CITIZENS MEMORIAL HOSPICE
NPI 1124157169
Hospice Care, Community Based in Bolivar, MO

NPI Status: Active since March 05, 2007

Contact Information

111 W BROADWAY ST
BOLIVAR, MO
ZIP 65613
Phone: (417) 328-6350
Fax: (417) 328-6987

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  • Organization
  • Hospice Care, Community Based
  • Accepts Insurance

About CITIZENS MEMORIAL HOSPICE

This page provides the complete NPI Profile along with additional information for Citizens Memorial Hospice, a provider established in Bolivar, Missouri operating as a Hospice Care, Community Based. The healthcare provider is registered in the NPI registry with number 1124157169 assigned on March 2007. The practitioner's primary taxonomy code is 251G00000X with license number 003-10H0 (MO). The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Citizens Memorial Hospice. The authorized official of this NPI record is Gary D. Fulbright (Executive Director)

NPI
1124157169
Provider Legal Name
CITIZENS MEMORIAL HEALTH CARE FOUNDATION
Other Organization Name
CITIZENS MEMORIAL HOSPICE
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
111 W BROADWAY ST BOLIVAR, MO 65613
Location Phone
(417) 328-6350
Location Fax
(417) 328-6987
Mailing Address
1500 N OAKLAND AVE BOLIVAR, MO 65613
Mailing Phone
(417) 326-6000
Mailing Fax
(417) 328-6987
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-05-2007
Last Update Date
02-18-2020
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According to the Hospice Quality Reporting Program (HQRP) data this facility is other and was certified on 10-19-2009 This facility was recently evaluated on the following quality measures: average daily census, hospice served at least 1 patient with both medicare and medicaid coverage during one year, hospice served at least 1 patient enrolled in medicare advantage during one year, care provided in assisted living facility and care provided in home, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Hospice Care, Community Based

Taxonomy Code
251G00000X
Type
Agencies
License No.
003-10H0
License State
MO

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA (QualChoice) - POS
  • Complete Gold - PPO
  • Complete Gold + Vision + Adult Dental - PPO
  • Connected Silver - PPO
  • Connected Silver (QualChoice) - POS
  • Connected Silver (QualChoice) + Vision + Adult Dental - POS
  • Connected Silver (QualChoiceLife) - PPO
  • Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
  • Connected Silver + Vision + Adult Dental - PPO
  • Elite Bronze - PPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Choice Bronze HSA - EPO
  • Choice Bronze HSA + Vision + Adult Dental - EPO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - EPO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold - PPO
  • Elite Gold + Vision + Adult Dental - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

GARY D. FULBRIGHT

Authorized Official Title
EXECUTIVE DIRECTOR
Authorized Official Phone
(417) 328-6501

Hospice Care Information

The Centers for Medicare and Medicaid Services Hospice Quality Reporting Program (HQRP) data provides information on the quality of care that hospice facilities are providing to their patients. The quality reporting data gives families and patients the information they need to decide which hospice is right for them.

