CITIZENS CARE CENTER

The information listed below provides an in-depth look into the type and quality of care offered at Citizens Care Center. It is important to note that when evaluating if a nursing home is right for you or a loved one, ratings should not be taken as the sole deciding factor, but as one of many aspects to be considered.

Address

CITIZENS CARE CENTER
415 S. MARKET STREET
HAVRE DE GRACE, MD 21078
(410) 939-5500

Nursing Home Ratings

Health Inspections
Quality Measures
Nursing Staff
R.N. Staff Only

Overall Rating

Percent of Beds Occupied

83%

Number of Residents and Certified Beds

Residents: 165
Certified Beds: 200

This Facility Accepts

Medicare
Medicaid

Operational Details

Operated By Government - County
Offers Only Resident Counseling
This Facility is Not Part of a Chain or Franchise

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Nearby Cities:

Belcamp | Rising Sun | Bel Air

Resident Services

The information below lists services this facility has provided for residents from October through December 2010. During this period, the most common type of service provided was "Ultra-High Rehabilitation". To get a better idea of the types of services that are commonly performed, compare the "Percent of Service Days" column below. These services are based on submitted claims to Medicare and do not provide a complete overview of all the services provided by Citizens Care Center. For more information read our guide on how nursing facilities are reimbursed, types of services, and ADL index scores.

Resident Services

Resident Conditions

Percent of Service Days

High Rehabilitation Plus Extensive Services

Rehabilitation 325 Minutes Per Week Minimum

At least one rehabilitation discipline five days/week
Tracheostomy care
Ventilator or respirator
Isolation for active infectious disease while a resident
Activities of Daily Living (ADL) score of 2 or more

ADL Index Range: 2-10	1.8%
Total Percent:	1.8%

Medium Rehabilitation Plus Extensive Services

Rehabilitation 150 Minutes Per Week Minimum

Five days any combination of three rehabilitation disciplines
Tracheostomy care
Ventilator or respirator
Isolation for active infectious disease while a resident
Activities of Daily Living (ADL) score of 2 or more

ADL Index Range: 2-10	0.3%
Total Percent:	0.3%

Ultra-High Rehabilitation

Rehabilitation 720 Minutes Per Week Minimum

At least one rehabilitation discipline five days/week
A second rehabilitation discipline three days/week

ADL Index Range: 11-16	13.1%
ADL Index Range: 6-10	33.8%
ADL Index Range: 0-5	19.0%
Total Percent:	65.9%

Very High Rehabilitation

Rehabilitation 500 Minutes Per Week Minimum

At least one rehabilitation discipline five days/week

ADL Index Range: 11-16	2.9%
ADL Index Range: 6-10	5.7%
ADL Index Range: 0-5	4.7%
Total Percent:	13.3%

High Rehabilitation

Rehabilitation 325 Minutes Per Week Minimum

At least one rehabilitation discipline five days/week

ADL Index Range: 11-16	0.4%
ADL Index Range: 6-10	1.3%
ADL Index Range: 0-5	1.9%
Total Percent:	3.6%

Medium Rehabilitation

Rehabilitation 150 Minutes Per Week Minimum

Five days any combination of three rehabilitation disciplines

ADL Index Range: 11-16	0.8%
ADL Index Range: 6-10	2.1%
ADL Index Range: 0-5	5.5%
Total Percent:	8.4%

Special Care High

Comatose
Septicemia
Diabetes with daily injections and a change of order two or more days
Quadriplegia with ADL score greater or equal to 5
Chronic Obstructive Pulmonary Disease (COPD) and shortness of breath when lying flat
Fever with pneumonia, or vomiting, or weight loss, or feeding tube
Parenteral/IV feedings
Respiratory therapy for 7 days
Activities of Daily Living (ADL) score of 2 or more

ADL Index Range: 15-16 - No Signs of depression	0.7%
ADL Index Range: 6-10 - Signs of depression	0.6%
ADL Index Range: 2-5 - No Signs of depression	0.08%
Total Percent:	1.3%

Special Care Low

Cerebral palsy, multiple sclerosis, or Parkinson's disease with ADL score greater or equal to 5
Respiratory failure and oxygen therapy while a resident
Feeding tube where calories >= 51% or calories are in the range of 26-50% and fluid >= 501 mL)
Ulcers: 2 or more stage II or 1 or more stage III or IV pressure ulcers
Ulcers: 2 or more venous or arterial ulcers
Ulcers: 1 stage II pressure ulcer and 1 venous or arterial ulcer with 2 or more skin care treatments
Foot infection/diabetic foot ulcer/open lesions of foot with treatment
Radiation therapy while a resident
Dialysis while a resident
Activities of Daily Living (ADL) score of 2 or more

