HOLT SENIOR CARE AND REHAB CENTER, LLC

The information listed below provides an in-depth look into the type and quality of care offered at Holt Senior Care and Rehab Center, LLC. 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

HOLT SENIOR CARE AND REHAB CENTER, LLC
5091 WILLOUGHBY ROAD
HOLT, MI 48842
(517) 694-2144

Nursing Home Ratings

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

Overall Rating

Percent of Beds Occupied

88%

Number of Residents and Certified Beds

Residents: 91
Certified Beds: 104

This Facility Accepts

Medicare
Medicaid

Operational Details

Operated By For Profit - Partnership
Offers Both Resident and Family Counseling Services
This Facility is Part of a Chain or Franchise

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Nearby Cities:

Lansing | Dimondale | East Lansing

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 Holt Senior Care and Rehab Center, LLC. 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	0.8%
ADL Index Range: 6-10	0.9%
ADL Index Range: 0-5	4.9%
Total Percent:	6.7%

Very High Rehabilitation

Rehabilitation 500 Minutes Per Week Minimum

At least one rehabilitation discipline five days/week

ADL Index Range: 11-16	4.1%
ADL Index Range: 6-10	11.2%
ADL Index Range: 0-5	31.5%
Total Percent:	46.8%

High Rehabilitation

Rehabilitation 325 Minutes Per Week Minimum

At least one rehabilitation discipline five days/week

ADL Index Range: 11-16	4.0%
ADL Index Range: 6-10	10.1%
ADL Index Range: 0-5	18.6%
Total Percent:	32.7%

Medium Rehabilitation

Rehabilitation 150 Minutes Per Week Minimum

Five days any combination of three rehabilitation disciplines

ADL Index Range: 11-16	2.9%
ADL Index Range: 6-10	2.9%
ADL Index Range: 0-5	4.3%
Total Percent:	10.2%

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 - Signs of depression	0.5%
ADL Index Range: 2-5 - No Signs of depression	0.8%
Total Percent:	1.3%

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 - No Signs of depression	0.7%
Total Percent:	0.7%

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	0.3%
ADL Index Range: 0-1 - No Signs of depression	0.8%
Total Percent:	1.1%

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	0.6%
Total Percent:	0.6%

Rating Details For Holt Senior Care and Rehab Center, LLC

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	46 Minutes	1 Hour and 9 Minutes
Licensed Practical/Vocational Nurse (LPN/LVN) Hours	34 Minutes	38 Minutes
Certified Nursing Assistant (CNA) Hours	2 Hours and 7 Minutes	2 Hours and 24 Minutes
Total Licensed Nurse Hours	1 Hour and 20 Minutes	1 Hour and 47 Minutes
Total Nurse Hours	3 Hours and 26 Minutes	4 Hours and 11 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 Michigan are also provided for comparison purposes. Note: Figures below are averaged over the past nine months.

This Facility

Michigan Average

Long-Term Stay Preventive Actions

Percent of Long-Stay Residents Given Influenza Vaccination During the Flu Season	90-100%	89%
Percent of Long-Stay Residents Who Were Assessed and Given Pneumococcal Vaccination	90-100%	89%

Long-Term Stay Deficiencies

Percent of High-Risk Long-Stay Residents Who Have Pressure Sores	10%	10%
Percent of Long-Stay Residents Whose Ability to Move About in and Around Their Room Got Worse	7%	10%
Percent of Long-Stay Residents Who Had a Urinary Tract Infection	4%	9%
Percent of Long-Stay Residents Who Have/Had a Catheter Inserted and Left in Their Bladder	10%	5%
Percent of Long-Stay Residents Who Are More Depressed or Anxious	16%	13%
Percent of Long-Stay Residents Who Have Moderate to Severe Pain	1%	3%
Percent of Long-Stay Residents Whose Need for Help with Daily Activities Has Increased	8%	12%
Percent of Long-Stay Residents Who Spend Most of Their Time in Bed or in a Chair	-	4%
Percent of Low-Risk Long-Stay Residents Who Lose Control of Their Bowels or Bladder	61%	52%
Percent of Low-Risk Long-Stay Residents Who Have Pressure Sores	-	3%
Percent of Long-Stay Residents Who Were Physically Restrained	-	5%
Percent of Long-Stay Residents Who Lose Too Much Weight	3%	8%

Short-Term Stay Preventive Actions

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

Short-Term Stay Deficiencies

Percent of Short-Stay Residents Who Had Moderate to Severe Pain	10%	21%
Percent of Short-Stay Residents Who Have Delirium	9%	2%
Percent of Short-Stay Residents Who Have Pressure Sores	10%	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 12/10/2010.

