Granbury, TX

Harbor Lakes Nursing And Rehabilitation Center

5-star overall rating with 5-star inspections with 1 recent health deficiencies with 7 fire-safety deficiencies in the latest cycle

1300 2nd St, Granbury, TX

(817) 408-3800

Compare this facility

Overall

5 / 5

CMS overall stars

Health inspections

5 / 5

Survey and complaint cycles

Staffing

3 / 5

RN + nurse staffing

Quality measures

5 / 5

Resident outcomes and process measures

Quick facts

Facility snapshot

Beds

142

Certified beds

Average residents

91

Average occupied residents

Ownership

For-Profit

Publicly displayed owner type

Chain

Hmg Healthcare

Operator or chain grouping

Approved since

2008-06-03

CMS approved date

Coverage

Medicare + Medicaid

Participation flags

Chain footprint

33 facilities

Chain averages 3 overall / 3 health / 2 staffing / 4 quality stars

Changed ownership

No

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

0.40

Registered nurse staffing · state 0.44 · national 0.68

LPN hours / resident day

1.00

Licensed practical nurse staffing · state 0.95 · national 0.87

Aide hours / resident day

2.16

Nurse aide staffing · state 2.01 · national 2.35

Total nurse hours

3.56

All reported nurse hours · state 3.40 · national 3.89

Licensed hours

1.40

RN + LPN hours · state 1.38 · national 1.54

Weekend hours

3.08

Weekend nurse staffing · state 2.99 · national 3.43

Weekend RN hours

0.33

Weekend registered nurse coverage · state 0.34 · national 0.47

Physical therapist

0.03

Reported PT staffing · state 0.07 · national 0.07

Adjusted RN hours

0.44

CMS adjusted RN staffing hours

Adjusted total hours

3.91

CMS adjusted total nurse staffing hours

Case-mix index

1.25

Higher values indicate more complex resident acuity

RN turnover

38%

Annual RN turnover · state 52% · national 45%

Total nurse turnover

39%

Annual nurse turnover · state 52% · national 46%

SNF VBP

Value-based purchasing

Program rank

2,754

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

Performance score

47.96

Composite VBP score used to determine payment impact.

Payment multiplier

1.0016

Above 1.000 increases Medicare payment; below 1.000 reduces it.

Program components

How the VBP score is built

Readmission

5.22

Baseline 19.25% · Performance 19.01% · Measure score 5.22 · Achievement 5.22 · Improvement 0.56

Healthcare-associated infections

3.63

Baseline 6.42% · Performance 6.75% · Measure score 3.63 · Achievement 3.63 · Improvement 0

Total nurse turnover

7.33

Baseline 80.56% · Performance 36.92% · Measure score 7.33 · Achievement 6.55 · Improvement 7.33

Adjusted total nurse staffing

3

Baseline 3.56 hours · Performance 3.93 hours · Measure score 3 · Achievement 3 · Improvement 1.16

SNF QRP

Medicare quality reporting measures

Measure	Facility	National	Note
Potentially preventable 30-day readmission	10.25%	10.72% 0.5 pts better	No Different than the National Rate · Eligible stays 229 · Observed rate 9.17% · Lower 95% interval 8.21%
Discharge to community	65.33%	50.57% 14.8 pts better	Better than the National Rate · Eligible stays 201 · Observed rate 64.18% · Lower 95% interval 59.67%
Medicare spending per beneficiary	0.85	1.02 0.2 pts better
Drug regimen review with follow-up	100%	95.27% 4.7 pts better	Numerator 138 · Denominator 138
Falls with major injury	0.72%	0.77% 0.1 pts better	Numerator 1 · Denominator 138
Discharge self-care score	57.76%	53.69% 4.1 pts better	Numerator 67 · Denominator 116
Discharge mobility score	37.07%	50.94% 13.9 pts worse	Numerator 43 · Denominator 116
Pressure ulcers or injuries, new or worsened	1.45%	2.29% 0.8 pts better	Numerator 2 · Denominator 138 · Adjusted rate 1.66%
Healthcare-associated infections requiring hospitalization	6.75%	7.12% 0.4 pts better	No Different than the National Rate · Eligible stays 135 · Observed rate 5.93% · Lower 95% interval 3.9%
Staff COVID-19 vaccination coverage	0%	8.2% 8.2 pts worse	Numerator 0 · Denominator 97
Staff flu vaccination coverage	14.29%	42% 27.7 pts worse	Numerator 15 · Denominator 105
Discharge function score	47.41%	56.45% 9 pts worse	Numerator 55 · Denominator 116
Transfer of health information to provider	99.2%	95.95% 3.2 pts better	Numerator 124 · Denominator 125
Transfer of health information to patient	Not Available	96.28%	Numerator Not Available · Denominator 3 · Too few residents or stays to report publicly.
Resident COVID-19 vaccinations up to date	1.25%	25.2% 23.9 pts worse	Numerator 1 · Denominator 80

