General Information: GREEN VALLEY HEALTHCARE AND REHABILITATION CENTER
Nursing home name GREEN VALLEY HEALTHCARE AND REHABILITATION CENTER
Address6850 RUFE SNOW DR
FORT WORTH, TX 76148
Phone number (817) 514-4940
Located within a hospital No
Type of ownership For profit - Partnership
Owner operates multiple homesYes
Accept Medicare or Medicaid Medicare and Medicaid
Continue Care Retirement CommunityNo
Resident and family councils Resident
Certified number of beds 90
Total number of residents 91
Perc of occupied beds 101
Sprinkler status Yes
Number of Facility Reported Incidents2
Number of Substantiated Complaints5
Number of Fines0
Total Amount of Fines$0
Total Number of Penalties0
Total Number of Penalties0
Ratings Summary: GREEN VALLEY HEALTHCARE AND REHABILITATION CENTER
Overall rating 3
3
Nursing Home Staffing 1
1
Registered Nurses only 1
1
Health Inspections 3
3
Quality Measures 5
5
Nursing Home Staffing Info: GREEN VALLEY HEALTHCARE AND REHABILITATION CENTER
National AverageTexas AverageGREEN VALLEY HEALTHCARE AND REHABILITATION CENTER
Overall staff rating NA NA 1
1
Registered Nurses only rating NANA 1
1
Total Number of Residents NA NA 91
Total Number of Nurse Staff Hours per Resident per Day 4.11 hours 3.79 hours 2.62 hours
Total Number of Licensed Nurse Staff Hours per Resident per Day 1.64 hours 1.49 hours 1.19 hours
Registered Nurses Hours per Residents per Day 0.81 hours 0.57 hours 0.31 hours
Licensed Practical or Vacation Nurses Hours per Resident per Day 0.83 hours 0.92 hours 0.88 hours
Certified Nursing Assistants Hours per Residents per Day 2.47 hours 2.3 hours 1.43 hours
Physical Therapy Staffing Hours per Resident Per Day 0.1 hours 0.08 hours 0.13 hours
Health Survey: GREEN VALLEY HEALTHCARE AND REHABILITATION CENTER
Heath Survey Summary on 2013-07-19
Total Number of Health Deficiencies 2
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Heath Survey Summary on 2012-06-27
Total Number of Health Deficiencies 1
Scope and Severity of most Severe Health Deficiency Isolated/Minimal harm or potential for actual harm
Heath Survey Summary on 2011-05-27
Total Number of Health Deficiencies 6
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Health Survey Details: GREEN VALLEY HEALTHCARE AND REHABILITATION CENTER
Inspection Results: 07/19/2013
Corrected Deficiency Scope and Severity
08/01/2013 Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%. Pattern/Minimal harm or potential for actual harm
08/01/2013 Make sure that nurse aides show they have the skills and techniques to be able to care for residents' needs. Pattern/Minimal harm or potential for actual harm
Inspection Results: 06/27/2012
Corrected Deficiency Scope and Severity
08/04/2012 Assess in a timely manner the resident when the resident enters the nursing home. Isolated/Minimal harm or potential for actual harm
Inspection Results: 05/27/2011
Corrected Deficiency Scope and Severity
07/08/2011 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. Isolated/Minimal harm or potential for actual harm
07/08/2011 Store, cook, and serve food in a safe and clean way. Widespread /Minimal harm or potential for actual harm
07/08/2011 Provide care for residents in a way that maintains or improves their dignity and respect in full recognition of their individuality. Isolated/Minimal harm or potential for actual harm
07/08/2011 Provide routine and emergency drugs through a licensed pharmacist and only under the general supervision of a licensed nurse. Pattern/Minimal harm or potential for actual harm
07/08/2011 Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. Widespread /Minimal harm or potential for actual harm
07/08/2011 Make sure that nurse aides show they have the skills and techniques to be able to care for residents' needs. Pattern/Minimal harm or potential for actual harm

