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Elgin Nursing And Rehabilitation Center

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About Elgin Nursing And Rehabilitation Center

General Information

Legal Business NameSmithville Hospital Authority
Ownership TypeGovernment - Hospital District
Changed Ownership In The Last 12 MonthsYes
First Accepted MedicareFebruary 14, 2008 (9 years)
Capacity120
Residents101
Percent Occupied84%
Program ParticipationMedicare And Medicaid
Resident And Family CouncilsResident
In HospitalNo
Continuing Care Retirement CommunityNo
Special Focus FacilityNo
Auto Sprinkler System In Required AreasYes

Ratings for Elgin Nursing And Rehabilitation Center

Elgin Nursing And Rehabilitation Center
was reviewed by Medicare to have a rating of 1 out of 5. About Medicare Ratings
Overall Rating
Health Inspections Rating
Quality Measures Rating
Staff Rating
RN Staff Rating

Overall Ratings of Texas Nursing Homes

Fines, Complaints, and Inspection Problems in the Past 3 Years

Note that this facility has changed ownership within the past 12 months.

Compare The Number of Problems

Types of Problems at Nursing Homes

Some issues within a nursing home are much more severe than others. Medicare evaluates each problem based on 2 scales: the number of residents affected by a problem and the severity of the potential or actual harm to residents based on the problem. We have color coded the matrix below to make it easier to pick out the more severe problems. In general, orange and red issues related to the treatment of a resident are considered substandard quality of care.

  Residents Affected
Severity of the Deficiency Few Some Many
Immediate jeopardy to resident health or safety J K L
Actual harm that is not immediate jeopardy G H I
No actual harm with potential for more than minimal harm that is not immediate jeopardy D E F
No actual harm with potential for minimal harm A B C

August 28, 2015 - 16 months ago

 Residents AffectedSeveritySource/TypeDescription
FManyPotential for HarmHealth InspectionStore, cook, and serve food in a safe and clean way.
ESomePotential for HarmHealth InspectionMaintain drug records and properly mark/label drugs and other similar products according to accepted professional standards.
ESomePotential for HarmComplaint+InspectionGive the right treatment and services to residents who display physical or psychosocial problems adapting to changes in circumstances.
ESomePotential for HarmHealth InspectionMake sure that nurse aides show they have the skills and techniques to be able to care for residents' needs.
ESomePotential for HarmHealth InspectionGive 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.
ESomePotential for HarmHealth InspectionDevelop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property.
ESomePotential for HarmHealth InspectionAssist those residents who need help with eating/drinking, grooming and personal and oral hygiene.
ESomePotential for HarmHealth InspectionEnsure that residents with limited range of motion receive appropriate treatment and services to increase range of motion or prevent further decrease in range of motion.
ESomePotential for HarmHealth InspectionProtect each resident from mistreatment, neglect and misappropriation of personal property.

August 26, 2015 - 16 months ago

 Residents AffectedSeveritySource/TypeDescription
FManyPotential for HarmFire Safety InspectionExits that are free from obstructions and can be used at all times.
FManyPotential for HarmFire Safety InspectionProperly working alarms on sprinkler valves.
FManyPotential for HarmFire Safety InspectionApproved construction type or materials.
CManyPotential for Minimal HarmFire Safety InspectionPortable fire extinguishers.

February 19, 2015 - 2 years ago

 Residents AffectedSeveritySource/TypeDescription
ESomePotential for HarmComplaintDevelop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property.
ESomePotential for HarmComplaint1) Hire only people with 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.

