DOWNTOWN HEALTH AND REHABILITATION CENTER

The information listed below provides an in-depth look into the type and quality of care offered at Downtown Health and Rehabilitation Center. It is important to note that when evaluating if a nursing home is right for you or a loved one, ratings should not be taken as the sole deciding factor, but as one of many aspects to be considered.

Address

DOWNTOWN HEALTH AND REHABILITATION CENTER
424 S ADAMS ST
FORT WORTH, TX 76104
(817) 335-5781

Nursing Home Ratings

Health Inspections
Quality Measures
Nursing Staff
R.N. Staff Only

Overall Rating

Percent of Beds Occupied

49%

Number of Residents and Certified Beds

Residents: 79
Certified Beds: 161

This Facility Accepts

Medicare
Medicaid

Operational Details

Operated By For Profit - Corporation
Offers Only Resident Counseling
This Facility is Part of a Chain or Franchise

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Nearby Cities:

White Settlement | Richland Hills | Lake Worth

Resident Services

The information below lists services this facility has provided for residents from October through December 2010. During this period, the most common type of service provided was "Ultra-High Rehabilitation". To get a better idea of the types of services that are commonly performed, compare the "Percent of Service Days" column below. These services are based on submitted claims to Medicare and do not provide a complete overview of all the services provided by Downtown Health and Rehabilitation Center. For more information read our guide on how nursing facilities are reimbursed, types of services, and ADL index scores.

Resident Services

Resident Conditions

Percent of Service Days

Ultra-High Rehabilitation

Rehabilitation 720 Minutes Per Week Minimum

At least one rehabilitation discipline five days/week
A second rehabilitation discipline three days/week

ADL Index Range: 11-16	3.6%
ADL Index Range: 6-10	27.8%
ADL Index Range: 0-5	38.9%
Total Percent:	70.3%

Very High Rehabilitation

Rehabilitation 500 Minutes Per Week Minimum

At least one rehabilitation discipline five days/week

ADL Index Range: 11-16	9.9%
ADL Index Range: 6-10	2.5%
ADL Index Range: 0-5	9.9%
Total Percent:	22.2%

High Rehabilitation

Rehabilitation 325 Minutes Per Week Minimum

At least one rehabilitation discipline five days/week

ADL Index Range: 11-16	1.9%
ADL Index Range: 0-5	1.0%
Total Percent:	2.9%

Medium Rehabilitation

Rehabilitation 150 Minutes Per Week Minimum

Five days any combination of three rehabilitation disciplines

ADL Index Range: 0-5	3.9%
Total Percent:	3.9%

Extensive Services

Tracheostomy care
Ventilator or respirator
Isolation for active infectious disease while a resident
Activities of Daily Living (ADL) score of 2 or more

ADL Index Range: 2-16 - Tracheostomy care or ventilator/respirator	0.6%
Total Percent:	0.6%

Special Care High

Comatose
Septicemia
Diabetes with daily injections and a change of order two or more days
Quadriplegia with ADL score greater or equal to 5
Chronic Obstructive Pulmonary Disease (COPD) and shortness of breath when lying flat
Fever with pneumonia, or vomiting, or weight loss, or feeding tube
Parenteral/IV feedings
Respiratory therapy for 7 days
Activities of Daily Living (ADL) score of 2 or more

ADL Index Range: 6-10 - No Signs of depression	0.1%
Total Percent:	0.1%

Rating Details For Downtown Health and Rehabilitation Center

Nursing Staff -

The nursing staff is the most important part of what determines the quality of care and comfort of a resident in a nursing home. Government regulations set expectations on time spent with each resident based on the services being provided. The breakdown below lists the nursing types (RN, LPN, LVN, CNA) and a comparison of the reported and expected hours per resident per day.

Nursing Hours Per Resident Per Day	Reported	Expected
Registered Nurse (RN) Hours	35 Minutes	1 Hour and 11 Minutes
Licensed Practical/Vocational Nurse (LPN/LVN) Hours	1 Hour and 10 Minutes	40 Minutes
Certified Nursing Assistant (CNA) Hours	2 Hours and 13 Minutes	2 Hours and 14 Minutes
Total Licensed Nurse Hours	1 Hour and 45 Minutes	1 Hour and 51 Minutes
Total Nurse Hours	3 Hours and 58 Minutes	4 Hours and 5 Minutes

Quality of Care -

Medicare determines quality of care ratings for nursing facilities by surveying several "quality measures", which are broken down into long-term and short-term stay residents, as well as if the action is preventive or if there is a deficiency in the quality of care. State averages for Texas are also provided for comparison purposes. Note: Figures below are averaged over the past nine months.

