{"schema_version":"1.0.0","facility":{"id":"cms-265663","ccn":"265663","name":"Fulton Nursing & Rehab","source_name":"FULTON NURSING & REHAB","facility_types":["skilled_nursing_facility","nursing_home"],"primary_type":"skilled_nursing_facility","universe":"cms_certified_nursing_homes","source_type_label":"Medicare and Medicaid","status":"active","status_label":"Active CMS certification","status_evidence":"VERIFIED","state":"MO","address":{"line1":"1510 Bluff Street","city":"Fulton","state":"MO","zip":"65251","county_name":"Callaway County","county_fips":"29027","county_method":"name_match","ssa_county_code":"130","urban":true},"location":{"lat":38.8598,"lon":-91.944,"method":"cms_published_coordinates"},"phone":"5736420202","certification":{"authority":"CMS","ccn":"265663","program":"Medicare and Medicaid","medicare":true,"medicaid":true,"first_approved":"1996-12-16","certified_beds":100,"resides_in_hospital":false,"evidence_class":"VERIFIED","care_compare_url":"https://www.medicare.gov/care-compare/details/nursing-home/265663"},"licenses":[{"state":"MO","authority":"Missouri Department of Health and Senior Services, Section for Long-Term Care Regulation","license_number":"052993","state_facility_id":"03492","license_type":"Skilled nursing facility","status":"active","licensed_beds":100,"capacity_unit":"beds","effective_date":"2025-09-24","expiration_date":"2027-09-23","licensee":"N & R OF FULTON, INC","licensee_entity_type":"Profit Corporation","certification_status":"Medicare/Medicaid","ccn":"265663","as_of":"2026-11-04","evidence_class":"VERIFIED","source_id":"mo_dhss_ltc_directory","source_url":"https://data.mo.gov/d/fenu-sipv","link_method":"exact_ccn"}],"capacity":{"certified_beds":100,"licensed_beds":100,"avg_residents_per_day":66.6},"ownership_type":"For profit - Corporation","ownership_class":"for_profit","legal_business_name":"N & R OF FULTON, INC.","flags":{"ccrc":false,"abuse_icon":false,"high_performing":false,"inspection_over_2y":false,"changed_ownership_12mo":false,"resident_family_council":"Resident","sprinklers_all_areas":"Yes"},"ratings":{"overall":{"value":2},"health_inspection":{"value":2},"quality_measures":{"value":2},"long_stay_qm":{"value":2},"short_stay_qm":{"footnote":"2"},"staffing":{"value":2},"universe":"cms_certified_nursing_homes"},"staffing":{"nurse_aide_hprd":2.08395,"lpn_hprd":0.42514,"rn_hprd":0.19222,"licensed_hprd":0.61736,"total_nurse_hprd":2.7013,"weekend_total_nurse_hprd":2.49121,"weekend_rn_hprd":0.19231,"pt_hprd":0.04335,"nursing_turnover_pct":63.8,"rn_turnover_pct":50,"administrators_left":0,"case_mix_index":1.03017,"case_mix_index_ratio":0.73048,"case_mix_total_nurse_hprd":2.84951,"adjusted_total_nurse_hprd":3.66894,"source":"Payroll-Based Journal (PBJ), as published by CMS"},"health_survey_score":{"cycle1_date":"2025-06-27","cycle1_deficiencies":16,"cycle1_score":124,"cycle2_date":"2024-05-02","cycle23_deficiencies":21,"cycle23_score":156,"total_weighted_score":132},"cms_penalty_counts":{"fines":1,"fine_total":8018,"payment_denials":0,"total":1},"chain":{"id":"cms-chain-290","cms_chain_id":"290","name":"JAMES & JUDY