).

Of the 109 licensed nursing homes throughout Maine, 22 boast five-star ratings, 34 have four stars, 27 have three stars, 21 have two stars and five are stuck with just one star.

The ranking system, established by the federal Centers for Medicare and Medicaid Services in 2008, doesn’t stop there.

Beside the overall rankings, you’ll find individual scores for each facility’s regular health inspections (done every nine to 15 months in Maine), its self-reported staffing levels, and a rating for “quality measures” reflecting the actual care each patient receives.

“This is a resource that every person who places anyone in a nursing home can look at,” said John Martins, spokesman for the DHHS. “If it were me, I’d be looking for a facility that has four or five stars.”

Which brings us back to Saint Joseph’s Manor.

It has an overall “below average” rating of two stars. Its health-inspections score is a paltry one star, while its staffing and quality-measures scores come in respectively at four stars and two stars.

In other words, maggots or no maggots, there’s plenty of room for improvement.

“I certainly have to respect that rating at this point in time,” conceded Hamlin, noting that he and director of nursing Danielle Sullivan have come aboard within the past year (when the overall rating was one star) and “hope to do more” to improve the Saint Joseph’s score in the coming months.

Still, Hamlin insisted, visitors to Saint Joseph’s today will quickly see that the rankings don’t tell the whole story.

While a few families have called to express concern, he said, he and his staff have received a “tremendous outpouring of support” from patients and their families.

“It’s clean. It’s nice,” he said. “The residents have a good life here.”

Maybe they should make that a policy.

Columnist Bill Nemitz can be contacted at 791-6323 or at:

[email protected]