July 24, 2014 - 2 years ago

 Residents AffectedSeveritySource/TypeDescription
FManyPotential for HarmHealth InspectionStore, cook, and serve food in a safe and clean way.
FManyPotential for HarmHealth InspectionKeep accurate, complete and organized clinical records on each resident that meet professional standards.
FManyPotential for HarmHealth InspectionDevelop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
FManyPotential for HarmHealth InspectionMaintain 15 months of resident assessments in the resident's active clinical record.
FManyPotential for HarmHealth InspectionAssure that each residentís assessment is updated at least once every 3 months.
ESomePotential for HarmHealth InspectionMake sure that nurse aides show they have the skills and techniques to be able to care for residents' needs.
ESomePotential for HarmFire Safety InspectionAn approved automatic sprinkler system connected to the fire alarm system.
ESomePotential for HarmHealth InspectionKeep each resident free from physical restraints, unless needed for medical treatment.
ESomePotential for HarmHealth InspectionEnsure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents.
ESomePotential for HarmFire Safety InspectionExits that are accessible at all times.
ESomePotential for HarmHealth InspectionEnsure that each resident who enters the nursing home without a catheter is not given a catheter, unless medically necessary, and that incontinent patients receive proper services to prevent urinary tract infections and restore normal bladder functions.

Staffing Levels Per Resident per Day

Medicare determines the expected staffing time per resident per day depending on level of care the residents of Elgin Nursing And Rehabilitation Center require. It is important to compare the reported time to expected time for a single facility instead of comparing the amount of time per resident of two facilities. Learn why.

2hr 10min
2hr 25min
ReportedExpected
CNA
40min
40min
ReportedExpected
LPN
40min
1hr 20min
ReportedExpected
RN
3hr 30min
4hr 25min
ReportedExpected
Total Nursing

This facility also provides approximately 25min per resident per WEEK of physical therapist time.

Quality Measures for Long Stay Residents

97.1%
94.4%
94.4%
90.7%
Q1 2015Q2 2015Q3 2015TX
Assessed and Appropriately Given the Seasonal Influenza Vaccine
90.4%
95.4%
99.0%
87.9%
Q1 2015Q2 2015Q3 2015TX
Assessed and Appropriately Given the Pneumococcal Vaccine
43.6%
42.5%
62.8%
46.9%
Q1 2015Q2 2015Q3 2015TX
Low Risk Residents Who Lose Control of Their Bowel or Bladder
17.9%
18.0%
22.2%
22.3%
Q1 2015Q2 2015Q3 2015TX
Received an Antipsychotic Medication
42.3%
16.0%
28.0%
19.6%
Q1 2015Q2 2015Q3 2015TX
Need for Help with ADLs has Increased
1.0%
2.7%
2.6%
8.8%
Q1 2015Q2 2015Q3 2015TX
Self Report Moderate to Severe Pain
5.9%
6.4%
10.0%
6.3%
Q1 2015Q2 2015Q3 2015TX
Lose Too Much Weight
9.9%
7.5%
5.2%
6.6%
Q1 2015Q2 2015Q3 2015TX
High Risk Residents With Pressure Ulcers
5.2%
6.9%
16.0%
6.1%
Q1 2015Q2 2015Q3 2015TX
Have Depressive Symptoms
3.9%
3.7%
6.0%
5.1%
Q1 2015Q2 2015Q3 2015TX
With a Urinary Tract Infection
3.8%
3.7%
2.9%
3.5%
Q1 2015Q2 2015Q3 2015TX
Experiencing One or More Falls with Major Injury
1.8%
3.0%
1.8%
3.3%
Q1 2015Q2 2015Q3 2015TX
With a Catheter Inserted and Left in Their Bladder
9.6%
2.8%
2.9%
0.6%
Q1 2015Q2 2015Q3 2015TX
Were Physically Restrained

Quality Measures for Short Stay Residents

22.6%
48.1%
57.1%
71.4%
Q1 2015Q2 2015Q3 2015TX
Assessed and Appropriately Given the Pneumococcal Vaccine
26.7%
26.2%
26.2%
71.1%
Q1 2015Q2 2015Q3 2015TX
Were Assessed and Appropriately Given the Seasonal Influenza Vaccine
-
-
14.3%
16.5%
Q1 2015Q2 2015Q3 2015TX
* The data for this facility for some quarters is unavailable.
Self Report Moderate to Severe Pain
5.3%
0.0%
3.6%
3.2%
Q1 2015Q2 2015Q3 2015TX
Newly Received an Antipsychotic Medication
0.0%
2.2%
2.0%
1.0%
Q1 2015Q2 2015Q3 2015TX
With Pressure Ulcers That Are New or Worsened