LINCOLN"},"operator_id":"op-n-and-r-of-fulton-inc","first_seen":"2026-11-07T00:15:24.640Z","last_changed":"2026-11-07T00:15:24.640Z","profile_url":"https://www.medicare.gov/care-compare/details/nursing-home/265663","provenance":[{"source_id":"cms_provider_info","source_record_id":"265663","url":"https://data.cms.gov/provider-data/api/1/datastore/query/4pq5-n9py/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=265663&conditions%5B0%5D%5Boperator%5D=%3D","retrieved_at":"2026-11-07T00:15:24.640Z","source_updated_at":"2026-10-01","effective_date":"2026-10-01","jurisdiction":"US-CMS","fields":["name","address","phone","certification","certified_beds","ownership_type","legal_business_name","chain"],"evidence_class":"VERIFIED","status":"current"},{"source_id":"cms_provider_info","source_record_id":"265663","url":"https://data.cms.gov/provider-data/api/1/datastore/query/4pq5-n9py/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=265663&conditions%5B0%5D%5Boperator%5D=%3D","retrieved_at":"2026-11-07T00:15:24.640Z","source_updated_at":"2026-10-01","effective_date":"2026-10-01","jurisdiction":"US-CMS","fields":["ratings","staffing","health_survey_score"],"evidence_class":"VERIFIED","status":"current","note":"Five-Star ratings and PBJ staffing apply to the CMS-certified universe only."},{"source_id":"mo_dhss_ltc_directory","source_record_id":"03492","url":"https://data.mo.gov/d/fenu-sipv","retrieved_at":"2026-11-07T14:53:42.852Z","source_updated_at":"2026-11-04","effective_date":"2026-11-04","jurisdiction":"MO","fields":["state_license","licensed_beds","licensee"],"evidence_class":"VERIFIED","status":"current","note":"Linked to the CMS record by exact CCN."}],"inspection_summary":{"count":14,"health_count":11,"fire_count":3,"complaint_count":8,"latest_date":"2026-04-09","latest_standard_health":"2025-06-27","earliest_date":"2023-04-13","window_note":"CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.","evidence_class":"VERIFIED"},"deficiency_summary":{"count":73,"health_count":50,"fire_count":23,"open_count":0,"actual_harm_count":1,"immediate_jeopardy_count":0,"serious_count":1,"complaint_count":9,"by_severity":{"potential":67,"minimal":5,"actual_harm":1},"by_scope_severity":{"D":15,"E":28,"F":24,"C":5,"G":1},"by_concept":{"clinical_care":23,"infection_prevention":8,"staffing":3,"emergency_preparedness":1,"environment_life_safety":22,"resident_rights":11,"medication":4,"food_nutrition":1},"type_ids":["cms-f0686","cms-f0657","cms-f0880","cms-f0727","cms-e0009","cms-k0222","cms-k0321","cms-k0353","cms-k0511","cms-k0712","cms-k0918","cms-f0881","cms-f0882","cms-f0578","cms-f0656","cms-f0689","cms-f0883","cms-f0637","cms-f0695","cms-f0698","cms-f0732","cms-f0580","cms-f0600","cms-k0281","cms-k0372","cms-k0741","cms-k0920","cms-k0923","cms-k0347","cms-f0584","cms-f0625","cms-f0658","cms-f0677","cms-f0758","cms-f0761","cms-f0801","cms-f0583","cms-f0636","cms-f0638","cms-f0641","cms-f0577","cms-k0500","cms-k0761","cms-k0914","cms-k0925","cms-f0623","cms-f0680"],"evidence_class":"VERIFIED"},"penalty_summary":{"count":1,"fines":1,"fine_total":8018,"payment_denials":0,"latest_date":"2024-10-02"},"ownership_summary":{"disclosures":7,"organizations":1,"individuals":6,"not_available":false}},"row":{"id":"cms-265663","ccn":"265663","name":"Fulton Nursing & Rehab","types":["skilled_nursing_facility","nursing_home"],"status":"active","state":"MO","city":"Fulton","zip":"65251","county_fips":"29027","county_name":"Callaway County","address":"1510 Bluff Street","beds":100,"residents":66.6,"ownership":"for_profit","operator_id":"op-n-and-r-of-fulton-inc","operator_name":"N & R of Fulton, Inc","chain_id":"cms-chain-290","chain_name":"James & Judy