This Facility

Texas Average

Long-Term Stay Preventive Actions

Percent of Long-Stay Residents Who Were Assessed and Given Pneumococcal Vaccination	90-100%	88%
Percent of Long-Stay Residents Given Influenza Vaccination During the Flu Season	90-100%	91%

Long-Term Stay Deficiencies

Percent of Long-Stay Residents Who Have Moderate to Severe Pain	3%	4%
Percent of Long-Stay Residents Who Are More Depressed or Anxious	16%	13%
Percent of Low-Risk Long-Stay Residents Who Have Pressure Sores	-	3%
Percent of Low-Risk Long-Stay Residents Who Lose Control of Their Bowels or Bladder	42%	46%
Percent of Long-Stay Residents Whose Ability to Move About in and Around Their Room Got Worse	15%	12%
Percent of High-Risk Long-Stay Residents Who Have Pressure Sores	6%	12%
Percent of Long-Stay Residents Whose Need for Help with Daily Activities Has Increased	16%	18%
Percent of Long-Stay Residents Who Had a Urinary Tract Infection	2%	9%
Percent of Long-Stay Residents Who Have/Had a Catheter Inserted and Left in Their Bladder	5%	5%
Percent of Long-Stay Residents Who Were Physically Restrained	-	4%
Percent of Long-Stay Residents Who Spend Most of Their Time in Bed or in a Chair	7%	6%
Percent of Long-Stay Residents Who Lose Too Much Weight	1%	6%

Short-Term Stay Preventive Actions

Percent of Short-Stay Residents Who Were Assessed and Given Pneumococcal Vaccination	90-100%	79%
Percent of Short-Stay Residents Given Influenza Vaccination During the Flu Season	90-100%	84%

Short-Term Stay Deficiencies

Percent of Short-Stay Residents Who Have Delirium	-	3%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain	16%	16%
Percent of Short-Stay Residents Who Have Pressure Sores	12%	11%

Health Inspection Details -

All Medicare and/or Medicaid certified nursing home must undergo health inspections on average once a year, but may be more frequent if the facility is peforming poorly. These inspections cover most aspects of life in a nursing home, and are broken down into deficiencies types, which including: Pharmacy Service, Administration, Resident Rights, Nutrition and Dietary, Resident Assessment, Environmental, and Mistreatment. Below are the list of deficiencies found by inspectors in the past few years along with the degree of harm and how many residents may have been affected. Note: The most recent health survey was on 10/22/2010.

Degree of Harm

- Potential for Minimal Harm
- Minimal Harm or Potential for Harm
- Resident Harmed
- Immediate Jeopardy to Resident Health

Residents Affected

- Isolated
- Some Residents
- Many Residents

Deficiencies Found By Inspectors

Degree of Harm

Residents Affected

Administration

1) Review the Work of Each Nurse Aide Every Year; or 2) Give Regular Training for the Nurse Aides. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
Make Sure That Nurse Aides Show They Have the Skills to Be Able to Care for Residents. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
Give or Get Lab Tests to Meet the Needs of Residents. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
Keep Accurate and Appropriate Medical Records. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
Set Up or Keep a Group of People to Review and Ensure Quality. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
Make Sure That Nurse Aides Show They Have the Skills to Be Able to Care for Residents. Inspection Date: 09/25/2009 Correction Date: 11/05/2009
Keep Accurate and Appropriate Medical Records. Inspection Date: 09/25/2009 Correction Date: 11/05/2009
Make Sure That Nurse Aides Show They Have the Skills to Be Able to Care for Residents. Inspection Date: 10/22/2010 Correction Date: 12/31/2010
Keep Accurate and Appropriate Medical Records. Inspection Date: 10/22/2010 Correction Date: 12/31/2010

Environmental

Provide Needed Housekeeping and Maintenance. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
Have a Program to Keep Infection from Spreading. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
Keep All Essential Equipment Working Safely. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
Make Sure There is a Program to Prevent/Deal with Mice, Insects, or Other Pests. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
Keep Safe, Clean and Homelike Surroundings. Inspection Date: 09/25/2009 Correction Date: 11/05/2009
Provide Needed Housekeeping and Maintenance. Inspection Date: 09/25/2009 Correction Date: 11/05/2009
Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents. Inspection Date: 10/22/2010 Correction Date: 12/31/2010
Have a Program to Keep Infection from Spreading. Inspection Date: 10/22/2010 Correction Date: 12/31/2010

Mistreatment

Protect Each Resident from All Abuse, Physical Punishment, and Being Separated from Others. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
1) Hire Only People Who Have No Legal History of Abusing, Neglecting or Mistreating Residents; or 2) Report and Investigate Any Acts or Reports of Abuse, Neglect or Mistreatment of Residents. Inspection Date: 10/22/2010 Correction Date: 12/31/2010
Write and Use Policies That Forbid Mistreatment, Neglect and Abuse of Residents and Theft of Residents' Property. Inspection Date: 10/22/2010 Correction Date: 12/31/2010

