Arlington, TX

Greenbrier Health Care Center

1-star overall rating with 1-star inspections with $187,620 in total fines with 9 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle

301 W Randol Mill Rd, Arlington, TX

(817) 460-2002

Compare this facility

Overall

1 / 5

CMS overall stars

Health inspections

1 / 5

Survey and complaint cycles

Staffing

1 / 5

RN + nurse staffing

Quality measures

4 / 5

Resident outcomes and process measures

Quick facts

Facility snapshot

Beds

114

Certified beds

Average residents

Average occupied residents

Ownership

For-Profit

Publicly displayed owner type

Chain

Summit Ltc

Operator or chain grouping

Approved since

2001-07-03

CMS approved date

Coverage

Medicare + Medicaid

Participation flags

Chain footprint

9 facilities

Chain averages 2 overall / 3 health / 1 staffing / 3 quality stars

Changed ownership

Within the last 12 months

Family council

Yes

Resident and family council reported

Sprinklers

Yes

Automatic sprinklers in all required areas

Staffing

Hours and turnover

RN hours / resident day

0.32

Registered nurse staffing · state 0.44 · national 0.68

LPN hours / resident day

1.05

Licensed practical nurse staffing · state 0.95 · national 0.87

Aide hours / resident day

1.57

Nurse aide staffing · state 2.01 · national 2.35

Total nurse hours

2.94

All reported nurse hours · state 3.40 · national 3.89

Licensed hours

1.37

RN + LPN hours · state 1.38 · national 1.54

Weekend hours

2.52

Weekend nurse staffing · state 2.99 · national 3.43

Weekend RN hours

0.23

Weekend registered nurse coverage · state 0.34 · national 0.47

Physical therapist

0.01

Reported PT staffing · state 0.07 · national 0.07

Adjusted RN hours

0.32

CMS adjusted RN staffing hours

Adjusted total hours

2.98

CMS adjusted total nurse staffing hours

Case-mix index

1.35

Higher values indicate more complex resident acuity

RN turnover

Annual RN turnover

Total nurse turnover

59%

Annual nurse turnover · state 52% · national 46%

SNF VBP

Value-based purchasing

Program rank

4,278

Lower is better among SNFs in the FY 2026 VBP program.

Performance score

40.62

Composite VBP score used to determine payment impact.

Payment multiplier

0.9935

Above 1.000 increases Medicare payment; below 1.000 reduces it.

Program components

How the VBP score is built

Readmission

Not reported

This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.

Healthcare-associated infections

Not reported

This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.

Total nurse turnover

3.05

Performance 51.22% · Measure score 3.05 · Achievement 3.05 · This facility did not have sufficient data to calculate a baseline period measure result.

Adjusted total nurse staffing

5.08

Baseline 0.96 hours · Performance 3.65 hours · Measure score 5.08 · Achievement 2 · Improvement 5.08

SNF QRP

Medicare quality reporting measures

Measure	Facility	National	Note
Potentially preventable 30-day readmission	12.24%	10.72% 1.5 pts worse	No Different than the National Rate · Eligible stays 29 · Observed rate 24.14% · Lower 95% interval 7.97%
Discharge to community	Not Available	50.57%	Not Available · Eligible stays 16 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly.
Medicare spending per beneficiary	1.23	1.02 0.2 pts worse
Drug regimen review with follow-up	95.83%	95.27% 0.6 pts better	Numerator 23 · Denominator 24
Falls with major injury	8.33%	0.77% 7.6 pts worse	Numerator 2 · Denominator 24
Discharge self-care score	Not Available	53.69%	Numerator Not Available · Denominator 8 · Too few residents or stays to report publicly.
Discharge mobility score	Not Available	50.94%	Numerator Not Available · Denominator 8 · Too few residents or stays to report publicly.
Pressure ulcers or injuries, new or worsened	0%	2.29% 2.3 pts better	Numerator 0 · Denominator 24 · Adjusted rate 0%
Healthcare-associated infections requiring hospitalization	Not Available	7.12%	Not Available · Eligible stays 20 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly.
Staff COVID-19 vaccination coverage	5.88%	8.2% 2.3 pts worse	Numerator 5 · Denominator 85
Staff flu vaccination coverage	5.26%	42% 36.7 pts worse	Numerator 6 · Denominator 114
Discharge function score	Not Available	56.45%	Numerator Not Available · Denominator 8 · Too few residents or stays to report publicly.
Transfer of health information to provider	Not Available	95.95%	Numerator Not Available · Denominator 18 · Too few residents or stays to report publicly.
Transfer of health information to patient	Not Available	96.28%	Numerator Not Available · Denominator 5 · Too few residents or stays to report publicly.
Resident COVID-19 vaccinations up to date	Not Available	25.2%	Numerator Not Available · Denominator 11 · Too few residents or stays to report publicly.

