REVIEW 2015: Greenhaven Health and Rehabilitation has increased from a 1 star to a 2 star facility which is ranked as "Below Average." The staffing levels at Greenhaven nursing home are 2 stars "below average". As has been stated many times, staffing levels are the primary indicator of good care in most nursing homes. The chart below shows Greenhaven staffing levels, NC staffing and the far right column is US averages. Here are the 2015 staffing numbers as reported by the Greenhaven nursing home:
|Total number of residents||66||87.2||87.4|
|Total number of licensed nurse staff hours per resident per day||1 hour and 30 minutes||1 hour and 39 minutes||1 hour and 40 minutes|
|RN hours per resident per day||24 minutes||46 minutes||50 minutes|
|LPN/LVN hours per resident per day||1 hour and 6 minutes||53 minutes||50 minutes|
|CNA hours per resident per day||2 hours and 34 minutes||2 hours and 24 minutes||2 hours and 27 minutes|
|Physical therapy staff hours per resident per day||9 minutes||6 minutes||6 minutes|
As you can see, the RN staffing levels are only 24 minutes while the average in North Carolina is 46 minutes. So, the Greenhaven nursing home has about half of the average number of RNs. They do have more LPNs, but LPNs can't perform primary assessments like full RNs. I also just noticed an odd thing, the total number of residents in this nursing home is only 66. This facility can hold 120 residents, and just a few years ago had 105 residents. So, this nursing home according to this report is half empty.
Quality Measures- is 5 stars or "Much above average"! That is the highest score a nursing home can receive. With this low nurse staffing levels, the nurses that they do have must work very hard. Wait. As I read this report, I am again confused by the state inspection and ranking systems. Look at the Greehaven quality measures report. They really didn't score that well. For example, only 66% of short term residents got flu shots while the state average is 83%. Only 45% of the residents got pneumonia shots while the state average is 83% or almost twice as high. The long term resident scores were much better, but not all. For example, 5.8% of their residents had a catheter while the state average is 2.8% or about half. Perhaps there was a medical need for catherizations, but sometimes this is indicative of poor nursing assessments and leaving catheters in place for convenience. While 5 stars is undestandable, it may be a little high for this assessment.
Health Inspections- Greenhaven got 1 star or "Much Below Average". However, Greenhaven only had 3 deficiencies and the average in NC is 4. So, they got 25% less than the average. Also, to me the deficiencies don't seem very bad. Greenhaven was cited for medication error rate of 5.4% and the standard is to keep the rate under 5% or they get cited. So, this was only .4% above this. Of course, medication errors can cause severe problems, it did not in this case. Another deficiency was failure to post staffing levels. The last deficiency was making sure to mark drugs properly. While I don't intend to make light of these issues, this in no way should warrant a 1 star.
Conclusion- Greenhaven nursing home has had severe problems in the past. Perhaps, this is clouding the judgment of surveyors currently. The health inspection was ranked too low. However, this facility does have inadequate RN staffing. Ultimately, it appears that Greenhaven has improved a lot over the last few years but is still a below average nursing home. Hopefully, it will continue to improve.
May 2013 update: the facility was cited by the state for failing to have a pharmacist review medications, using out of date medications and incredibly they appeared to be putting residents in the activities room and the dining room in the dark around lunch time.
Greenhaven Health and Rehabilitation Center in Greensboro received an overall one-star rating by Medicare.gov in 2012, which is "much below average". This is only one of a few nursing homes in our area that go such a low rating. If you are curious, I have put together a list ranking and reviews of Greensboro area nursing homes. Greenhaven is owned by the Britthaven nursing home chain out of Kinston, North Carolina. The Britthaven Nursing Home chain is one of the largest private nursing home chain in the United States. Britthaven has homes in North Carolina, Kentucky and Virginia with a net profit of $35 million and gross revenue of $448 million.
November 2013 updated staffing still 1 star:
|GREENHAVEN HEALTH AND REHABILITATION CENTER Staffing||NORTH CAROLINA AVERAGE||NATIONAL AVERAGE|
|Total Number of Residents||105||88.1||87.8|
|Total number of licensed nurse staff hours per resident per day||1 hour and 12 minutes||1 hour and 37 minutes||1 hour and 37 minutes|
|RN Hours per Resident per Day||27 minutes||45 minutes||48 minutes|
|LPN/LVN Hours per Resident per Day||45 minutes||52 minutes||50 minutes|
|CNA Hours per Resident per Day||2 hours and 17 minutes||2 hours and 26 minutes||2 hours and 28 minutes|
|Physical Therapy Staff Hours per Resident per Day||6 minutes||7 minutes||6 minutes|
As you can see, the total staffing is up just a little but is still 1 star which is the lowest score a nursing home can receive. PT is up, but CNA staffing is down.
Greenhaven itself is a large nursing home with 120 beds but only 105 residents. If you want to get an idea of the level of care provided at a nursing home, look at the staffing levels. The problem with nursing homes isn't the nurses and CNAs. The problem is that there aren't enough of them. As for 2012, Greenhaven got two stars "below average" for staffing and have a few staffing issues that stick out:
|GREENHAVEN HEALTH AND REHABILITATION CENTER undefined||NORTH CAROLINA AVERAGE||NATIONAL AVERAGE|
|Total Number of Residents||105||88.9||88.2|
|Total Number of Licensed Nurse Staff Hours per Resident per day||1 hour|
|RN Hours per Resident per Day||29 minutes||45 minutes||47 minutes|
|LPN/LVN Hours per Resident per Day||36 minutes||52 minutes||50 minutes|
|CNA Hours per Resident per Day||2 hours|
|Physical Therapy Staff Hours per Resident per Day||2 minutes||7 minutes||6 minutes|
(The far right is the US average, the middle is the NC average, and the left is Greenhaven) First, the average nursing home in North Carolina has 50% more skilled nursing (RN and LPN) staff per resident than Greenhaven. The average skilled nursing staff hours per patient day in N.C. is 1 hour and 36 minutes. The average staff hours at Greenhaven is only 1 hour and 5 minutes. Since the other nursing homes have 30 minutes more and 30 minutes is around 50% of their one hour, this is a large difference. Remember, this is just compared to the "average" and that this not the same as "adequate". If the average nursing home in NC doesn't have adequate staffing, Greenhaven's is even lower. Frankly, this low staffing level is terrible and one of the lowest that I have ever seen.
