GRANGER NURSING & REHABILITATION CENTER

The information listed below provides an in-depth look into the type and quality of care offered at Granger Nursing & 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

GRANGER NURSING & REHABILITATION CENTER
2001 KENNEDY STREET
GRANGER, IA 50109
(515) 999-2588

Nursing Home Ratings

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

Overall Rating

Percent of Beds Occupied

75%

Number of Residents and Certified Beds

Residents: 50
Certified Beds: 67

This Facility Accepts

Medicare
Medicaid

Operational Details

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

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Nearby Cities:

Polk City | Madrid | Dallas Center

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 "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 Granger Nursing & 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

High Rehabilitation Plus Extensive Services

Rehabilitation 325 Minutes Per Week Minimum

At least one rehabilitation discipline five days/week
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: 2-10	2.9%
Total Percent:	2.9%

Medium Rehabilitation Plus Extensive Services

Rehabilitation 150 Minutes Per Week Minimum

Five days any combination of three rehabilitation disciplines
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: 2-10	3.1%
Total Percent:	3.1%

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: 6-10	2.5%
Total Percent:	2.5%

Very High Rehabilitation

Rehabilitation 500 Minutes Per Week Minimum

At least one rehabilitation discipline five days/week

ADL Index Range: 11-16	1.7%
ADL Index Range: 6-10	3.1%
ADL Index Range: 0-5	0.4%
Total Percent:	5.2%

High Rehabilitation

Rehabilitation 325 Minutes Per Week Minimum

At least one rehabilitation discipline five days/week

ADL Index Range: 11-16	17.9%
ADL Index Range: 6-10	10.2%
ADL Index Range: 0-5	6.5%
Total Percent:	34.5%

Medium Rehabilitation

Rehabilitation 150 Minutes Per Week Minimum

Five days any combination of three rehabilitation disciplines

ADL Index Range: 11-16	5.8%
ADL Index Range: 6-10	10.9%
ADL Index Range: 0-5	5.0%
Total Percent:	21.7%

Low Rehabilitation

Rehabilitation 45 Minutes Per Week Minimum

Three days any combination of three rehabilitation disciplines
Two services of restorative nursing six days per week

ADL Index Range: 0-10	5.8%
Total Percent:	5.8%

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	2.5%
ADL Index Range: 2-16 - Isolation for active infectious disease	2.7%
Total Percent:	5.2%

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: 2-5 - No Signs of depression	4.2%
Total Percent:	4.2%

Special Care Low

Cerebral palsy, multiple sclerosis, or Parkinson's disease with ADL score greater or equal to 5
Respiratory failure and oxygen therapy while a resident
Feeding tube where calories >= 51% or calories are in the range of 26-50% and fluid >= 501 mL)
Ulcers: 2 or more stage II or 1 or more stage III or IV pressure ulcers
Ulcers: 2 or more venous or arterial ulcers
Ulcers: 1 stage II pressure ulcer and 1 venous or arterial ulcer with 2 or more skin care treatments
Foot infection/diabetic foot ulcer/open lesions of foot with treatment
Radiation therapy while a resident
Dialysis while a resident
Activities of Daily Living (ADL) score of 2 or more

ADL Index Range: 11-14 - Signs of depression	0.8%
ADL Index Range: 6-10 - No Signs of depression	1.2%
Total Percent:	1.9%

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 - Signs of depression	5.8%
ADL Index Range: 6-10 - No Signs of depression	0.6%
ADL Index Range: 2-5 - Signs of depression	3.6%
ADL Index Range: 2-5 - No Signs of depression	3.1%
Total Percent:	13.1%

Rating Details For Granger Nursing & 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	45 Minutes	1 Hour
Licensed Practical/Vocational Nurse (LPN/LVN) Hours	34 Minutes	44 Minutes
Certified Nursing Assistant (CNA) Hours	2 Hours and 1 Minutes	2 Hours and 30 Minutes
Total Licensed Nurse Hours	1 Hour and 19 Minutes	1 Hour and 44 Minutes
Total Nurse Hours	3 Hours and 20 Minutes	4 Hours and 14 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 Iowa are also provided for comparison purposes. Note: Figures below are averaged over the past nine months.

This Facility

Iowa Average

Long-Term Stay Preventive Actions

Percent of Long-Stay Residents Given Influenza Vaccination During the Flu Season	90-100%	93%
Percent of Long-Stay Residents Who Were Assessed and Given Pneumococcal Vaccination	90-100%	94%

Long-Term Stay Deficiencies

Percent of Long-Stay Residents Who Have Moderate to Severe Pain	1%	4%
Percent of Long-Stay Residents Who Had a Urinary Tract Infection	8%	9%
Percent of Long-Stay Residents Who Lose Too Much Weight	3%	6%
Percent of Long-Stay Residents Whose Need for Help with Daily Activities Has Increased	11%	13%
Percent of Long-Stay Residents Who Have/Had a Catheter Inserted and Left in Their Bladder	6%	6%
Percent of Long-Stay Residents Who Spend Most of Their Time in Bed or in a Chair	2%	2%
Percent of High-Risk Long-Stay Residents Who Have Pressure Sores	6%	8%
Percent of Long-Stay Residents Whose Ability to Move About in and Around Their Room Got Worse	1%	10%
Percent of Low-Risk Long-Stay Residents Who Have Pressure Sores	2%	3%
Percent of Low-Risk Long-Stay Residents Who Lose Control of Their Bowels or Bladder	30%	44%
Percent of Long-Stay Residents Who Were Physically Restrained	2%	4%
Percent of Long-Stay Residents Who Are More Depressed or Anxious	19%	16%

Short-Term Stay Preventive Actions

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

Short-Term Stay Deficiencies

Percent of Short-Stay Residents Who Have Delirium	1%	5%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain	-	23%
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 04/14/2011.

