Federal inspection record · CMS data as of October 1, 2026
Carriage Square Rehab And Healthcare Center
4009 Gene Field Road, Saint Joseph, MO · (816) 364-1526
- Certified beds
- 130
- Residents per day
- 87
- Ownership
- For-Profit
- Chain
- Ama Holdings
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- January 1, 1989
1
How this home got 1 star
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Missouri.
-
Staffing
★★★★★no change (already 1)
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
-
Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
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Overall
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Missouri homes
Carriage Square Rehab And Healthcare Center carries 255.25 inspection points. That is fewer than 7% of Missouri's 479 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Missouri: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–20 pts
- 4★ 20–54 pts
- 3★ 54–93.75 pts
- 2★ 93.75–159 pts
- 1★ over 159 pts
Bars show every rated home in Missouri by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
58 health citations on record since 2021. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
Harm and immediate-jeopardy citations (2)
-
J
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
-
G
Provide safe, appropriate pain management for a resident who requires such services.
Everything else, by area of care
Resident Rights12E
- E
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- E
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
- E
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
- E
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
- E
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
- E
Honor the resident's right to manage his or her financial affairs.
- E
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
- E
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
- E
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
- D
Allow residents to self-administer drugs if determined clinically appropriate.
- D
Reasonably accommodate the needs and preferences of each resident.
- D
Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.
Quality of Life and Care11E
- E
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- E
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- E
Provide safe and appropriate respiratory care for a resident when needed.
- E
Provide care and assistance to perform activities of daily living for any resident who is unable.
- E
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- E
Provide care or services that was trauma informed and/or culturally competent.
- D
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- D
Provide safe and appropriate respiratory care for a resident when needed.
- E
Provide safe and appropriate respiratory care for a resident when needed.
- D
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
- D
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Resident Assessment and Care Planning6E
- E
Ensure services provided by the nursing facility meet professional standards of quality.
- B
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- E
Ensure services provided by the nursing facility meet professional standards of quality.
Infection Control6F
- E
Provide and implement an infection prevention and control program.
- E
Provide and implement an infection prevention and control program.
- F
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
- E
Provide and implement an infection prevention and control program.
- D
Implement a program that monitors antibiotic use.
- F
Provide and implement an infection prevention and control program.
Administration5F
- F
Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse.
- F
Develop, implement, and/or maintain an effective training program for all new and existing staff members.
- F
Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.
- F
Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
- F
Provide training in compliance and ethics.
Nutrition and Dietary5E
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- D
Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.
Freedom from Abuse, Neglect, and Exploitation5E
- D
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Respond appropriately to all alleged violations.
- D
Protect each resident from the wrongful use of the resident's belongings or money.
- E
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Nursing and Physician Services3F
- F
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
- E
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
- D
Post nurse staffing information every day.
Pharmacy Service2E
- D
Ensure that residents are free from significant medication errors.
- E
Ensure medication error rates are not 5 percent or greater.
Environmental1F
- F
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Inspection history
2025-03-14
22 health deficiencies · 5 fire-safety deficiencies
Top issue: Administration (5 deficiencies)
2023-07-14
18 health deficiencies · 17 fire-safety deficiencies
Top issue: Quality of Life and Care (5 deficiencies)
2021-08-05
18 health deficiencies · 8 fire-safety deficiencies
Top issue: Resident Rights (7 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 42 min of nursing staff time a day, 23 min of it from a registered nurse.
This home
3 h 42 min
Missouri average
3 h 24 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 72% of nursing staff and 69% of registered nurses left in the past year, along with 1 administrator.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Fines and payment denials
$48,685 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2025-03-14 | Fine | $48,685 |
6
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.1 pts worse | 2.1 | 2.0 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.2 pts worse | 2.4 | 2.2 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine23.3 pts worse | 60.7% | 84.0% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine4.4 pts better | 95.2% | 90.8% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury0.2 pts worse | 4.2% | 4.0% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms29.1 pts worse | 49.1% | 20.0% | 13.5% |
| Percentage of long-stay residents who lose too much weight4.7 pts better | 0.4% | 5.1% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication4.8 pts better | 20.8% | 25.6% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication5.5 pts better | 18.0% | 23.5% | 15.4% |
| Percentage of long-stay residents who were physically restrainedAbout the same | 0.0% | 0.0% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened3.1 pts better | 12.7% | 15.8% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased2.1 pts worse | 19.5% | 17.4% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.3 pts better | 0.6% | 0.9% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection0.2 pts better | 2.0% | 2.2% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence9.2 pts worse | 26.3% | 17.1% | 18.3% |
| Percentage of long-stay residents with pressure ulcers0.2 pts better | 4.2% | 4.4% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine44.8 pts worse | 20.9% | 65.7% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit8.7 pts worse | 22.1% | 13.4% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication1 pts better | 1.1% | 2.1% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine19 pts worse | 42.4% | 61.4% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission5.2 pts worse | 30.9% | 25.7% | 23.4% |
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Who owns and runs it
9 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Mo Operation Holdings De Spe LLC | 5% Or Greater Direct Ownership Interest · Organization | 99% | 8 facilities |
| Ama Holdings LLC | 5% Or Greater Indirect Ownership Interest · Organization | 0% | 13 facilities |
| Byrom, Amy | W-2 Managing Employee · Individual | 0% | 2 facilities |
| Def Holdings LLC | 5% Or Greater Indirect Ownership Interest · Organization | 0% | 13 facilities |
| Marx, Asher | 5% Or Greater Indirect Ownership Interest · Individual | 0% | 13 facilities |
| Marx, Asher | Corporate Director · Individual | 0% | 13 facilities |
| Mo Operation Holdings De Spe LLC | Operational/Managerial Control · Organization | 0% | 8 facilities |
| Wolf, Jacques | 5% Or Greater Indirect Ownership Interest · Individual | 0% | 13 facilities |
| Wolf, Jacques | Corporate Director · Individual | 0% | 13 facilities |
·
Fire safety
30 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke9F
- F
Properly install and monitor supervisory attachments on automatic sprinkler systems.
- F
Have approved installation, maintenance and testing program for fire alarm systems.
- F
Inspect, test, and maintain automatic sprinkler systems.
- F
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- E
Provide properly protected cooking facilities.
- E
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- E
Inspect, test, and maintain automatic sprinkler systems.
- E
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Gas, Vacuum, and Electrical Systems8F
- F
Have generator or other power source capable of supplying service within 10 seconds.
- F
Ensure proper usage of power strips and extension cords.
- E
Meet requirements for the installation and maintenance of electrical systems.
- F
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- F
Have generator or other power source capable of supplying service within 10 seconds.
- E
Ensure proper usage of power strips and extension cords.
- E
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- E
Have generator or other power source capable of supplying service within 10 seconds.
Miscellaneous6F
- F
Have simulated fire drills held at unexpected times.
- F
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- E
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
- E
Have restrictions on the use of portable space heaters.
- F
Provide a written emergency evacuation plan.
- E
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Egress3E
- E
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- E
Install emergency lighting that can last at least 1 1/2 hours.
- D
Have properly located and lighted "Exit" signs.
Construction2E
- E
Use approved construction type or materials.
- E
Use approved construction type or materials.
Services2E
- E
Have properly installed electrical wiring and gas equipment.
- D
Have properly installed electrical wiring and gas equipment.
·
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