Second, the breakdown of the staffing levels also shows low RN and LPN staffing levels compared to the average. In NC, the average RN hours is 45 minutes while Greenhaven only provided 29 minutes. In NC, the average LPN hours is 52 minutes while Greenhaven only provided 36 minutes. The Greenhaven CNA hours actually exceeded the NC average, which is good. The overall numbers show a lack of skilled staff. RNs in particular are needed to perform primary assessments of residents, develop Care Plans, identify changes in condition, etc.
Of course, state staffing averages for nursing homes doesn't give you a complete picture. You will also need to look at the acuity levels of the residents. If a nursing home has residents that can all take care of themselves, then they can get by with less staff. On the other hand, if the facility has a lot of total care residents with high acuity levels and high RUG scores, they will need more staff. RUG stands for Resource Utilization Group. The RUG scores determine the level of money that a nursing home gets paid. The RUG is based upon the needs of a resident. If they need more care, nursing homes should be paid more to provide more staff. However, often, the nursing homes just keep the extra money.
As for inspections, Greenhaven did fairly well in their last inspection in May 2012. They received four deficiencies which is about average in NC. However, over the last few years, the facility has had multiple "Immediate Jeopardy" deficiencies regarding resident health or safety. You can see a breakdown of these deficiencies here: https://www.medicare.gov/nursinghomecompare/search.html
One very positive note is the Quality Measures for the facility that was four stars "above average". The incidence of fall was lower, UTIs lower, incontinence lower and no restraint use. On the negative side, their residents who reported pain was much higher and incidents of pressure sores was higher. However, above average is a good rating. The only problem with this type of indicator is the limited data for the time frame around the survey. Most facilities only have a survey once a year or so, which doesn't reflect the other days of the year.
If you want to get an idea if a nursing home is a good one, go to nursing home compare. Look for facilities with higher star ratings. Would you go eat at a restaurant that got a "B" sanitation rating? While the star rating isn't the same, it is some evidence and allows at a minimum a comparison to other homes in the community. However, don't just look at the star rating itself. It is more important to look at the reasons for the star rating. The most important reason by far is staffing. If a nursing home doesn't have enough help, they will not provide good care. Nurses and CNAs will try their best, but fail. Residents will not be fed properly, they won't be clean and dry, medication errors will occur, turnover will be high, etc. Look for a nursing home that at least meets the state average, unless they can show low acuity levels.
The above information on Greenhaven was from nursing home compare. I did notice another website that had a few personal reviews of the facility: http://local-nursing-homes.com/nursinghome.cfm?detail=reviews&home=greenhaven-health-and-rehabilitation-center&provnum=345132
I will try to continue to add information on all homes in the Guilford County area. As a nursing home abuse attorney, I do handle cases all over the state. However, my goal with these blogs is to provide information. If the public is knowledgeable, then nursing homes will have a financial incentive to provide better care.
UPDATE- I started to try and summarize and rank all of the nursing homes in the Guilford County and Greensboro areas. If you would like to see a ranking of best to worst of all homes, click on Guilford County Greensboro area nursing home review.
Customer reviews- May 2013 This morning I was looking at some online reviews for Greenhaven when I found this one:
First of all, I gave a one because you can't go any lower. Maybe a 0.25 at best. Here is my recommendation: FOR WHATEVER REASON, DO NOT EVEN CONSIDER GREENHAVEN HEALTH AND REHAB at
801 Greenhaven Drive; Greensboro, NC 27406. I have been here for 5 years, and I have tried several times to be transferred to other facilities, but for whatever reason I was denied. Usually no space. I do suffer from MRSA and that probably played a lot into it. Greenhaven has recently gone through new management, and good employees are leaving as fast as rats on a sinking ship. They are constantly short-handed with CNAs on the halls, they frequently run out of supplies, the kitchen staff does as it pleases as far as preparing food. They constantly mess up food orders and resent the fact that they have to make it right. In one week, as of May 21, 2013, they have lost their Social Worker, Front Office Manager, Payroll Clerk, and the admissions clerk and human resources person have put a notice. In three months they have lost key personnel and replaced with young, inexperienced staff that are not educated to how things are to be done with the care of the residents. They lost maybe the best or one of the best wound care nurses in the state to a better facility, because she was able to go somewhere else making more money and working half as hard. In other words: THEY ARE UNDERPAID AND OVERWORKED. Who do you think suffers from this: THE RESIDENTS! Just to let you know, I am fairly educated, (enough to know when things are misconstrued as this place is), I am of sound mind, and what I speak is the truth. I was working on my career of 21 years when I contacted MRSA, and complications from that have put me in a nursing home. Accept this if you will, but understand this. I am living my hell and that is why I am trying to tell others to keep them from making the same mistake. STAY AWAY, DON'T EVEN INQUIRE!
We should take all online reviews with a grain of salt. At any 120 bed facility, you will have some residents and family who are angry. On the other hand, this review is consistent with what is typical at nurinsg homes with these low staffing levels. It makes you feel bad for the residents and the staff alike.