Lincoln","lat":38.8598,"lon":-91.944,"overall":2,"health_rating":2,"staffing_rating":2,"qm_rating":2,"nurse_hprd":2.7,"turnover":63.8,"inspections":14,"last_inspection":"2026-04-09","deficiencies":73,"serious":1,"ij":0,"open":0,"penalties":1,"fines_total":8018,"deficiency_type_ids":["cms-f0686","cms-f0657","cms-f0880","cms-f0727","cms-e0009","cms-k0222","cms-k0321","cms-k0353","cms-k0511","cms-k0712","cms-k0918","cms-f0881","cms-f0882","cms-f0578","cms-f0656","cms-f0689","cms-f0883","cms-f0637","cms-f0695","cms-f0698","cms-f0732","cms-f0580","cms-f0600","cms-k0281","cms-k0372","cms-k0741","cms-k0920","cms-k0923","cms-k0347","cms-f0584","cms-f0625","cms-f0658","cms-f0677","cms-f0758","cms-f0761","cms-f0801","cms-f0583","cms-f0636","cms-f0638","cms-f0641","cms-f0577","cms-k0500","cms-k0761","cms-k0914","cms-k0925","cms-f0623","cms-f0680"],"universe":"cms","licensed_beds":100,"state_license":"MO 052993","state_actions":0,"state_serious":0,"last_changed":"2026-11-07T00:15:24.640Z"},"operator":{"id":"op-n-and-r-of-fulton-inc","name":"N & R of Fulton, Inc","legal_name":"N & R OF FULTON, INC","facility_count":1,"states":["MO"],"match_method":"exact_normalized_legal_name","evidence_class":"CORROBORATED"},"chain":{"id":"cms-chain-290","name":"James & Judy Lincoln","cms_chain_id":"290","facility_count":55,"states":["AR","MO"],"cms_reported":{"facility_count":55,"avg_overall_rating":2.6,"avg_health_inspection_rating":2.7,"avg_staffing_rating":2.3,"avg_qm_rating":2.7}},"ownership":[{"owner_type":"individual","owner_name":"James Lincoln","role":"direct_owner","role_raw":"5% OR GREATER DIRECT OWNERSHIP INTEREST","percentage":50,"percentage_raw":"50%","association_date":"1998-08-01","owner_name_raw":"LINCOLN, JAMES"},{"owner_type":"individual","owner_name":"Judy Lincoln","role":"direct_owner","role_raw":"5% OR GREATER DIRECT OWNERSHIP INTEREST","percentage":50,"percentage_raw":"50%","association_date":"1998-08-01","owner_name_raw":"LINCOLN, JUDY"},{"owner_id":"org-n-and-r-of-fulton-inc","owner_type":"organization","owner_name":"N & R of Fulton, Inc","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"1998-08-01"},{"owner_type":"individual","owner_name":"Brandon Bysor","role":"officer_director","role_raw":"CORPORATE DIRECTOR","percentage_raw":"NOT APPLICABLE","association_date":"2022-12-30","owner_name_raw":"BYSOR, BRANDON"},{"owner_type":"individual","owner_name":"Timothy Drake","role":"officer_director","role_raw":"CORPORATE DIRECTOR","percentage_raw":"NOT APPLICABLE","association_date":"1998-08-01","owner_name_raw":"DRAKE, TIMOTHY"},{"owner_type":"individual","owner_name":"Charlotte Stutts","role":"officer_director","role_raw":"CORPORATE OFFICER","percentage_raw":"NOT APPLICABLE","association_date":"1998-08-01","owner_name_raw":"STUTTS, CHARLOTTE"},{"owner_type":"individual","owner_name":"Victoria Gilbert","role":"managing_employee","role_raw":"W-2 MANAGING EMPLOYEE","percentage_raw":"NOT APPLICABLE","association_date":"2022-12-30","owner_name_raw":"GILBERT, VICTORIA"}],"inspections":[{"id":"cms-265663-20260409-health","ccn":"265663","date":"2026-04-09","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Complaint"],"cycles":[1],"footnotes":[],"derived_from_citations":false,"kind":"complaint","deficiency_count":1,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0686","ss":"D","sl":2,"cs":"corrected","cd":"2026-05-26","cmp":1}]},{"id":"cms-265663-20260114-health","ccn":"265663","date":"2026-01-14","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Complaint"],"cycles":[1],"footnotes":[],"derived_from_citations":false,"kind":"complaint","deficiency_count":1,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0657","ss":"D","sl":2,"cs":"corrected","cd":"2026-02-22","cmp":1}]},{"id":"cms-265663-20251231-health","ccn":"265663","date":"2025-12-31","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Complaint"],"cycles":[1],"footnotes":[],"derived_from_citations":false,"kind":"complaint","deficiency_count":1,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0880","ss":"E","sl":2,"cs":"corrected","cd":"2026-01-17","cmp":1}]},{"id":"cms-265663-20251119-health","ccn":"265663","date":"2025-11-19","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Complaint"],"cycles":[1],"footnotes":[],"derived_from_citations":false,"kind":"complaint","deficiency_count":1,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0727","ss":"E","sl":2,"cs":"corrected","cd":"2025-11-27","cmp":1}]},{"id":"cms-265663-20250627-fire","ccn":"265663","date":"2025-06-27","domain":"fire","authority":"CMS / state survey agency","survey_types":["Fire Safety Standard"],"cycles":[1],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":7,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-e0009","ss":"F","sl":2,"cs":"corrected","cd":"2025-07-30","std":1,"tv":"New"},{"t":"cms-k0222","ss":"F","sl":2,"cs":"corrected","cd":"2025-07-30","std":1,"tv":"New"},{"t":"cms-k0321","ss":"F","sl":2,"cs":"corrected","cd":"2025-07-30","std":1,"tv":"New"},{"t":"cms-k0353","ss":"F","sl":2,"cs":"corrected","cd":"2025-07-30","std":1,"tv":"New"},{"t":"cms-k0511","ss":"F","sl":2,"cs":"corrected","cd":"2025-07-30","std":1,"tv":"New"},{"t":"cms-k0712","ss":"F","sl":2,"cs":"corrected","cd":"2025-07-30","std":1,"tv":"New"},{"t":"cms-k0918","ss":"F","sl":2,"cs":"corrected","cd":"2025-07-30","std":1,"tv":"New"}]},{"id":"cms-265663-20250627-health","ccn":"265663","date":"2025-06-27","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Standard"],"cycles":[1],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":12,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0578","ss":"E","sl":2,"cs":"corrected","cd":"2025-07-30","std":1},{"t":"cms-f0637","ss":"D","sl":2,"cs":"corrected","cd":"2025-07-30","std":1},{"t":"cms-f0656","ss":"E","sl":2,"cs":"corrected","cd":"2025-07-30","std":1},{"t":"cms-f0657","ss":"E","sl":2,"cs":"corrected","cd":"2025-07-30","std":1},{"t":"cms-f0689","ss":"E","sl":2,"cs":"corrected","cd":"2025-07-30","std":1},{"t":"cms-f0695","ss":"D","sl":2,"cs":"corrected","cd":"2025-07-30","std":1},{"t":"cms-f0698","ss":"D","sl":2,"cs":"corrected","cd":"2025-07-30","std":1},{"t":"cms-f0880","ss":"F","sl":2,"cs":"corrected","cd":"2025-07-30","std":1},{"t":"cms-f0881","ss":"F","sl":2,"cs":"corrected","cd":"2025-07-30","std":1},{"t":"cms-f0882","ss":"F","sl":2,"cs":"corrected","cd":"2025-07-30","std":1},{"t":"cms-f0883","ss":"E","sl":2,"cs":"corrected","cd":"2025-07-30","std":1},{"t":"cms-f0732","ss":"C","sl":1,"cs":"corrected","cd":"2025-07-30","std":1}]},{"id":"cms-265663-20250514-health","ccn":"265663","date":"2025-05-14","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Complaint"],"cycles":[2],"footnotes":[],"derived_from_citations":false,"kind":"complaint","deficiency_count":2,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0580","ss":"D","sl":2,"cs":"corrected","cd":"2025-05-23","cmp":1},{"t":"cms-f0600","ss":"D","sl":2,"cs":"past_noncompliance","cd":"2025-04-30","cmp":1}]},{"id":"cms-265663-20241002-health","ccn":"265663","date":"2024-10-02","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Complaint"],"cycles":[2],"footnotes":[],"derived_from_citations":false,"kind":"complaint","deficiency_count":1,"max_severity_level":3,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0600","ss":"G","sl":3,"cs":"past_noncompliance","cd":"2024-09-30","cmp":1}]},{"id":"cms-265663-20240502-fire","ccn":"265663","date":"2024-05-02","domain":"fire","authority":"CMS / state survey agency","survey_types":["Fire Safety