MARK TWAIN CARING CENTER

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 "Very 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 Mark Twain Caring Center. For more information read our guide on how nursing facilities are reimbursed, types of services, and ADL index scores.

Ultra-High Rehabilitation Plus Extensive Services

Very High Rehabilitation Plus Extensive Services

Medium Rehabilitation Plus Extensive Services

Ultra-High Rehabilitation

Very High Rehabilitation

High Rehabilitation

Special Care High

Reduced Physical Function

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.

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 Missouri are also provided for comparison purposes. Note: Figures below are averaged over the past nine months.

Long-Term Stay Preventive Actions

Long-Term Stay Deficiencies

Short-Term Stay Preventive Actions

Short-Term Stay Deficiencies

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 09/02/2010.

Administration

Follow All Laws and Professional Standards. Inspection Date: 07/23/2009 Correction Date: 09/16/2009

Environmental

Keep Safe, Clean and Homelike Surroundings. Inspection Date: 09/12/2008 Correction Date: 10/31/2008
Provide Needed Housekeeping and Maintenance. Inspection Date: 09/12/2008 Correction Date: 10/31/2008
Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents. Inspection Date: 09/12/2008 Correction Date: 10/31/2008
Have a Program to Keep Infection from Spreading. Inspection Date: 09/12/2008 Correction Date: 10/31/2008
Provide Needed Housekeeping and Maintenance. Inspection Date: 07/23/2009 Correction Date: 09/16/2009
Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents. Inspection Date: 07/23/2009 Correction Date: 09/16/2009
Have a Program to Keep Infection from Spreading. Inspection Date: 07/23/2009 Correction Date: 09/16/2009
Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents. Inspection Date: 09/02/2010 Correction Date: 10/21/2010
Have a Program to Keep Infection from Spreading. Inspection Date: 09/02/2010 Correction Date: 10/21/2010

Mistreatment

Keep Each Resident Free from Physical Restraints, Unless Needed for Medical Treatment. Inspection Date: 09/12/2008 Correction Date: 10/31/2008

Nutrition and Dietary

Prepare Food That is Nutritional, Appetizing, Tasty, Attractive, Well-Cooked, and at the Right Temperature. Inspection Date: 09/12/2008 Correction Date: 10/31/2008
Offer Other Nutritional Food to Each Resident Who Will Not Eat the Food Served. Inspection Date: 09/12/2008 Correction Date: 10/31/2008
Store, Cook, and Give out Food in a Safe and Clean Way. Inspection Date: 09/12/2008 Correction Date: 10/31/2008
Store, Cook, and Give out Food in a Safe and Clean Way. Inspection Date: 07/23/2009 Correction Date: 09/16/2009
1) Provide 3 Meals Daily at Regular Times; or 2) Serve Breakfast Within 14 Hours After Dinner; or 3) Offer a Snack at Bedtime Each Day. Inspection Date: 09/02/2010 Correction Date: 10/21/2010

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: 09/12/2008 Correction Date: 10/31/2008
Keep the Rate of Medication Errors (Wrong Drug, Wrong Dose, Wrong Time) to Less Than 5%. Inspection Date: 09/12/2008 Correction Date: 10/31/2008
Properly Mark Drugs and Other Similar Products. Inspection Date: 09/12/2008 Correction Date: 10/31/2008

Quality Care

Give Professional Services That Meet a Professional Standard of Quality. Inspection Date: 09/12/2008 Correction Date: 10/31/2008
Give Professional Services That Follow Each Resident's Written Care Plan. Inspection Date: 09/12/2008 Correction Date: 10/31/2008
Give Each Resident Care and Services to Get or Keep the Highest Quality of Life Possible. Inspection Date: 09/12/2008 Correction Date: 10/31/2008
Make Sure That Residents Who Cannot Care for Themselves Receive Help with Eating/Drinking, Grooming and Hygiene. Inspection Date: 09/12/2008 Correction Date: 10/31/2008
Give Professional Services That Meet a Professional Standard of Quality. Inspection Date: 07/23/2009 Correction Date: 09/16/2009
Make Sure That Residents Who Cannot Care for Themselves Receive Help with Eating/Drinking, Grooming and Hygiene. Inspection Date: 07/23/2009 Correction Date: 09/16/2009
Give Residents Proper Treatment to Prevent New Bed (Pressure) Sores or Heal Existing Bed Sores. Inspection Date: 07/23/2009 Correction Date: 09/16/2009
Make Sure That Residents with Reduced Range of Motion Get Proper Treatment and Services to Increase Range of Motion. Inspection Date: 07/23/2009 Correction Date: 09/16/2009
Give Professional Services That Meet a Professional Standard of Quality. Inspection Date: 09/02/2010 Correction Date: 10/21/2010
Give Professional Services That Follow Each Resident's Written Care Plan. Inspection Date: 09/02/2010 Correction Date: 10/21/2010
Give Each Resident Care and Services to Get or Keep the Highest Quality of Life Possible. Inspection Date: 09/02/2010 Correction Date: 10/21/2010
Make Sure That Residents Who Cannot Care for Themselves Receive Help with Eating/Drinking, Grooming and Hygiene. Inspection Date: 09/02/2010 Correction Date: 10/21/2010

Resident Assessment

Do a New Assessment After Any Major Change in a Resident's Physical or Mental Health. Inspection Date: 09/12/2008 Correction Date: 10/31/2008
Develop a Complete Care Plan That Meets All of a Resident's Needs, with Timetables and Actions That Can Be Measured. Inspection Date: 09/12/2008 Correction Date: 10/31/2008
Develop a Complete Care Plan That Meets All of a Resident's Needs, with Timetables and Actions That Can Be Measured. Inspection Date: 07/23/2009 Correction Date: 09/16/2009