Fire Safety Survey: GREEN VALLEY HEALTHCARE AND REHABILITATION CENTER
Fire Safety Survey Summary on 2013-07-17
Total Number of Fire SafetyDeficiencies 6
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2012-06-26
Total Number of Fire SafetyDeficiencies 5
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2011-05-25
Total Number of Fire SafetyDeficiencies 4
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Fire Safety Survey: GREEN VALLEY HEALTHCARE AND REHABILITATION CENTER
Fire Safety Survey Results: 07/17/2013
Corrected Deficiency Severity
08/21/2013 Corridor and hallway doors that block smoke. Widespread /Minimal harm or potential for actual harm
08/21/2013 Smoke barrier doors that can resist smoke for at least 20 minutes. Pattern/Minimal harm or potential for actual harm
08/21/2013 Special areas constructed so that walls can resist fire for one hour or an approved fire extinguishing system. Isolated/Minimal harm or potential for actual harm
08/21/2013 Exits that are accessible at all times. Isolated/Minimal harm or potential for actual harm
08/21/2013 Corridors or aisles that are unobstructed and are at least 8 feet in width. Widespread /Minimal harm or potential for actual harm
08/21/2013 Properly protected cooking facilities. Widespread/Potential for minimal harm
Fire Safety Survey Results: 06/26/2012
Corrected Deficiency Severity
08/04/2012 Walls that prevent smoke from passing through and would resist fire for at least one hour. Widespread/Potential for minimal harm
08/04/2012 Exits that are accessible at all times. Widespread /Minimal harm or potential for actual harm
08/04/2012 Corridor and hallway doors that block smoke. Pattern/Minimal harm or potential for actual harm
08/04/2012 Posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Widespread /Minimal harm or potential for actual harm
08/04/2012 Exits that are free from obstructions and can be used at all times. Widespread/Potential for minimal harm
Fire Safety Survey Results: 05/25/2011
Corrected Deficiency Severity
07/09/2011 Walls that prevent smoke from passing through and would resist fire for at least one hour. Pattern/Minimal harm or potential for actual harm
07/09/2011 Posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Widespread /Minimal harm or potential for actual harm
07/09/2011 Properly protected cooking facilities. Widespread/Potential for minimal harm
07/09/2011 No-smoking signs where oxygen is used. Pattern/Minimal harm or potential for actual harm

Resident Complaints: GREEN VALLEY HEALTHCARE AND REHABILITATION CENTER
Date Complaint Substantiated: 09/11/2013
CorrectedCategoryDeficiencySeverity
10/15/2013Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. E
10/15/2013Keep accurate, complete and organized clinical records on each resident that meet professional standards. E
Date Complaint Substantiated: 02/07/2013
CorrectedCategoryDeficiencySeverity
02/25/2013Provide care for residents in a way that maintains or improves their dignity and respect in full recognition of their individuality. D
Date Complaint Substantiated: 05/17/2012
CorrectedCategoryDeficiencySeverity
05/18/2012Provide necessary care and services to maintain or improve the highest well being of each resident . H
05/18/2012Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. H

Quality Measures: GREEN VALLEY HEALTHCARE AND REHABILITATION CENTER
Quality Measures National Average Texas Average GREEN VALLEY HEALTHCARE AND REHABILITATION CENTER
Overall quality rating NA NA 5
5
Long-Stay Residents
Percent of Long Stay Residents Whose Need for Help with ADLs has Increased 15.4% 19.2% 6.7%
Percent of Long Stay Residents Who Self Report Moderate to Severe Pain 8.3% 9.1% 0.4%
Percent of High Risk Long Stay Residents With Pressure Ulcers 6.1% 6.8% 7.5%
Percent of Long Stay Residents Who Lose Too Much Weight 7.2% 6.0% 5.1%
Percent of Low Risk Long Stay Residents Who Lose Control of Their Bowel or Bladder 43.9% 43.2% 29.1%
Percent of Long Stay Residents with a Catheter Inserted and Left in Their Bladder 3.2% 3.2% 4.6%
Percent of Long Stay Residents With a Urinary Tract Infection 6.2% 7.2% 7.6%
Percent of Long Stay Residents Who Have Depressive Symptoms 6.3% 8.1% 1.3%
Percent of Long Stay Residents Who Were Physically Restrained 1.4% 1.2% 0.0%
Percent of Long Stay Residents Experiencing One or More Falls with Major Injury 3.2% 3.5% 4.2%
Percent of Long Stay Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine 92.7% 90.4% 61.7%
Percent of Long Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 94.3% 89.7% 73.1%
Percent of Long Stay Residents Who Received an Antipsychotic Medication 20.7% 27.1% 27.0%
Short-Stay Residents
Percent of Short Stay Residents Who Self Report Moderate to Severe Pain 19.2% 18.8% 3.7%
Percent of Short Stay Residents With Pressure Ulcers That Are New or Worsened 1.2% 1.2% 0.6%
Percent of Short Stay Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine 83.4% 74.3% 21.7%
Percent of Short Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 82.4% 73.2% 26.0%
Percent of Short Stay Residents Who Newly Received an Antipsychotic Medication 2.6% 3.6% 3.4%

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