ADMISSION FOR THOSE WHO NEED FULL CARE

 Our admission criteria have been developed to include adults age 18 and over who may have spent at least six months post-onset of injury in sub-acute and other residential facilities where aggressive coma stimulation, medication, and physical therapies are prescribed.  

Criteria for admissions: 

1. Between the ages of 18 and 54 upon admission 

2. Has a severe and permanent disorder of consciousness, such as a traumatic or acquired brain injury 

3. Certified disabled by the Social Security Administration or the State Medical Review Team 

4. Requires full assistance for all Activities of Daily Living 

Program Limitations: 

Granite House is not a rehabilitation facility but does provide passive range of motion therapy and weight-bearing therapy. 

We do not provide 24-hour Registered Nurse care. 

  Our residents require full assistance for mobility, do not communicate verbally, and may either eat softened foods with assistance 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 transfers between bed and wheelchair.    

       After one year post-injury, the recovery potential for patients in a minimally conscious state is very low, and we want to ensure that every individual has at least had every chance for the best outcome possible. Our residents will have already reached the last phase in coma stimulation programs and may already be in a long-term care facility, with or without a Brain Injury program. 

         Other potential residents may have been cared for at home, especially those whose brain injury occurred at a very young age. These families are very special to us because they understand the level of care and daily routines that they have provided themselves.  

Neurological Status/Level of Consciousness: 

                 Minimally Conscious State
1. Level of consciousness must be characterized as Minimally Conscious, identified otherwise as Level III on the Rancho Los Amigos Scale of Cognitive Functioning, or “Rancho Scale.”
2. Candidate can demonstrate response to visual, auditory and physical stimuli that is purposeful and not purely reflexive
3. Must have a preliminary neurological assessment by Donna Koning, MD (retired), a Granite House Admissions Committee member, and may require formal clinical evaluation by a practicing neurologist or physiatrist before determination of eligibility.  

 4. 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.   

  For more information about the Minimally Conscious State, follow LINK to this article

  For more information about the Rancho Scale, follow LINK to this article.  

Although our residents require full care, they must be medically stable upon admission, specifically: 

1. Do not have a condition which requires 24-hour continuous monitoring by a Registered Nurse.
2. Do not have a known progressive neuromuscular degenerative disease.
3. Do not have a tracheostomy and is not ventilator dependent.
4. Do 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.
5. Free of severe or life-threatening allergies to common environmental allergens, e.g. nuts, flowers, perfumes, animals etc. which require special precautions.
6. Cannot be using medications or substances that require excessive staff resources to manage.
7. Granite House does not accept individuals who have a chronic contagious infectious disease that would put other patients or staff at risk.