GREENBRIER NURSING AND REHABILITATION CENTER
Address
3526 W ERWIN ST
TYLER, TX 75702
(903) 593-6441
Nursing Home Ratings
| Health Inspections | |
| Quality Measures | |
| Nursing Staff | |
| R.N. Staff Only | |
| Overall Rating | |
Percent of Beds Occupied
58%Number of Residents and Certified Beds
- Residents: 70
- Certified Beds: 120
This Facility Accepts
- Medicare
- Medicaid
Operational Details
- Operated By For Profit - Corporation
- Offers Both Resident and Family Counseling Services
- This Facility is Part of a Chain or Franchise
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 "Very 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 Greenbrier Nursing 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
- At least one rehabilitation discipline five days/week
- A second rehabilitation discipline three days/week
| ADL Index Range: 11-16 | 4.0% |
| ADL Index Range: 6-10 | 8.1% |
| ADL Index Range: 0-5 | 9.4% |
| Total Percent: | 21.5% |
Very High Rehabilitation
- At least one rehabilitation discipline five days/week
| ADL Index Range: 11-16 | 5.4% |
| ADL Index Range: 6-10 | 22.8% |
| ADL Index Range: 0-5 | 8.0% |
| Total Percent: | 36.3% |
High Rehabilitation
- At least one rehabilitation discipline five days/week
| ADL Index Range: 11-16 | 1.1% |
| ADL Index Range: 6-10 | 4.2% |
| ADL Index Range: 0-5 | 5.7% |
| Total Percent: | 11.0% |
Medium Rehabilitation
- Five days any combination of three rehabilitation disciplines
| ADL Index Range: 6-10 | 8.4% |
| ADL Index Range: 0-5 | 6.5% |
| Total Percent: | 14.9% |
Clinically Complex
- Pneumonia, hemiplegia with ADL score >=5
- Surgical wounds or open lesions with treatment
- Burns
- Chemotherapy while a resident
- Oxygen therapy while a resident
- IV medications or transfusions while a resident
- Extensive Services, Special Care High or Special Care Low qualifier and ADL score of 0 or 1
| ADL Index Range: 11-14 - No Signs of depression | 1.9% |
| ADL Index Range: 6-10 - No Signs of depression | 1.3% |
| Total Percent: | 3.2% |
Behavioral Symptoms and Cognitive Performance
- Cognitive impairment BIMS score less than or equal to 9
- CPS great than or equal to 3
- Hallucinations or delusions
- Physical or verbal behavioral symptoms toward others
- Other behavioral symptoms
- Rejection of care or wandering
- Activities of Daily Living (ADL) score of 5 or less
| ADL Index Range: 0-1 - Less restorative nursing | 1.3% |
| Total Percent: | 1.3% |
Reduced Physical Function
- Urinary and/or bowel training program
- Passive and/or active range of motion (ROM)
- Amputation/prosthesis training
- Dressing or grooming training
- Eating or swallowing training
- Transfer training
- Splint or brace assistance
- Bed mobility and/or walking training
- Communication training
| ADL Index Range: 6-10 - Two or more restorative nursing on 6+ days/wk | 1.3% |
| ADL Index Range: 6-10 - Less restorative nursing | 6.5% |
| ADL Index Range: 0-1 - Less restorative nursing | 4.0% |
| Total Percent: | 11.8% |
Rating Details For Greenbrier Nursing 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 8 Minutes |
| Licensed Practical/Vocational Nurse (LPN/LVN) Hours | 41 Minutes | 40 Minutes |
| Certified Nursing Assistant (CNA) Hours | 2 Hours and 38 Minutes | 2 Hours and 18 Minutes |
| Total Licensed Nurse Hours | 1 Hour and 17 Minutes | 1 Hour and 48 Minutes |
| Total Nurse Hours | 3 Hours and 55 Minutes | 4 Hours and 6 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 | 87% | 88% |
| Percent of Long-Stay Residents Given Influenza Vaccination During the Flu Season | 89% | 91% |
Long-Term Stay Deficiencies
| Percent of Long-Stay Residents Who Lose Too Much Weight | 12% | 6% |
| Percent of Long-Stay Residents Who Were Physically Restrained | - | 4% |
| Percent of Long-Stay Residents Who Have Moderate to Severe Pain | 13% | 4% |
| Percent of Long-Stay Residents Whose Ability to Move About in and Around Their Room Got Worse | 7% | 12% |
| Percent of Low-Risk Long-Stay Residents Who Have Pressure Sores | 1% | 3% |
| Percent of Long-Stay Residents Who Have/Had a Catheter Inserted and Left in Their Bladder | 3% | 5% |
| Percent of Long-Stay Residents Who Spend Most of Their Time in Bed or in a Chair | 10% | 6% |
| Percent of Long-Stay Residents Whose Need for Help with Daily Activities Has Increased | 21% | 18% |
| Percent of Long-Stay Residents Who Are More Depressed or Anxious | 5% | 13% |
| Percent of Low-Risk Long-Stay Residents Who Lose Control of Their Bowels or Bladder | 50% | 46% |
| Percent of Long-Stay Residents Who Had a Urinary Tract Infection | 15% | 9% |
| Percent of High-Risk Long-Stay Residents Who Have Pressure Sores | 15% | 12% |
Short-Term Stay Preventive Actions
| Percent of Short-Stay Residents Who Were Assessed and Given Pneumococcal Vaccination | 86% | 79% |
| Percent of Short-Stay Residents Given Influenza Vaccination During the Flu Season | 71% | 84% |
Short-Term Stay Deficiencies
| Percent of Short-Stay Residents Who Have Delirium | - | 3% |
| Percent of Short-Stay Residents Who Have Pressure Sores | 6% | 11% |
| Percent of Short-Stay Residents Who Had Moderate to Severe Pain | 18% | 16% |
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 01/06/2011.