Standard"],"cycles":[2],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":7,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-k0222","ss":"F","sl":2,"cs":"corrected","cd":"2024-06-10","std":1,"tv":"New"},{"t":"cms-k0281","ss":"F","sl":2,"cs":"corrected","cd":"2024-06-10","std":1,"tv":"New"},{"t":"cms-k0347","ss":"D","sl":2,"cs":"corrected","cd":"2024-06-10","std":1,"tv":"New"},{"t":"cms-k0372","ss":"F","sl":2,"cs":"corrected","cd":"2024-06-10","std":1,"tv":"New"},{"t":"cms-k0741","ss":"F","sl":2,"cs":"corrected","cd":"2024-06-10","std":1,"tv":"New"},{"t":"cms-k0920","ss":"F","sl":2,"cs":"corrected","cd":"2024-06-10","std":1,"tv":"New"},{"t":"cms-k0923","ss":"E","sl":2,"cs":"corrected","cd":"2024-06-10","std":1,"tv":"New"}]},{"id":"cms-265663-20240502-health","ccn":"265663","date":"2024-05-02","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Standard"],"cycles":[2],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":16,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0583","ss":"D","sl":2,"cs":"corrected","cd":"2024-06-10","std":1},{"t":"cms-f0584","ss":"E","sl":2,"cs":"corrected","cd":"2024-06-10","std":1},{"t":"cms-f0625","ss":"E","sl":2,"cs":"corrected","cd":"2024-06-10","std":1},{"t":"cms-f0636","ss":"D","sl":2,"cs":"corrected","cd":"2024-06-10","std":1},{"t":"cms-f0637","ss":"E","sl":2,"cs":"corrected","cd":"2024-06-10","std":1},{"t":"cms-f0638","ss":"D","sl":2,"cs":"corrected","cd":"2024-06-10","std":1},{"t":"cms-f0641","ss":"D","sl":2,"cs":"corrected","cd":"2024-06-10","std":1},{"t":"cms-f0656","ss":"E","sl":2,"cs":"corrected","cd":"2024-06-10","std":1},{"t":"cms-f0658","ss":"E","sl":2,"cs":"corrected","cd":"2024-06-10","std":1},{"t":"cms-f0677","ss":"E","sl":2,"cs":"corrected","cd":"2024-06-10","std":1},{"t":"cms-f0689","ss":"E","sl":2,"cs":"corrected","cd":"2024-06-10","std":1},{"t":"cms-f0758","ss":"E","sl":2,"cs":"corrected","cd":"2024-06-10","std":1},{"t":"cms-f0761","ss":"E","sl":2,"cs":"corrected","cd":"2024-06-10","std":1},{"t":"cms-f0801","ss":"E","sl":2,"cs":"corrected","cd":"2024-06-10","std":1},{"t":"cms-f0880","ss":"F","sl":2,"cs":"corrected","cd":"2024-06-10","std":1},{"t":"cms-f0577","ss":"C","sl":1,"cs":"corrected","cd":"2024-06-10","std":1}]},{"id":"cms-265663-20240221-health","ccn":"265663","date":"2024-02-21","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Complaint"],"cycles":[3],"footnotes":[],"derived_from_citations":false,"kind":"complaint","deficiency_count":1,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0658","ss":"E","sl":2,"cs":"corrected","cd":"2024-04-02","cmp":1}]},{"id":"cms-265663-20231024-health","ccn":"265663","date":"2023-10-24","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Complaint"],"cycles":[3],"footnotes":[],"derived_from_citations":false,"kind":"complaint","deficiency_count":1,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0638","ss":"E","sl":2,"cs":"corrected","cd":"2023-12-04","cmp":1}]},{"id":"cms-265663-20230413-fire","ccn":"265663","date":"2023-04-13","domain":"fire","authority":"CMS / state survey agency","survey_types":["Fire Safety