Citizens Memorial Healthcare Facility
1218 West Locust, Po Box 590, Bolivar, MO 65613


Citizens Memorial Healthcare Facility is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 265545. The address is 1218 West Locust, Po Box 590, Bolivar, MO 65613. The zip code is 65613. The phone number is 4173267648.


Citizens Memorial Healthcare Facility · 1218 West Locust, Po Box 590, Bolivar, MO 65613

Federal Provider Number 265545
Provider Name CITIZENS MEMORIAL HEALTHCARE FACILITY
Address 1218 WEST LOCUST, PO BOX 590
BOLIVAR, MO 65613
Phone Number 4173267648
SSA County Code 821
County Name Polk
Ownership Type Non profit - Other
Certified Beds 111
Certified Beds Residents 107
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name CITIZENS MEMORIAL HEALTH CARE FOUNDATION
Date First Approved to Provide Medicare Medicaid Services 09/27/1993
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Both
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 4
Health Inspection Rating 3
Quality Measure Rating 5
Staffing Rating 3
RN Staffing Rating 3
Reported CNA Staffing Hours per Resident per Day 2.5472
Reported LPN Staffing Hours per Resident per Day 0.24533
Reported RN Staffing Hours per Resident per Day 0.57196
Reported Licensed Staffing Hours per Resident per Day 0.81729
Reported Total Nurse Staffing Hours per Resident per Day 3.36449
Reported Physical Therapist Staffing Hours per Resident Per Day 0.05981
Expected CNA Staffing Hours per Resident per Day 2.31802
Expected LPN Staffing Hours per Resident per Day 0.59729
Expected RN Staffing Hours per Resident per Day 0.8578
Expected Total Nurse Staffing Hours per Resident per Day 3.77311
Adjusted CNA Staffing Hours per Resident per Day 2.6963
Adjusted LPN Staffing Hours per Resident per Day 0.34091
Adjusted RN Staffing Hours per Resident per Day 0.49821
Adjusted Total Nurse Staffing Hours per Resident per Day 3.59436
Cycle 1 Total Number of Health Deficiencies 4
Cycle 1 Number of Standard Health Deficiencies 4
Cycle 1 Health Deficiency Score 52
Cycle 1 Standard Survey Health Date 03/02/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 52
Cycle 2 Total Number of Health Deficiencies 5
Cycle 2 Number of Standard Health Deficiencies 5
Cycle 2 Health Deficiency Score 32
Cycle 2 Standard Health Survey Date 03/25/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 32
Cycle 3 Total Number of Health Deficiencies 1
Cycle 3 Number of Standard Health Deficiencies 1
Cycle 3 Health Deficiency Score 4
Cycle 3 Standard Health Survey Date 01/23/2015
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 4
Total Weighted Health Survey Score 37.333
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Citizens Memorial Healthcare Facility

Owner Name Role Association Date
BABB, DONALD (Individual) DIRECTOR since 09/24/1986
DONNELL, WILLIAM (Individual) DIRECTOR since 03/14/2012
FULBRIGHT, GARY (Individual) OFFICER since 09/24/1986
GREGORY, BRADLEY (Individual) OFFICER since 07/01/1991
HUNTER, DEREK (Individual) DIRECTOR since 07/01/2007
JOHNSON, NEALE (Individual) DIRECTOR since 08/18/2011
MEENTS, DANA (Individual) DIRECTOR since 10/14/2010
MEYER, RENEE (Individual) MANAGING EMPLOYEE since 07/01/1997
MOLDER, CATHERINE (Individual) OFFICER since 03/01/2002
PAYNE, RUSSEL (Individual) DIRECTOR since 02/16/2012
STRADER, DAVE (Individual) OFFICER since 07/01/1991
TILLEY, KIM (Individual) MANAGING EMPLOYEE since 12/31/2014