ADL Index Range: 15-16 - No Signs of depression	1.0%
Total Percent:	1.0%

Clinically Complex

Pneumonia, hemiplegia with ADL score >=5
Surgical wounds or open lesions with treatment
Burns
Chemotherapy while a resident
Oxygen therapy while a resident
IV medications or transfusions while a resident
Extensive Services, Special Care High or Special Care Low qualifier and ADL score of 0 or 1

ADL Index Range: 11-14 - No Signs of depression	0.4%
ADL Index Range: 6-10 - No Signs of depression	0.5%
ADL Index Range: 0-1 - Signs of depression	1.6%
Total Percent:	2.5%

Reduced Physical Function

Urinary and/or bowel training program
Passive and/or active range of motion (ROM)
Amputation/prosthesis training
Dressing or grooming training
Eating or swallowing training
Transfer training
Splint or brace assistance
Bed mobility and/or walking training
Communication training

ADL Index Range: 11-14 - Less restorative nursing	0.7%
ADL Index Range: 6-10 - Less restorative nursing	1.2%
Total Percent:	1.8%

Rating Details For Citizens Care Center

Nursing Staff -

The nursing staff is the most important part of what determines the quality of care and comfort of a resident in a nursing home. Government regulations set expectations on time spent with each resident based on the services being provided. The breakdown below lists the nursing types (RN, LPN, LVN, CNA) and a comparison of the reported and expected hours per resident per day.

Nursing Hours Per Resident Per Day	Reported	Expected
Registered Nurse (RN) Hours	44 Minutes	1 Hour and 5 Minutes
Licensed Practical/Vocational Nurse (LPN/LVN) Hours	1 Hour and 8 Minutes	42 Minutes
Certified Nursing Assistant (CNA) Hours	2 Hours and 11 Minutes	2 Hours and 30 Minutes
Total Licensed Nurse Hours	1 Hour and 52 Minutes	1 Hour and 47 Minutes
Total Nurse Hours	4 Hours and 3 Minutes	4 Hours and 17 Minutes

Quality of Care -

Medicare determines quality of care ratings for nursing facilities by surveying several "quality measures", which are broken down into long-term and short-term stay residents, as well as if the action is preventive or if there is a deficiency in the quality of care. State averages for Maryland are also provided for comparison purposes. Note: Figures below are averaged over the past nine months.

This Facility

Maryland Average

Long-Term Stay Preventive Actions

Percent of Long-Stay Residents Who Were Assessed and Given Pneumococcal Vaccination	90-100%	87%
Percent of Long-Stay Residents Given Influenza Vaccination During the Flu Season	90-100%	90%

Long-Term Stay Deficiencies

Percent of Long-Stay Residents Who Have/Had a Catheter Inserted and Left in Their Bladder	2%	4%
Percent of Low-Risk Long-Stay Residents Who Have Pressure Sores	2%	3%
Percent of Long-Stay Residents Who Lose Too Much Weight	10%	8%
Percent of Long-Stay Residents Who Had a Urinary Tract Infection	8%	9%
Percent of High-Risk Long-Stay Residents Who Have Pressure Sores	7%	12%
Percent of Long-Stay Residents Who Are More Depressed or Anxious	10%	9%
Percent of Long-Stay Residents Whose Need for Help with Daily Activities Has Increased	15%	14%
Percent of Long-Stay Residents Whose Ability to Move About in and Around Their Room Got Worse	10%	11%
Percent of Long-Stay Residents Who Have Moderate to Severe Pain	6%	2%
Percent of Low-Risk Long-Stay Residents Who Lose Control of Their Bowels or Bladder	60%	57%
Percent of Long-Stay Residents Who Were Physically Restrained	-	4%
Percent of Long-Stay Residents Who Spend Most of Their Time in Bed or in a Chair	21%	7%

Short-Term Stay Preventive Actions

Percent of Short-Stay Residents Given Influenza Vaccination During the Flu Season	89%	80%
Percent of Short-Stay Residents Who Were Assessed and Given Pneumococcal Vaccination	90-100%	77%

Short-Term Stay Deficiencies

Percent of Short-Stay Residents Who Have Pressure Sores	23%	13%
Percent of Short-Stay Residents Who Have Delirium	-	2%
Percent of Short-Stay Residents Who Had Moderate to Severe Pain	34%	14%

Health Inspection Details -

All Medicare and/or Medicaid certified nursing home must undergo health inspections on average once a year, but may be more frequent if the facility is peforming poorly. These inspections cover most aspects of life in a nursing home, and are broken down into deficiencies types, which including: Pharmacy Service, Administration, Resident Rights, Nutrition and Dietary, Resident Assessment, Environmental, and Mistreatment. Below are the list of deficiencies found by inspectors in the past few years along with the degree of harm and how many residents may have been affected. Note: The most recent health survey was on 07/15/2010.