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

Environmental

Provide Needed Housekeeping and Maintenance. Inspection Date: 01/14/2009 Correction Date: 02/10/2009
Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents. Inspection Date: 01/14/2009 Correction Date: 02/10/2009
Make Sure That a Working Call System is Available in Each Resident's Room or Bathroom and Bathing Area. Inspection Date: 01/14/2009 Correction Date: 02/10/2009
Have Enough Outside Airflow. Inspection Date: 01/14/2009 Correction Date: 02/10/2009
Provide Needed Housekeeping and Maintenance. Inspection Date: 11/25/2009 Correction Date: 12/31/2009
Make Sure That a Working Call System is Available in Each Resident's Room or Bathroom and Bathing Area. Inspection Date: 11/25/2009 Correction Date: 12/31/2009

Mistreatment

Write and Use Policies That Forbid Mistreatment, Neglect and Abuse of Residents and Theft of Residents' Property. Inspection Date: 01/14/2009 Correction Date: 02/10/2009
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: 12/10/2010 Correction Date: 01/14/2011
Write and Use Policies That Forbid Mistreatment, Neglect and Abuse of Residents and Theft of Residents' Property. Inspection Date: 12/10/2010 Correction Date: 01/14/2011

Nutrition and Dietary

Store, Cook, and Give out Food in a Safe and Clean Way.

Inspection Date: 11/25/2009
Correction Date: 12/31/2009

Pharmacy Service

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. Inspection Date: 01/14/2009 Correction Date: 02/10/2009
Keep the Rate of Medication Errors (Wrong Drug, Wrong Dose, Wrong Time) to Less Than 5%. Inspection Date: 01/14/2009 Correction Date: 02/10/2009
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. Inspection Date: 11/25/2009 Correction Date: 12/31/2009
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. Inspection Date: 12/10/2010 Correction Date: 01/14/2011

Quality Care

Give Each Resident Care and Services to Get or Keep the Highest Quality of Life Possible. Inspection Date: 01/14/2009 Correction Date: 02/10/2009
Use a Registered Nurse at Least 8 Hours a Day, 7 Days a Week. Inspection Date: 01/14/2009 Correction Date: 02/10/2009
Make Sure That Residents Receive Treatment/Services to Continue to Be Able to Care for Themselves, Unless a Change is Unavoidable. Inspection Date: 11/25/2009 Correction Date: 12/31/2009
Give Residents Proper Treatment to Prevent New Bed (Pressure) Sores or Heal Existing Bed Sores. Inspection Date: 11/25/2009 Correction Date: 12/31/2009
Make Sure That Each Resident Who Enters the Nursing Home Without a Catheter is Not Given a Catheter, Unless It is Necessary. Inspection Date: 11/25/2009 Correction Date: 12/31/2009
Give Each Resident Care and Services to Get or Keep the Highest Quality of Life Possible. Inspection Date: 12/10/2010 Correction Date: 01/14/2011

Resident Assessment

Provide a Final Summary of the Resident's Health Status and a Summary of the Resident's Stay, when the Resident is Ready to Leave the Nursing Home. Inspection Date: 01/14/2009 Correction Date: 02/10/2009
Develop a Plan with the Resident and Family for the Resident's Care After Leaving the Nursing Home. Inspection Date: 01/14/2009 Correction Date: 02/10/2009
Make Sure That Doctors Visit Residents Regularly, As Required. Inspection Date: 01/14/2009 Correction Date: 02/10/2009
Develop a Complete Care Plan That Meets All of a Resident's Needs, with Timetables and Actions That Can Be Measured. Inspection Date: 11/25/2009 Correction Date: 12/31/2009
Develop a Plan with the Resident and Family for the Resident's Care After Leaving the Nursing Home. Inspection Date: 11/25/2009 Correction Date: 12/31/2009

Resident Rights

Keep Each Resident's Personal and Medical Records Private and Confidential. Inspection Date: 01/14/2009 Correction Date: 02/10/2009
Give the Resident's Legal Representative the Same Rights As the Resident. Inspection Date: 11/25/2009 Correction Date: 12/31/2009
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: 12/10/2010 Correction Date: 01/14/2011

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)	11/25/2009	$975
Civil Money Penalty (CMP)	12/10/2010	$4,550

Deficiencies from Complaints and Incidents

The table below lists incident reports by the nursing staff or administration for Holt Senior Care and Rehab Center, LLC, 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