65613 · Nursing Home

Parkview Health Care Facility 119 West Forest, Bolivar, MO 65613

Bolivar · Nursing Home

Pleasant View Health Care Center 214 North Water Street, Bolivar, TN 38008
Pine Meadows Health Care and Rehabilitation Center 700 Nuckolls Road, Bolivar, TN 38008
Hennis Care Centre of Bolivar 300 Yant Street, Nw, Bolivar, OH 44612
Parkview Health Care Facility 119 West Forest, Bolivar, MO 65613

MO · Nursing Home

Westridge Gardens Rehab & Health Care Center 11901 Jessica Lane, Raytown, MO 64138
Woodland Manor Nursing Center 100 Woodland Court, Arnold, MO 63010
Truman Healthcare & Rehabilitation Center 206 West First Street, Lamar, MO 64759
Ozark Rehabilitation & Health Care Center 1083 Ozark Care Drive, Po Box 270, Osage Beach, MO 65065
St James Living Center 415 Sidney Street, Po Box 69, Saint James, MO 65559
Ridgeview Living Community 500 Barrett Drive, Malden, MO 63863
Cypress Point-skilled Nursing By Americare 801 Baliff Drive, Dexter, MO 63841
Bethesda Southgate 5943 Telegraph Road, Saint Louis, MO 63129
Hidden Lake Care Center 11400 Hidden Lake Drive, Raytown, MO 64133
Garden View Care Center of Chesterfield 1025 Chesterfield Pointe Parkway, Chesterfield, MO 63017
La Belle Manor Care Center 1002 Central, La Belle, MO 63447
Joplin Gardens 2810 South Jackson Avenue, Joplin, MO 64804
Monticello House 1115 K Land Drive, Po Box 740, Jackson, MO 63755
Clark County Nursing Home 1260 North Johnson Street, Kahoka, MO 63445
Medicalodges Nevada 1210 West Ashland, Nevada, MO 64772
Festus Manor 627 Westwood Drive South, Festus, MO 63028
Ozarks Methodist Manor, The 205 South College, Po Box 403, Marionville, MO 65705
Beautiful Savior Home 1003 South Cedar Street, Belton, MO 64012
Riverways Manor 403 Watercress Road, Box 969, Van Buren, MO 63965
Sunnyview Nursing Home & Apartments 1311 E 28th Street, Trenton, MO 64683
St Francois Manor 1180 Old Jackson Road, Farmington, MO 63640
Moore-few Care Center 901 South Adams, Nevada, MO 64772
Good Shepherd Care Center 1101 West Clay Road, Versailles, MO 65084
Nhc Healthcare, Maryland Heights 2920 Fee Fee Road, Maryland Heights, MO 63043
Liberty Health and Wellness 2201 Glenn Hendren Dr, Liberty, MO 64068
Golden Age Living Center 404 E Third Street, Po Box 307, Stover, MO 65078
Strafford Care Center 505 West Evergreen, Strafford, MO 65757
Southgate Living Center 500 Truman Boulevard, Caruthersville, MO 63830
Mount Carmel Senior Living - O'fallon, LLC 206 North Main Street, O Fallon, MO 63366
Carroll House 307 Grand, Carrollton, MO 64633
Alexian Bros Sherbrooke Village 4005 Ripa Avenue, Saint Louis, MO 63125
Gainesville Health Care Center 77 Medical Drive, Po Box 628, Gainesville, MO 65655
Osage Beach Rehabilitation and Health Care Center 844 Passover Road, Osage Beach, MO 65065
Southbrook-skilled Nursing By Americare 1108 West Liberty, Farmington, MO 63640
Beth Haven Nursing Home 2500 Pleasant Street, Hannibal, MO 63401
Licking Park Manor 209 Hickory Street, Licking, MO 65542
Hill Crest Manor 801 South Colby, Hamilton, MO 64644
Riverdell Care Center 1121 11th Street, Boonville, MO 65233
Meramec Nursing Center 940 Mattox Drive, Sullivan, MO 63080
Pillars of North County Health & Rehab Center, The 13700 Old Halls Ferry Road, Florissant, MO 63033