Quality measures

Resident outcomes and process scores

Measure	Facility	State	National	Note
Number of hospitalizations per 1000 long-stay resident days	0.6	2.1 1.5 pts better	1.9 1.3 pts better	Long Stay · 20240701-20250630 · Adjusted 0.6 · Observed 0.5 · Expected 1.6 · Used in QM five-star
Number of outpatient emergency department visits per 1000 long-stay resident days	1.1	2.1 1 pts better	1.8 0.7 pts better	Long Stay · 20240701-20250630 · Adjusted 1.1 · Observed 1.0 · Expected 1.4 · Used in QM five-star
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	100.0%	97.9% 2.1 pts better	95.5% 4.5 pts better	Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0%
Percentage of long-stay residents experiencing one or more falls with major injury	6.2%	3.3% 2.9 pts worse	3.3% 2.9 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 1.6% · Q2 5.2% · Q3 8.5% · Q4 9.4% · 4Q avg 6.2% · Used in QM five-star
Percentage of long-stay residents who have depressive symptoms	2.5%	2.7% 0.2 pts better	11.4% 8.9 pts better	Long Stay · 2024Q4-2025Q3 · Q1 4.9% · Q2 0.0% · Q3 5.2% · Q4 0.0% · 4Q avg 2.5%
Percentage of long-stay residents who lose too much weight	2.4%	3.3% 0.9 pts better	5.4% 3 pts better	Long Stay · 2024Q4-2025Q3 · Q1 5.4% · Q2 0.0% · Q3 2.3% · Q4 2.1% · 4Q avg 2.4%
Percentage of long-stay residents who received an antianxiety or hypnotic medication	12.1%	18.9% 6.8 pts better	19.6% 7.5 pts better	Long Stay · 2024Q4-2025Q3 · Q1 10.0% · Q2 9.8% · Q3 15.9% · Q4 12.5% · 4Q avg 12.1%
Percentage of long-stay residents who received an antipsychotic medication	7.3%	10.8% 3.5 pts better	16.7% 9.4 pts better	Long Stay · 2024Q4-2025Q3 · Q1 13.2% · Q2 7.5% · Q3 2.4% · Q4 6.7% · 4Q avg 7.3% · 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	10.9%	15.4% 4.5 pts better	16.3% 5.4 pts better	Long Stay · 2024Q4-2025Q3 · Q1 5.3% · Q2 24.0% · Q3 11.7% · Q4 2.9% · 4Q avg 10.9% · Used in QM five-star
Percentage of long-stay residents whose need for help with daily activities has increased	6.0%	16.1% 10.1 pts better	14.9% 8.9 pts better	Long Stay · 2024Q4-2025Q3 · Q1 8.1% · Q2 10.0% · Q3 4.8% · Q4 2.1% · 4Q avg 6.0% · 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	9.3%	15.0% 5.7 pts better	19.8% 10.5 pts better	Long Stay · 2024Q4-2025Q3 · Q1 18.1% · Q2 13.8% · Q3 6.6% · Q4 0.0% · 4Q avg 9.3%
Percentage of long-stay residents with pressure ulcers	5.6%	4.2% 1.4 pts worse	5.1% 0.5 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 4.8% · Q2 5.3% · Q3 7.2% · Q4 5.2% · 4Q avg 5.6% · 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 99.5% · Q3 99.5% · Q4 99.5% · 4Q avg 99.6%
Percentage of short-stay residents who had an outpatient emergency department visit	9.3%	12.0% 2.7 pts better	12.0% 2.7 pts better	Short Stay · 20240701-20250630 · Adjusted 9.3% · Observed 8.9% · Expected 10.7% · Used in QM five-star
Percentage of short-stay residents who newly received an antipsychotic medication	0.0%	1.5% 1.5 pts better	1.6% 1.6 pts better	Short 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 short-stay residents who were assessed and appropriately given the seasonal influenza vaccine	99.5%	88.0% 11.5 pts better	79.7% 19.8 pts better	Short Stay · 2024Q3-2025Q2 · 4Q avg 99.5%
Percentage of short-stay residents who were rehospitalized after a nursing home admission	22.6%	25.9% 3.3 pts better	23.9% 1.3 pts better	Short Stay · 20240701-20250630 · Adjusted 22.6% · Observed 21.0% · Expected 22.1% · Used in QM five-star