Resident Rights

Keep Each Resident's Personal and Medical Records Private and Confidential. Inspection Date: 09/12/2008 Correction Date: 10/31/2008
Provide Care in a Way That Keeps or Builds Each Resident's Dignity and Self Respect. Inspection Date: 09/12/2008 Correction Date: 10/31/2008
Keep Each Resident's Personal and Medical Records Private and Confidential. Inspection Date: 07/23/2009 Correction Date: 09/16/2009
Keep Each Resident's Personal and Medical Records Private and Confidential. Inspection Date: 09/02/2010 Correction Date: 10/21/2010

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

Administration

Give Lab Tests Only when the Attending Doctor Ordered Them. Complaint Filed: 02/19/2009 Correction Date: 03/24/2009

Environmental

Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents. Complaint Filed: 01/21/2010 Correction Date: 03/16/2010
Provide Needed Housekeeping and Maintenance. Complaint Filed: 02/26/2010 Correction Date: 03/16/2010
Provide Needed Housekeeping and Maintenance. Complaint Filed: 03/17/2011 Correction Date: 05/04/2011

Quality Care

Give Professional Services That Meet a Professional Standard of Quality. Complaint Filed: 04/01/2008 Correction Date: 05/14/2008
Make Sure That Residents Who Cannot Care for Themselves Receive Help with Eating/Drinking, Grooming and Hygiene. Complaint Filed: 01/23/2009 Correction Date: 03/17/2009
Give Professional Services That Meet a Professional Standard of Quality. Complaint Filed: 02/19/2009 Correction Date: 03/24/2009
Make Sure That Residents Who Cannot Care for Themselves Receive Help with Eating/Drinking, Grooming and Hygiene. Complaint Filed: 05/29/2009 Correction Date: 07/08/2009
Provide Activities to Meet the Needs of Each Resident. Complaint Filed: 01/21/2010 Correction Date: 03/16/2010
Give or Get Special Rehabilitation if in the Patient's Plan of Care. Complaint Filed: 02/26/2010 Correction Date: 03/16/2010
Make Sure That Residents Who Cannot Care for Themselves Receive Help with Eating/Drinking, Grooming and Hygiene. Complaint Filed: 02/26/2010 Correction Date: 03/16/2010
Make Sure That Each Resident Who Enters the Nursing Home Without a Catheter is Not Given a Catheter, Unless It is Necessary. Complaint Filed: 02/26/2010 Correction Date: 03/16/2010
Give Each Resident Care and Services to Get or Keep the Highest Quality of Life Possible. Complaint Filed: 02/26/2010 Correction Date: 03/16/2010

Resident Assessment

Develop a Plan with the Resident and Family for the Resident's Care After Leaving the Nursing Home. Complaint Filed: 02/26/2010 Correction Date: 03/16/2010

Nursing homes certified by Medicare and/or Medicaid are required to have fire safety inspections to meet Life Safety Code (LSC) standards. Below is a list of deficiencies that Mark Twain Caring Center had in recent fire safety inspections. This information can be used to see if all standards were met, the degree of harm, the number of residents affected, and the date when deficiencies were corrected. Note: The most recent fire safety survey was on 09/02/2010.

Automatic Sprinkler Systems

Automatic Sprinkler Systems That Have Been Maintained in Working Order. Inspection Date: 09/12/2008 Correction Date: 10/31/2008

Building Construction

Approved Construction Type or Materials. Inspection Date: 09/12/2008 Correction Date: 10/31/2008

Corridor Walls and Doors

Corridor and Hallway Doors That Block Smoke. Inspection Date: 09/12/2008 Correction Date: 10/31/2008

Electrical

Properly Installed Electrical Wiring and Equipment. Inspection Date: 09/12/2008 Correction Date: 10/31/2008

Exits and Egress

Exits That Are Accessible at All Times. Inspection Date: 09/12/2008 Correction Date: 10/31/2008
Corridors or Aisles That Are Unobstructed and Are at Least 8 Feet in Width. Inspection Date: 09/12/2008 Correction Date: 10/31/2008

Furnishings and Decorations

Restrictions on the Use of Flammable Curtains. Inspection Date: 09/12/2008 Correction Date: 10/31/2008

Medical Gases and Anesthetizing Areas

No-Smoking Signs Where Oxygen is Used. Inspection Date: 07/23/2009 Correction Date: 09/16/2009

Smoke Compartmentation and Control

Walls or Barriers That Prevent Smoke from Passing Through and Would Resist Fire for at Least One Hour. Inspection Date: 09/12/2008 Correction Date: 10/31/2008
Smoke Barrier Doors That Can Resist Smoke for at Least 20 Minutes. Inspection Date: 09/12/2008 Correction Date: 10/31/2008
Walls or Barriers That Prevent Smoke from Passing Through and Would Resist Fire for at Least One Hour. Inspection Date: 07/23/2009 Correction Date: 09/16/2009
Walls or Barriers That Prevent Smoke from Passing Through and Would Resist Fire for at Least One Hour. Inspection Date: 09/02/2010 Correction Date: 10/21/2010

Smoking Regulations

Posted "No-Smoking" Signs in Areas Where Smoking is Not Permitted or Did Not Provide Ashtrays Where Smoking Was Allowed. Inspection Date: 09/12/2008 Correction Date: 10/31/2008
Posted "No-Smoking" Signs in Areas Where Smoking is Not Permitted or Did Not Provide Ashtrays Where Smoking Was Allowed. Inspection Date: 07/23/2009 Correction Date: 09/16/2009