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
Quickly Tell the Resident's Doctor the Results of Lab Tests.
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Environmental
Provide Bedrooms That Don't Allow Residents to See Each Other when Privacy is Needed.
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Have a Program to Keep Infection from Spreading.
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Make Sure That the Nursing Home Area is Safe, Easy to Use, Clean and Comfortable.
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Pharmacy Service
Keep the Rate of Medication Errors (Wrong Drug, Wrong Dose, Wrong Time) to Less Than 5%.
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Keep the Rate of Medication Errors (Wrong Drug, Wrong Dose, Wrong Time) to Less Than 5%.
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Have Drugs and Other Similar Products Available, Which Are Needed Every Day and in Emergencies, and Give Them out Properly.
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Keep the Rate of Medication Errors (Wrong Drug, Wrong Dose, Wrong Time) to Less Than 5%.
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Quality Care
Give Residents Proper Treatment to Prevent New Bed (Pressure) Sores or Heal Existing Bed Sores.
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Resident Assessment
Make a Complete Assessment That Covers All Questions for Areas That Are Listed in Official Regulations.
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Develop a Complete Care Plan That Meets All of a Resident's Needs, with Timetables and Actions That Can Be Measured.
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Resident Rights
Send and Promptly Deliver Unopened Mail to Residents.
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Let Residents Give Themselves Their Drugs if They Are Able.
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Provide Care in a Way That Keeps or Builds Each Resident's Dignity and Self Respect.
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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) | 12/04/2009 | $2,275 |
| Civil Money Penalty (CMP) | 02/11/2010 | $4,940 |
| Denial of Payment for New Admission (DPNA) | 02/11/2010 | - |
Deficiencies from Complaints and Incidents
The table below lists incident reports by the nursing staff or administration for Greenbrier Nursing 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 |
Pharmacy Service
Have Drugs and Other Similar Products Available, Which Are Needed Every Day and in Emergencies, and Give Them out Properly.
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1) Make Sure That Residents Who Take Drugs Are Not Given Too Many Doses or for Too Long; 2) Make Sure That the Use of Drugs is Carefully Watched; or 3) Stop or Change Drugs That Cause Unwanted Effects.
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Quality Care
Give Each Resident Enough Fluids to Keep Them Healthy and Prevent Dehydration.
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Give the Right Treatment and Services to Residents Who Have Mental or Social Problems Adjusting.
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Make Sure That Each Resident's Nutritional Needs Were Met.
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Fire Safety
Nursing homes certified by Medicare and/or Medicaid are required to have fire safety inspections to meet Life Safety Code (LSC) standards. Below is a list of deficiencies that Greenbrier Nursing and Rehabilitation Center had in recent fire safety inspections. This information can be used to see if all standards were met, the degree of harm, the number of residents affected, and the date when deficiencies were corrected. Note: The most recent fire safety survey was on 01/04/2011.
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 |
Automatic Sprinkler Systems
An Approved Automatic Sprinkler System Connected to the Fire Alarm System.
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Automatic Sprinkler Systems That Have Been Maintained in Working Order.
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An Approved Automatic Sprinkler System Connected to the Fire Alarm System.
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Building Service Equipment
Heating and Ventilation Systems That Have Been Properly Installed According to the Manufacturer's Instructions.
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Electrical
Weekly Inspections and Monthly Testing of Generators.
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A Separate and Independent Backup Electrical Power Source.
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Weekly Inspections and Monthly Testing of Generators.
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Properly Installed Electrical Wiring and Equipment.
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Exits and Egress
Exits That Are Accessible at All Times.
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Exits That Are Accessible at All Times.
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Exits That Are Accessible at All Times.
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Hazardous Area
Construction That Can Resist Fire for One Hour or an Approved Fire Extinguishing System.
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Construction That Can Resist Fire for One Hour or an Approved Fire Extinguishing System.
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Construction That Can Resist Fire for One Hour or an Approved Fire Extinguishing System.
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Smoke Compartmentation and Control
Walls or Barriers That Prevent Smoke from Passing Through and Would Resist Fire for at Least One Hour.
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Smoking Regulations
Posted "No-Smoking" Signs in Areas Where Smoking is Not Permitted or Did Not Provide Ashtrays Where Smoking Was Allowed.
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