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

Post Nurse Staffing Information.

Inspection Date: 04/29/2010
Correction Date: 05/29/2010

Environmental

Keep Safe, Clean and Homelike Surroundings. Inspection Date: 04/29/2010 Correction Date: 05/29/2010
Provide Needed Housekeeping and Maintenance. Inspection Date: 04/29/2010 Correction Date: 05/29/2010
Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents. Inspection Date: 04/29/2010 Correction Date: 05/29/2010
Make Sure That the Nursing Home Area is Safe, Easy to Use, Clean and Comfortable. Inspection Date: 04/29/2010 Correction Date: 05/29/2010
Make Sure There is a Program to Prevent/Deal with Mice, Insects, or Other Pests. Inspection Date: 04/29/2010 Correction Date: 05/29/2010

Nutrition and Dietary

Store, Cook, and Give out Food in a Safe and Clean Way. Inspection Date: 10/20/2010 Correction Date: 11/19/2010
Hire Enough Skilled Workers to Carry out Dietary Service. Inspection Date: 04/14/2011 Correction Date: 04/29/2011
Make Sure That the Attending Doctor Orders Special Diets. Inspection Date: 04/14/2011 Correction Date: 04/29/2011

Pharmacy Service

Keep the Rate of Medication Errors (Wrong Drug, Wrong Dose, Wrong Time) to Less Than 5%. Inspection Date: 04/29/2010 Correction Date: 05/29/2010
Make Sure That Residents Are Safe from Serious Medication Errors. Inspection Date: 04/29/2010 Correction Date: 08/18/2010
Keep the Rate of Medication Errors (Wrong Drug, Wrong Dose, Wrong Time) to Less Than 5%. Inspection Date: 10/20/2010 Correction Date: 11/19/2010
Properly Mark Drugs and Other Similar Products. Inspection Date: 04/14/2011 Correction Date: 04/29/2011

Quality Care

Give Professional Services That Follow Each Resident's Written Care Plan. Inspection Date: 04/29/2010 Correction Date: 05/29/2010
Make Sure That Each Resident Who Enters the Nursing Home Without a Catheter is Not Given a Catheter, Unless It is Necessary. Inspection Date: 04/29/2010 Correction Date: 05/29/2010
Make Sure That Each Resident's Nutritional Needs Were Met. Inspection Date: 04/29/2010 Correction Date: 01/01/1900
Give Professional Services That Follow Each Resident's Written Care Plan. Inspection Date: 10/20/2010 Correction Date: 11/19/2010
Make Sure That Residents Who Cannot Care for Themselves Receive Help with Eating/Drinking, Grooming and Hygiene. Inspection Date: 10/20/2010 Correction Date: 11/19/2010
Give Proper Treatment to Residents with Feeding Tubes to Prevent Problems (Such As Aspiration Pneumonia, Diarrhea, Vomiting, Dehydration, Metabolic Abnormalities, Nasal-Pharyngeal Ulcers) and Help Restore Eating Skills, if Possible. Inspection Date: 10/20/2010 Correction Date: 11/19/2010
Properly Care for Residents Needing Special Services, Including: Injections, Colostomy, Ureostomy, Ileostomy, Tracheostomy Care, Tracheal Suctioning, Respiratory Care, Foot Care, and Prostheses. Inspection Date: 10/20/2010 Correction Date: 11/19/2010
Make Sure That Residents Who Cannot Care for Themselves Receive Help with Eating/Drinking, Grooming and Hygiene. Inspection Date: 04/14/2011 Correction Date: 04/29/2011
Give Proper Treatment to Residents with Feeding Tubes to Prevent Problems (Such As Aspiration Pneumonia, Diarrhea, Vomiting, Dehydration, Metabolic Abnormalities, Nasal-Pharyngeal Ulcers) and Help Restore Eating Skills, if Possible. Inspection Date: 04/14/2011 Correction Date: 04/29/2011

Resident Rights

Send and Promptly Deliver Unopened Mail to Residents.

Inspection Date: 04/29/2010
Correction Date: 05/29/2010

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)	08/05/2009	$1,268
Civil Money Penalty (CMP)	11/06/2008	$1,560
Civil Money Penalty (CMP)	04/29/2010	$4,713
Denial of Payment for New Admission (DPNA)	11/06/2008	-
Denial of Payment for New Admission (DPNA)	08/05/2009	-
Denial of Payment for New Admission (DPNA)	04/29/2010	-

Deficiencies from Complaints and Incidents

The table below lists incident reports by the nursing staff or administration for Granger Nursing & 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