CARRIAGE SQUARE HEALTH CARE CENTER

The information listed below provides an in-depth look into the type and quality of care offered at Carriage Square Health 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

CARRIAGE SQUARE HEALTH CARE CENTER
4009 GENE FIELD ROAD
SAINT JOSEPH, MO 64506
(816) 364-1526

Nursing Home Ratings

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

Overall Rating

Percent of Beds Occupied

88%

Number of Residents and Certified Beds

Residents: 114
Certified Beds: 130

This Facility Accepts

Medicare
Medicaid

Operational Details

Operated By For Profit - Corporation
Offers Both Resident and Family Counseling Services
This Facility is Not Part of a Chain or Franchise

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Nearby Cities:

Savannah | Gower | Oregon

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 "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 Carriage Square Health 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	1.1%
Total Percent:	1.1%

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: 6-10	2.9%
ADL Index Range: 0-5	10.5%
Total Percent:	13.4%

Very High Rehabilitation

Rehabilitation 500 Minutes Per Week Minimum

At least one rehabilitation discipline five days/week

ADL Index Range: 6-10	15.3%
ADL Index Range: 0-5	10.8%
Total Percent:	26.2%

High Rehabilitation

Rehabilitation 325 Minutes Per Week Minimum

At least one rehabilitation discipline five days/week

ADL Index Range: 11-16	4.9%
ADL Index Range: 6-10	20.4%
ADL Index Range: 0-5	6.5%
Total Percent:	31.8%

Medium Rehabilitation

Rehabilitation 150 Minutes Per Week Minimum

Five days any combination of three rehabilitation disciplines

ADL Index Range: 6-10	5.1%
Total Percent:	5.1%

Extensive Services

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: 2-16 - Isolation for active infectious disease	8.5%
Total Percent:	8.5%

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: 11-14 - No Signs of depression	2.5%
Total Percent:	2.5%

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: 6-10 - No Signs of depression	7.0%
Total Percent:	7.0%

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 - Signs of depression	0.7%
Total Percent:	0.7%

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: 6-10 - Less restorative nursing	3.8%
Total Percent:	3.8%

Rating Details For Carriage Square Health 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	15 Minutes	58 Minutes
Licensed Practical/Vocational Nurse (LPN/LVN) Hours	38 Minutes	37 Minutes
Certified Nursing Assistant (CNA) Hours	2 Hours and 45 Minutes	2 Hours and 27 Minutes
Total Licensed Nurse Hours	53 Minutes	1 Hour and 35 Minutes
Total Nurse Hours	3 Hours and 38 Minutes	4 Hours and 2 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 Missouri are also provided for comparison purposes. Note: Figures below are averaged over the past nine months.

This Facility

Missouri Average

Long-Term Stay Preventive Actions

Percent of Long-Stay Residents Given Influenza Vaccination During the Flu Season	90-100%	93%
Percent of Long-Stay Residents Who Were Assessed and Given Pneumococcal Vaccination	90-100%	88%

Long-Term Stay Deficiencies

Percent of Low-Risk Long-Stay Residents Who Have Pressure Sores	-	3%
Percent of Long-Stay Residents Who Lose Too Much Weight	11%	7%
Percent of Long-Stay Residents Who Were Physically Restrained	-	4%
Percent of Long-Stay Residents Who Have/Had a Catheter Inserted and Left in Their Bladder	6%	5%
Percent of Low-Risk Long-Stay Residents Who Lose Control of Their Bowels or Bladder	44%	38%
Percent of Long-Stay Residents Who Spend Most of Their Time in Bed or in a Chair	5%	3%
Percent of Long-Stay Residents Who Are More Depressed or Anxious	13%	11%
Percent of Long-Stay Residents Whose Ability to Move About in and Around Their Room Got Worse	4%	9%
Percent of Long-Stay Residents Who Had a Urinary Tract Infection	9%	9%
Percent of Long-Stay Residents Who Have Moderate to Severe Pain	2%	4%
Percent of High-Risk Long-Stay Residents Who Have Pressure Sores	6%	10%
Percent of Long-Stay Residents Whose Need for Help with Daily Activities Has Increased	7%	11%

Short-Term Stay Preventive Actions

Percent of Short-Stay Residents Given Influenza Vaccination During the Flu Season	90-100%	87%
Percent of Short-Stay Residents Who Were Assessed and Given Pneumococcal Vaccination	90-100%	83%

Short-Term Stay Deficiencies

Percent of Short-Stay Residents Who Had Moderate to Severe Pain	9%	20%
Percent of Short-Stay Residents Who Have Pressure Sores	2%	11%
Percent of Short-Stay Residents Who Have Delirium	-	4%

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 09/10/2010.