Quality measures

Resident outcomes and process scores

Measure	Facility	State	National	Note
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine	100.0%	97.1% 2.9 pts better	93.4% 6.6 pts better	Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 100.0%
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine	97.5%	97.9% 0.4 pts worse	95.5% 2 pts better	Long Stay · 2024Q3-2025Q2 · 4Q avg 97.5%
Percentage of long-stay residents experiencing one or more falls with major injury	4.4%	3.3% 1.1 pts worse	3.3% 1.1 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 5.1% · Q3 7.3% · Q4 4.7% · 4Q avg 4.4% · Used in QM five-star
Percentage of long-stay residents who have depressive symptoms	0.0%	2.7% 2.7 pts better	11.4% 11.4 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0%
Percentage of long-stay residents who lose too much weight	0.8%	3.3% 2.5 pts better	5.4% 4.6 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 2.9% · 4Q avg 0.8%
Percentage of long-stay residents who received an antianxiety or hypnotic medication	8.0%	18.9% 10.9 pts better	19.6% 11.6 pts better	Long Stay · 2024Q4-2025Q3 · Q1 15.2% · Q2 6.2% · Q3 2.9% · Q4 8.1% · 4Q avg 8.0%
Percentage of long-stay residents who received an antipsychotic medication	12.6%	10.8% 1.8 pts worse	16.7% 4.1 pts better	Long Stay · 2024Q4-2025Q3 · Q1 12.5% · Q2 16.0% · Q3 11.1% · Q4 11.1% · 4Q avg 12.6% · Used in QM five-star
Percentage of long-stay residents who were physically restrained	0.0%	0.0% About the same	0.1% 0.1 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0%
Percentage of long-stay residents whose ability to walk independently worsened	5.3%	15.4% 10.1 pts better	16.3% 11 pts better	Long Stay · 2024Q4-2025Q3 · 4Q avg 5.3% · Used in QM five-star
Percentage of long-stay residents whose need for help with daily activities has increased	4.2%	16.1% 11.9 pts better	14.9% 10.7 pts better	Long Stay · 2024Q4-2025Q3 · Q1 7.4% · Q2 3.4% · Q3 6.5% · Q4 0.0% · 4Q avg 4.2% · Used in QM five-star
Percentage of long-stay residents with a catheter inserted and left in their bladder	0.0%	0.5% 0.5 pts better	1.0% 1 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star
Percentage of long-stay residents with a urinary tract infection	0.0%	0.8% 0.8 pts better	1.7% 1.7 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star
Percentage of long-stay residents with new or worsened bowel or bladder incontinence	6.4%	15.0% 8.6 pts better	19.8% 13.4 pts better	Long Stay · 2024Q4-2025Q3 · Q1 3.1% · Q2 5.8% · Q3 11.9% · Q4 4.5% · 4Q avg 6.4%
Percentage of long-stay residents with pressure ulcers	1.2%	4.2% 3 pts better	5.1% 3.9 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 2.5% · Q3 0.0% · Q4 2.2% · 4Q avg 1.2% · Used in QM five-star
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine	99.6%	89.7% 9.9 pts better	81.7% 17.9 pts better	Short Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 98.4% · Q3 100.0% · Q4 100.0% · 4Q avg 99.6%
Percentage of short-stay residents who had an outpatient emergency department visit	14.3%	12.0% 2.3 pts worse	12.0% 2.3 pts worse	Short Stay · 20240701-20250630 · Adjusted 14.3% · Observed 16.7% · Expected 13.0% · Used in QM five-star
Percentage of short-stay residents who newly received an antipsychotic medication	0.7%	1.5% 0.8 pts better	1.6% 0.9 pts better	Short Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 2.7% · 4Q avg 0.7% · Used in QM five-star
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine	95.3%	88.0% 7.3 pts better	79.7% 15.6 pts better	Short Stay · 2024Q3-2025Q2 · 4Q avg 95.3%
Percentage of short-stay residents who were rehospitalized after a nursing home admission	29.0%	25.9% 3.1 pts worse	23.9% 5.1 pts worse	Short Stay · 20240701-20250630 · Adjusted 29.0% · Observed 33.3% · Expected 27.4% · Used in QM five-star

Survey summary

Recent inspection cycles

Cycle 1 Health 2024-11-20 · Fire 2024-11-20

9 health deficiencies

Top issue: Quality of Life and Care (2 deficiencies)