CMS Certification Number (CCN)261508
Ownership TypeOther
Medicare Certification Date10-19-2009
Quality Measure Measure Score
Average Daily Census
Number of patients cared for by a hospice on average each day
52.0
Hospice served at least 1 patient with both Medicare and Medicaid coverage during one year
1= Hospice served at least 1 patient with both Medicaid and Medicare coverage OR 0 = Hospice did not serve any patients with both Medicaid and Medicare coverage
Yes
Hospice served at least 1 patient enrolled in Medicare Advantage during one year
1 = Hospice served at least one patient enrolled in Medicare Advantage OR 0 = Hospice did not serve any patients enrolled in Medicare Advantage
Yes
Care Provided in Assisted Living Facility
Percentage of days patients received care in an assisted living facility
0 - Value is based on one year of data and does not indicate that the hospice would have 0% in more recent years.
Care Provided in Home
Percentage of days patients received care in home
32
Care Provided in Inpatient Hospice Facility
Percentage of days patients received care in an inpatient hospice
0 - Value is based on one year of data and does not indicate that the hospice would have 0% in more recent years.
Care Provided in Inpatient Hospital Facility
Percentage of days patients received care in an inpatient hospital
0 - Value is based on one year of data and does not indicate that the hospice would have 0% in more recent years.
Care Provided in Nursing Facility
Percentage of days patients received care in a nursing facility
67
Care Provided in All other locations
Percentage of days patients received care in other locations
1
Care Provided in Skilled Nursing Facility
Percentage of days patients received care in a skilled nursing facility
0 - Value is based on one year of data and does not indicate that the hospice would have 0% in more recent years.
Hospice and Palliative Care Treatment Preferences
Facility observed rate
99.7
Beliefs & Values Addressed (if desired by the patient)
Facility observed rate
99.0
Hospice and Palliative Care Pain Screening
Facility observed rate
99.7
Hospice and Palliative Care Pain Assessment
Facility observed rate
97.9
Hospice and Palliative Care Dyspnea Screening
Facility observed rate
94.8
Hospice and Palliative Care Dyspnea Treatment
Facility observed rate
98.3
Patient Treated with an Opioid Who Are Given a Bowel Regimen
Facility observed rate
96.3
Hospice and Palliative Care Composite Process Measure
Facility observed rate
89.9
Hospice Visits in the Last Days of Life
348
Hospice Visits in the Last Days of Life
Facility observed rate
49.7
Hospice Care Index Overall Score
Facility observed rate
8.0
CHC/GIP provided (% days)
46,592
CHC/GIP provided (% days)
Facility observed rate
0.0
CHC/GIP provided (% days)
51
Gaps in nursing visits (% elections)
256
Gaps in nursing visits (% elections)
Facility observed rate
40.2
Gaps in nursing visits (% elections)
31
Early live discharges (% live discharges)
49
Early live discharges (% live discharges)
Facility observed rate
4.1
Early live discharges (% live discharges)
35
Late live discharges (% live discharges)
49
Late live discharges (% live discharges)
Facility observed rate
49.0
Late live discharges (% live discharges)
74
Burdensome transitions, Type 1(% live discharges)
49
Burdensome transitions, Type 1 (% live discharges)
Facility observed rate
2.0
Burdensome transitions, Type 1 (% live discharges)
24
Burdensome transitions, Type 2(% live discharges)
49
Burdensome transitions, Type 2 (% live discharges)
Facility observed rate
0.0
Burdensome transitions, Type 2 (% live discharges)
43
Per-beneficiary spending (U.S. dollars $)
540
Per-beneficiary spending (U.S. dollars $)
Facility observed rate
13,204
Per-beneficiary spending (U.S. dollars $)
29
Nurse care minutes per routine home care days (minutes)
46,469
Nurse care minutes per routine home care days (minutes)
Facility observed rate
7.7
Nurse care minutes per routine home care days (minutes)
8
Skilled nursing minutes on weekends (% minutes)
360,000
Skilled nursing minutes on weekends (% minutes)
Facility observed rate
7.2
Skilled nursing minutes on weekends (% minutes)
41
Visits near death (% decedents)
421
Visits near death (% decedents)
Facility observed rate
88.8
Visits near death (% decedents)
30
Percent of Patients with Cancer
Percentage of patients at hospice who had Cancer as their primary diagnosis
16
Percent of Patients with Circulatory/heart disease
Percentage of patients at hospice who had Circulatory Heart Disease as their primary diagnosis
19
Percent of Patients with Dementia
Percentage of patients at hospice who had Dementia as their primary diagnosis
16
Percent of Patients with Other Conditions
Percentage of patients at hospice who had some other conditions as their primary diagnosis
0 - Value is based on one year of data and does not indicate that the hospice would have 0% in more recent years.
Percent of Patients with Respiratory disease
Percentage of patients at hospice who had Respiratory Disease as their primary diagnosis
11
Percent of Patients with Stroke
Percentage of patients at hospice who had Stroke as their primary diagnosis
7
Provided Routine Home Care and other levels of care
Th hospice had at least one incidence of routine home care and at least one more incidence of care at another level. Blank: hospice only provided care at routine home care level
Yes
Provided Routine Home Care only
The hospice had at least one incidence of RHC over the 3 years, and no incidences of care at any other level. Blank: the hospice had at least one incidence of care at another level
No

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1124157169, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
2
Doubled → 4
Pos 4
4
Unchanged
Pos 5
1
Doubled → 2
Pos 6
5
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
1
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 1 → 2 7 → 14 → 5 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 4 + 4 + 2 + 5 + 1 + 4 + 1 + 1 + 2 + 24 = 51

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 51 is 60. The difference is the calculated check digit.

60 - 51 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1124157169.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Home Health
111 W BROADWAY ST
BOLIVAR, MO 65613

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1124157169, enumerated as an "organization" on March 05, 2007.

The provider is located at 111 W BROADWAY ST BOLIVAR, MO 65613 and the phone number is (417) 328-6350.

Hospice Care, Community Based with taxonomy code 251G00000X.

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.