Survey summary

Recent inspection cycles

Cycle 1 Health 2025-09-11 · Fire 2025-09-11

1 health deficiencies

Top issue: Pharmacy Service (1 deficiency)

7 fire-safety deficiencies

Top issue: Smoke (3 deficiencies)

Cycle 2 Health 2024-08-15 · Fire 2024-08-15

10 health deficiencies

Top issue: Nutrition and Dietary (3 deficiencies)

0 fire-safety deficiencies

No concentrated fire-safety issue counts in this cycle.

Cycle 3 Health 2023-06-29 · Fire 2023-06-29

5 health deficiencies

Top issue: Resident Assessment and Care Planning (3 deficiencies)

0 fire-safety deficiencies

No concentrated fire-safety issue counts in this cycle.

Fire safety

Fire-safety citations

F · Potential for more than minimal harm 2025-09-11

K712 · Miscellaneous Deficiencies

Fire Safety

Have simulated fire drills held at unexpected times.

Corrected 2025-12-22

E · Potential for more than minimal harm 2025-09-11

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 2025-12-22

E · Potential for more than minimal harm 2025-09-11

K355 · Smoke Deficiencies

Fire Safety

Properly select, install, inspect, or maintain portable fire extinguishes.

Corrected 2025-12-22

E · Potential for more than minimal harm 2025-09-11

K372 · Smoke Deficiencies

Fire Safety

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

Corrected 2025-12-22

E · Potential for more than minimal harm 2025-09-11

K511 · Services Deficiencies

Fire Safety

Have properly installed electrical wiring and gas equipment.

Corrected 2025-12-22

E · Potential for more than minimal harm 2025-09-11

K923 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Have proper medical gas storage and administration areas.

Corrected 2025-12-22

D · Potential for more than minimal harm 2025-09-11

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 2025-12-22

Inspection history

Recent health citations

D · Potential for more than minimal harm 2025-09-11

F755 · Pharmacy Service Deficiencies

Health

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

Corrected 2025-09-22

F · Potential for more than minimal harm 2024-08-15

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 2024-09-09

E · Potential for more than minimal harm 2024-08-15

F657 · Resident Assessment and Care Planning Deficiencies

Health

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Corrected 2024-09-09

E · Potential for more than minimal harm 2024-08-15

F804 · Nutrition and Dietary Deficiencies

Health

Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

Corrected 2024-09-09

E · Potential for more than minimal harm 2024-08-15

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2024-09-09

D · Potential for more than minimal harm 2024-08-15

F602 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Protect each resident from the wrongful use of the resident's belongings or money.

Corrected 2024-09-09

D · Potential for more than minimal harm 2024-08-15

F655 · Resident Assessment and Care Planning Deficiencies

Health

Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted

Corrected 2024-09-09

D · Potential for more than minimal harm 2024-08-15

F759 · Pharmacy Service Deficiencies

Health

Ensure medication error rates are not 5 percent or greater.

Corrected 2024-09-09

D · Potential for more than minimal harm 2024-08-15

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 2024-09-09

B · Minimal harm 2024-08-15

F802 · Nutrition and Dietary Deficiencies

Health

Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.

Corrected 2024-09-09

D · Potential for more than minimal harm 2024-07-03

F842 · Resident Assessment and Care Planning Deficiencies

Health

Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Corrected 2024-08-02

E · Potential for more than minimal harm 2023-06-29

F755 · Pharmacy Service Deficiencies

Health

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

Corrected 2023-06-30

E · Potential for more than minimal harm 2023-06-29

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 2023-06-30

D · Potential for more than minimal harm 2023-06-29

F640 · Resident Assessment and Care Planning Deficiencies

Health

Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.

Corrected 2023-06-30

D · Potential for more than minimal harm 2023-06-29

F641 · Resident Assessment and Care Planning Deficiencies

Health

Ensure each resident receives an accurate assessment.

Corrected 2023-06-30

D · Potential for more than minimal harm 2023-06-29

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 2023-06-30

Penalties and ownership

What sits behind the stars

Ownership

Winnie-Stowell Hospital District

5% Or Greater Direct Ownership Interest · Organization

100% 75 facilities 2021-04-01

Balsamo, Krystal