5 fire-safety deficiencies

Top issue: Gas and Vacuum and Electrical Systems (2 deficiencies)

Cycle 2 Health 2023-09-28 · Fire 2023-09-28

12 health deficiencies

Top issue: Resident Assessment and Care Planning (4 deficiencies)

5 fire-safety deficiencies

Top issue: Smoke (3 deficiencies)

Cycle 3 Health 2022-08-04 · Fire 2022-08-04

4 health deficiencies

Top issue: Infection Control (2 deficiencies)

3 fire-safety deficiencies

Top issue: Smoke (2 deficiencies)

Fire safety

Fire-safety citations

F · Potential for more than minimal harm 2024-11-20

K324 · Smoke Deficiencies

Fire Safety

Provide properly protected cooking facilities.

Corrected 2024-12-20

F · Potential for more than minimal harm 2024-11-20

K916 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Have a battery powered remote alarm panel in a location accessible by operating personnel.

Corrected 2024-12-20

F · Potential for more than minimal harm 2024-11-20

K918 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Have generator or other power source capable of supplying service within 10 seconds.

Corrected 2024-12-20

E · Potential for more than minimal harm 2024-11-20

K321 · Smoke Deficiencies

Fire Safety

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

Corrected 2024-12-20

C · Minimal harm 2024-11-20

K211 · Egress Deficiencies

Fire Safety

Keep aisles, corridors, and exits free of obstruction in case of emergency.

Corrected 2024-12-20

E · Potential for more than minimal harm 2023-09-28

K222 · Egress Deficiencies

Fire Safety

Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.

Corrected 2023-10-25

E · Potential for more than minimal harm 2023-09-28

K321 · Smoke Deficiencies

Fire Safety

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

Corrected 2023-10-25

E · Potential for more than minimal harm 2023-09-28

K363 · Smoke Deficiencies

Fire Safety

Install corridor and hallway doors that block smoke.

Corrected 2023-10-25

E · Potential for more than minimal harm 2023-09-28

K372 · Smoke Deficiencies

Fire Safety

Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

Corrected 2023-10-25

C · Minimal harm 2023-09-28

K211 · Egress Deficiencies

Fire Safety

Keep aisles, corridors, and exits free of obstruction in case of emergency.

Corrected 2023-10-25

E · Potential for more than minimal harm 2022-08-04

K321 · Smoke Deficiencies

Fire Safety

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

Corrected 2022-09-09

E · Potential for more than minimal harm 2022-08-04

K363 · Smoke Deficiencies

Fire Safety

Install corridor and hallway doors that block smoke.

Corrected 2022-09-09

C · Minimal harm 2022-08-04

K211 · Egress Deficiencies

Fire Safety

Keep aisles, corridors, and exits free of obstruction in case of emergency.

Corrected 2022-09-01

Inspection history

Recent health citations

K · Immediate jeopardy 2026-01-10

F656 · Resident Assessment and Care Planning Deficiencies

Health

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Corrected 2026-01-11

K · Immediate jeopardy 2026-01-10

F686 · Quality of Life and Care Deficiencies

Health

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

Corrected 2026-01-11

J · Immediate jeopardy 2026-01-10

F580 · Resident Rights Deficiencies

Health

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

Corrected 2026-01-11

D · Potential for more than minimal harm 2026-01-10

F641 · Resident Assessment and Care Planning Deficiencies

Health

Ensure each resident receives an accurate assessment.

Corrected 2026-01-11

D · Potential for more than minimal harm 2025-12-02

F689 · Quality of Life and Care Deficiencies

Health

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Corrected 2025-12-03

E · Potential for more than minimal harm 2024-11-20

F812 · Nutrition and Dietary Deficiencies

Health

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Corrected 2024-12-18

D · Potential for more than minimal harm 2024-11-20

F583 · Resident Rights Deficiencies

Health

Keep residents' personal and medical records private and confidential.

Corrected 2024-12-18

D · Potential for more than minimal harm 2024-11-20

F761 · Pharmacy Service Deficiencies

Health

Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.

Corrected 2024-12-18

D · Potential for more than minimal harm 2024-11-20

F806 · Nutrition and Dietary Deficiencies

Health

Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.

Corrected 2024-12-18

D · Potential for more than minimal harm 2024-11-20

F919 · Environmental Deficiencies

Health

Make sure that a working call system is available in each resident's bathroom and bathing area.

Corrected 2024-12-18

E · Potential for more than minimal harm 2023-09-28

F550 · Resident Rights Deficiencies

Health

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Corrected 2023-10-20

E · Potential for more than minimal harm 2023-09-28

F812 · Nutrition and Dietary Deficiencies

Health

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Corrected 2023-10-20