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

Hire Nurse Aides Who Have Completed Required Training and Shown That They Are Skilled. Inspection Date: 04/23/2009 Correction Date: 06/18/2009
Train All Employees on What to Do in an Emergency. Inspection Date: 04/23/2009 Correction Date: 06/18/2009

Environmental

Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents. Inspection Date: 04/23/2009 Correction Date: 06/18/2009
Have a Program to Keep Infection from Spreading. Inspection Date: 04/23/2009 Correction Date: 06/18/2009
Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents. Inspection Date: 01/12/2010 Correction Date: 03/03/2010
Have a Program to Keep Infection from Spreading. Inspection Date: 01/12/2010 Correction Date: 03/03/2010
Make Sure That the Nursing Home Area is Free of Dangers That Cause Accidents. Inspection Date: 09/10/2010 Correction Date: 10/28/2010
Have a Program to Keep Infection from Spreading. Inspection Date: 09/10/2010 Correction Date: 11/20/2010

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.

Inspection Date: 04/23/2009
Correction Date: 06/18/2009

Nutrition and Dietary

Prepare Food That is Nutritional, Appetizing, Tasty, Attractive, Well-Cooked, and at the Right Temperature. Inspection Date: 04/23/2009 Correction Date: 06/18/2009
Provide Food in a Way That Meets a Resident's Needs. Inspection Date: 04/23/2009 Correction Date: 06/18/2009
Prepare Food That is Nutritional, Appetizing, Tasty, Attractive, Well-Cooked, and at the Right Temperature. Inspection Date: 09/10/2010 Correction Date: 10/28/2010

Pharmacy Service

Keep the Rate of Medication Errors (Wrong Drug, Wrong Dose, Wrong Time) to Less Than 5%. Inspection Date: 01/12/2010 Correction Date: 03/03/2010
Keep the Rate of Medication Errors (Wrong Drug, Wrong Dose, Wrong Time) to Less Than 5%. Inspection Date: 09/10/2010 Correction Date: 10/28/2010
Properly Mark Drugs and Other Similar Products. Inspection Date: 09/10/2010 Correction Date: 10/28/2010

Quality Care

Provide Social Services for Related Medical Problems to Help Each Resident Achieve the Highest Possible Quality of Life. Inspection Date: 04/23/2009 Correction Date: 06/18/2009
Give Professional Services That Meet a Professional Standard of Quality. Inspection Date: 04/23/2009 Correction Date: 06/18/2009
Give Each Resident Care and Services to Get or Keep the Highest Quality of Life Possible. Inspection Date: 04/23/2009 Correction Date: 06/18/2009
Make Sure That Each Resident Who Enters the Nursing Home Without a Catheter is Not Given a Catheter, Unless It is Necessary. Inspection Date: 04/23/2009 Correction Date: 06/18/2009
Make Sure That Residents with Reduced Range of Motion Get Proper Treatment and Services to Increase Range of Motion. Inspection Date: 04/23/2009 Correction Date: 06/18/2009
Give Professional Services That Meet a Professional Standard of Quality. Inspection Date: 01/12/2010 Correction Date: 03/03/2010
Make Sure That Residents Who Cannot Care for Themselves Receive Help with Eating/Drinking, Grooming and Hygiene. Inspection Date: 01/12/2010 Correction Date: 03/03/2010
Make Sure That Each Resident Who Enters the Nursing Home Without a Catheter is Not Given a Catheter, Unless It is Necessary. Inspection Date: 01/12/2010 Correction Date: 03/03/2010
Give Professional Services That Meet a Professional Standard of Quality. Inspection Date: 09/10/2010 Correction Date: 10/28/2010
Make Sure That Residents Who Cannot Care for Themselves Receive Help with Eating/Drinking, Grooming and Hygiene. Inspection Date: 09/10/2010 Correction Date: 11/20/2010
Make Sure That Each Resident Who Enters the Nursing Home Without a Catheter is Not Given a Catheter, Unless It is Necessary. Inspection Date: 09/10/2010 Correction Date: 10/28/2010
Make Sure That Each Resident's Nutritional Needs Were Met. Inspection Date: 09/10/2010 Correction Date: 10/28/2010
Develop/Implement Required Procedures for the Administration of Immunizations. Inspection Date: 09/10/2010 Correction Date: 10/28/2010

Resident Rights

Properly Hold, Secure and Manage Each Resident's Personal Money Which is Deposited with the Nursing Home. Inspection Date: 04/23/2009 Correction Date: 06/18/2009
Make Sure Each Resident Has the Right to Choose Activities, Schedules and Health Care According to His or Her Interests, Assessment, and Plan of Care. Inspection Date: 04/23/2009 Correction Date: 06/18/2009
Provide Services to Meet the Needs and Preferences of Each Resident. Inspection Date: 04/23/2009 Correction Date: 06/18/2009
Keep Each Resident's Personal and Medical Records Private and Confidential. Inspection Date: 09/10/2010 Correction Date: 10/28/2010
Provide Care in a Way That Keeps or Builds Each Resident's Dignity and Self Respect. Inspection Date: 09/10/2010 Correction Date: 10/28/2010

Enforcement

Below is a list of any civil penalities or denials of payment for new admissions (DPNA) that this facility received in the previous three years. Note: Monetary figures are not available for DPNAs.

Action Taken	Date	Amount
Denial of Payment for New Admission (DPNA)	04/23/2009	-

Deficiencies from Complaints and Incidents

The table below lists incident reports by the nursing staff or administration for Carriage Square Health 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