A family-focused long-term care residence
Neurological Status/Level of Consciousness: Minimally Conscious State
a. Candidates’ level of consciousness must be characterized as Minimally Conscious, identified otherwise as the
Level III on the Rancho Los Amigos Scale of Cognitive Functioning, or “Rancho Scale.”
b. Can demonstrate response to visual, auditory and physical stimuli that is purposeful and not purely reflexive
c. Must have a neurological assessment with the Granite House visiting neurologist, Dr. Donna Koning at the Stillwater
Medical Group, before determination of eligibility.
We have an opening at this time. Please contact Granite House through our Nursing Director, Anna Bohnen, RN at email@example.com for more information.
a. Applicant has a current service need that would be improved with admission to Granite House.
b. If the applicant is currently in an institutional or residential setting, the Granite House program would better
meet this person’s needs than their current living situation.
c. If the applicant is currently living with family or guardians, current or anticipated challenges exist in providing
long-term care to meet this person’s needs in their current care setting
d. Person is able to participate and benefit from Granite House programs offered: group music therapy; visiting
therapists such as pet therapy, recreational therapy, and sensory therapy; hydrotherapy, physician-directed
passive range of motion and programs of physical and occupational therapy; and can observe and/or
participate in group activities without disrupting or infringing on the rights of other residents during this time.
a. Does not have a condition which requires 24-hour continuous monitoring by a Registered Nurse.
b. Does not have a known progressive neuromuscular degenerative disease.
c. Does not have a tracheostomy and is not ventilator dependent.
d. Does not have a chronic condition that has required two or more hospitalizations or a prolonged hospitalization
of three weeks or more within the last six months, and for which there has been no treatment response.
e. Free of severe or life-threatening allergies to common environmental allergens, e.g. nuts, flowers, perfumes,
animals etc. which require special precautions.
f. Cannot be using medications or substances that require excessive staff resources to manage.
g. Granite House does not accept individuals who have a chronic contagious infectious disease that would put
other patients or staff at risk.
Families who would like to start the process of consideration for admission should contact Anna Bohnen, RN, our
Nursing Director at firstname.lastname@example.org to arrange a tour and pick up a pre-screening application.
Where are the residents coming from?
After about a year post-injury, the likelihood of full emergence of consciousness is very low, so rehab facilities and hospitals will discharge patients to long-term care unless the family is prepared to care for them. These are the families who need another alternative. They may be in long-term care when they come to us, or be at home where the family may not be able to care for them any longer.
Causes of traumatic brain injury could be car accidents, blows to
the head, sports injuries, falls or accidents, or physical violence.
Causes of acquired brain injury include: poisoning or exposure to toxic
substances,infection, strangulation, choking, or drowning, stroke, heart
attacks, tumors, aneurysms, neurological illnesses,or abuse of illegal drugs.
Our residents are all non-ambulatory, non-verbal, incontinent, and may either eat softened foods and/or have a G-tube for administration of medications and liquid nutrition. They need maximum assistance with all activities of daily living (ADL's), including full assist with motorized transfers between bed and wheelchair.
Our admission criteria have been developed to include adults age 18 and over who may have spent at least a year post-onset of injury in sub-acute and other residential facilities where aggressive coma stimulation, medication, and physical therapies are prescribed. After one year, the recovery potential for patients in a minimally conscious state is very low, and we establish our criteria this way to insure that every individual has at least had every chance for the best outcome possible. Our residents will have already reached the last phase in the aggressive coma stimulation programs offered by facilities such as Bethesda Rehabilitation Hospital in St. Paul and may already be in a long-term care facility, with or without a Brain Injury program.
Demographic and situational criteria
a. Between the ages of 18 and 54 upon admission
b. Has a severe and permanent disorder of consciousness, such as a traumatic or acquired brain injury
c. Minimum one year post-injury or onset of diagnosis
d. Resident of Twin Cities Seven County Metro Area
e. Certified disabled by the Social Security Administration or the State Medical Review Team
f. Requires full assistance for all Activities of Daily Living
g. Be on Minnesota Medical Assistance and eligible for CADI or DD waivered services.