Nutrition and Dietary

Store, Cook, and Give out Food in a Safe and Clean Way. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
Prepare Food That is Nutritional, Appetizing, Tasty, Attractive, Well-Cooked, and at the Right Temperature. Inspection Date: 09/25/2009 Correction Date: 11/05/2009
Provide Food in a Way That Meets a Resident's Needs. Inspection Date: 09/25/2009 Correction Date: 11/05/2009
Store, Cook, and Give out Food in a Safe and Clean Way. Inspection Date: 09/25/2009 Correction Date: 11/05/2009
Prepare Food That is Nutritional, Appetizing, Tasty, Attractive, Well-Cooked, and at the Right Temperature. Inspection Date: 10/22/2010 Correction Date: 12/31/2010
Store, Cook, and Give out Food in a Safe and Clean Way. Inspection Date: 10/22/2010 Correction Date: 12/31/2010

Pharmacy Service

Have Drugs and Other Similar Products Available, Which Are Needed Every Day and in Emergencies, and Give Them out Properly. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
Have Drugs and Other Similar Products Available, Which Are Needed Every Day and in Emergencies, and Give Them out Properly. Inspection Date: 10/22/2010 Correction Date: 12/31/2010

Quality Care

Provide Activities to Meet the Needs of Each Resident. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
Provide Social Services for Related Medical Problems to Help Each Resident Achieve the Highest Possible Quality of Life. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
Give Professional Services That Follow Each Resident's Written Care Plan. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
Make Sure That Each Resident's Nutritional Needs Were Met. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
Use a Registered Nurse at Least 8 Hours a Day, 7 Days a Week. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
Provide Social Services for Related Medical Problems to Help Each Resident Achieve the Highest Possible Quality of Life. Inspection Date: 09/25/2009 Correction Date: 11/05/2009
Make Sure That Residents Who Cannot Care for Themselves Receive Help with Eating/Drinking, Grooming and Hygiene. Inspection Date: 09/25/2009 Correction Date: 11/05/2009
Provide Activities to Meet the Needs of Each Resident. Inspection Date: 10/22/2010 Correction Date: 12/31/2010
Give Each Resident Care and Services to Get or Keep the Highest Quality of Life Possible. Inspection Date: 10/22/2010 Correction Date: 12/31/2010
Make Sure That Residents Who Cannot Care for Themselves Receive Help with Eating/Drinking, Grooming and Hygiene. Inspection Date: 10/22/2010 Correction Date: 12/31/2010

Resident Assessment

Make Sure All Assessments Are Accurate, Coordinated by an Rn, Done by the Right Professional, and Are Signed by the Person Completing Them. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
1) Develop a Complete Care Plan Within 7 Days of Each Resident's Admission; 2) Prepare a Care Plan with the Care Team, Including the Primary Nurse, Doctor, Resident or Resident's Family or Representative; or 3) Check and Update the Care Plan. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
Keep Assessments Completed in the Preceding 15 Months in the Resident's Active Record. Inspection Date: 10/30/2008 Correction Date: 12/13/2008

Resident Rights

Tell Each Resident Who Can Get Medicaid Benefits About 1) Which Items and Services Medicaid Covers and Which the Resident Must Pay For; or 2) How to Apply for Medicaid, Along with the Names and Addresses of State Groups That Can Help. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
Keep Each Resident's Personal and Medical Records Private and Confidential. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
Make Sure That Private Space is Available in the Nursing Home for Resident Groups or Residents' Families to Meet. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
Listen to the Resident or Family Groups or Act on Their Complaints or Suggestions. Inspection Date: 10/30/2008 Correction Date: 12/13/2008
Provide Care in a Way That Keeps or Builds Each Resident's Dignity and Self Respect. Inspection Date: 10/22/2010 Correction Date: 12/31/2010

Enforcement

Below is a list of any civil penalities or denials of payment for new admissions (DPNA) that this facility received in the previous three years. Note: Monetary figures are not available for DPNAs.

Action Taken	Date	Amount
Civil Money Penalty (CMP)	02/11/2011	$4,000
Civil Money Penalty (CMP)	02/11/2011	$6,000
Civil Money Penalty (CMP)	02/10/2009	$9,815
Civil Money Penalty (CMP)	02/10/2009	$106,080
Denial of Payment for New Admission (DPNA)	02/10/2009	-

Deficiencies from Complaints and Incidents

The table below lists incident reports by the nursing staff or administration for Downtown Health and Rehabilitation Center, as well as complaints by residents or their family in the previous three years.

Degree of Harm

- Potential for Minimal Harm
- Minimal Harm or Potential for Harm
- Resident Harmed
- Immediate Jeopardy to Resident Health

Residents Affected

- Isolated
- Some Residents
- Many Residents

Formal Complaints

Degree of Harm

Residents Affected