Degree of Harm

- Potential for Minimal Harm
- Minimal Harm or Potential for Harm
- Resident Harmed
- Immediate Jeopardy to Resident Health

Residents Affected

- Isolated
- Some Residents
- Many Residents

Deficiencies Found By Inspectors

Degree of Harm

Residents Affected

Administration

Keep Accurate and Appropriate Medical Records.

Inspection Date: 06/27/2008
Correction Date: 08/08/2008

Nutrition and Dietary

Provide Food in a Way That Meets a Resident's Needs. Inspection Date: 06/27/2008 Correction Date: 08/08/2008
Make Sure That the Attending Doctor Orders Special Diets. Inspection Date: 06/27/2008 Correction Date: 08/08/2008

Pharmacy Service

1) Make Sure That Residents Who Take Drugs Are Not Given Too Many Doses or for Too Long; 2) Make Sure That the Use of Drugs is Carefully Watched; or 3) Stop or Change Drugs That Cause Unwanted Effects. Inspection Date: 06/27/2008 Correction Date: 08/08/2008
At Least Once a Month, Have a Licensed Pharmacist Check the Drugs That Each Resident Takes. Inspection Date: 06/27/2008 Correction Date: 08/08/2008
1) Make Sure That Residents Who Take Drugs Are Not Given Too Many Doses or for Too Long; 2) Make Sure That the Use of Drugs is Carefully Watched; or 3) Stop or Change Drugs That Cause Unwanted Effects. Inspection Date: 07/15/2010 Correction Date: 07/31/2010
At Least Once a Month, Have a Licensed Pharmacist Check the Drugs That Each Resident Takes. Inspection Date: 07/15/2010 Correction Date: 07/31/2010

Quality Care

Give Each Resident Care and Services to Get or Keep the Highest Quality of Life Possible. Inspection Date: 06/27/2008 Correction Date: 08/08/2008
Give Each Resident Care and Services to Get or Keep the Highest Quality of Life Possible. Inspection Date: 07/15/2010 Correction Date: 07/31/2010
Give Residents Proper Treatment to Prevent New Bed (Pressure) Sores or Heal Existing Bed Sores. Inspection Date: 07/15/2010 Correction Date: 07/31/2010

Resident Assessment

Make a Complete Assessment That Covers All Questions for Areas That Are Listed in Official Regulations. Inspection Date: 07/15/2010 Correction Date: 07/31/2010
Develop a Complete Care Plan That Meets All of a Resident's Needs, with Timetables and Actions That Can Be Measured. Inspection Date: 07/15/2010 Correction Date: 07/31/2010

Resident Rights

Immediately Tell the Resident, Doctor, and a Family Member If: the Resident is Injured, There is a Major Change in Resident's Physical/Mental Health, There is a Need to Alter Treatment Significantly, or the Resident Must Be Transferred or Discharged.

Inspection Date: 06/27/2008
Correction Date: 08/08/2008

Deficiencies from Complaints and Incidents

The table below lists incident reports by the nursing staff or administration for Citizens Care Center, as well as complaints by residents or their family in the previous three years.

Degree of Harm

- Potential for Minimal Harm
- Minimal Harm or Potential for Harm
- Resident Harmed
- Immediate Jeopardy to Resident Health

Residents Affected

- Isolated
- Some Residents
- Many Residents

Formal Complaints

Degree of Harm

Residents Affected

Environmental

Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents. Complaint Filed: 06/27/2008 Correction Date: 08/08/2008
Be Designed, Built, Equipped, or Well Kept to Protect the Health and Safety of Residents, Workers, and the Public. Complaint Filed: 06/27/2008 Correction Date: 08/08/2008
Provide Needed Housekeeping and Maintenance. Complaint Filed: 06/27/2008 Correction Date: 08/08/2008
Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents. Complaint Filed: 03/25/2011 Correction Date: 04/09/2011

Mistreatment

1) Hire Only People Who Have No Legal History of Abusing, Neglecting or Mistreating Residents; or 2) Report and Investigate Any Acts or Reports of Abuse, Neglect or Mistreatment of Residents.

Complaint Filed: 08/17/2009
Correction Date: 08/28/2009