Standard"],"cycles":[3],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":9,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-k0353","ss":"F","sl":2,"cs":"corrected","cd":"2023-05-23","std":1,"tv":"New"},{"t":"cms-k0372","ss":"F","sl":2,"cs":"corrected","cd":"2023-05-23","std":1,"tv":"New"},{"t":"cms-k0500","ss":"F","sl":2,"cs":"corrected","cd":"2023-05-23","std":1,"tv":"New"},{"t":"cms-k0712","ss":"F","sl":2,"cs":"corrected","cd":"2023-05-23","std":1,"tv":"New"},{"t":"cms-k0761","ss":"F","sl":2,"cs":"corrected","cd":"2023-05-23","std":1,"tv":"New"},{"t":"cms-k0914","ss":"F","sl":2,"cs":"corrected","cd":"2023-05-23","std":1,"tv":"New"},{"t":"cms-k0918","ss":"F","sl":2,"cs":"corrected","cd":"2023-05-23","std":1,"tv":"New"},{"t":"cms-k0923","ss":"F","sl":2,"cs":"corrected","cd":"2023-05-23","std":1,"tv":"New"},{"t":"cms-k0925","ss":"E","sl":2,"cs":"corrected","cd":"2023-05-23","std":1,"tv":"New"}]},{"id":"cms-265663-20230413-health","ccn":"265663","date":"2023-04-13","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Standard"],"cycles":[3],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":13,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0584","ss":"E","sl":2,"cs":"corrected","cd":"2023-05-23","std":1},{"t":"cms-f0623","ss":"D","sl":2,"cs":"corrected","cd":"2023-05-23","std":1},{"t":"cms-f0625","ss":"D","sl":2,"cs":"corrected","cd":"2023-05-23","std":1},{"t":"cms-f0658","ss":"E","sl":2,"cs":"corrected","cd":"2023-05-23","std":1},{"t":"cms-f0677","ss":"E","sl":2,"cs":"corrected","cd":"2023-05-23","std":1},{"t":"cms-f0689","ss":"E","sl":2,"cs":"corrected","cd":"2023-05-23","std":1},{"t":"cms-f0698","ss":"D","sl":2,"cs":"corrected","cd":"2023-05-23","std":1},{"t":"cms-f0758","ss":"E","sl":2,"cs":"corrected","cd":"2023-05-23","std":1},{"t":"cms-f0761","ss":"E","sl":2,"cs":"corrected","cd":"2023-05-23","std":1},{"t":"cms-f0880","ss":"E","sl":2,"cs":"corrected","cd":"2023-05-23","std":1},{"t":"cms-f0680","ss":"C","sl":1,"cs":"corrected","cd":"2023-05-23","std":1},{"t":"cms-f0732","ss":"C","sl":1,"cs":"corrected","cd":"2023-05-23","std":1},{"t":"cms-f0882","ss":"C","sl":1,"cs":"corrected","cd":"2023-05-23","std":1}]}],"deficiency_types":{"cms-f0686":{"code":"F-0686","title":"Provide appropriate pressure ulcer care and prevent new ulcers from developing.","category":"Quality of Life and Care Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0657":{"code":"F-0657","title":"Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.","category":"Resident Assessment and Care Planning Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0880":{"code":"F-0880","title":"Provide and implement an infection prevention and control program.","category":"Infection Control Deficiencies","concept":"infection_prevention","concept_label":"Infection prevention"},"cms-f0727":{"code":"F-0727","title":"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.","category":"Nursing and Physician Services Deficiencies","concept":"staffing","concept_label":"Staffing & supervision"},"cms-e0009":{"code":"E-0009","title":"Include a process for Emergency Preparedness collaboration.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"cms-k0222":{"code":"K-0222","title":"Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.","category":"Egress Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0321":{"code":"K-0321","title":"Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.","category":"Smoke Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0353":{"code":"K-0353","title":"Inspect, test, and maintain automatic sprinkler systems.","category":"Smoke Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0511":{"code":"K-0511","title":"Have properly installed electrical wiring and gas equipment.","category":"Services Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0712":{"code":"K-0712","title":"Have simulated fire drills held at unexpected times.","category":"Miscellaneous Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0918":{"code":"K-0918","title":"Have generator or other power source capable of supplying service within 10 seconds.","category":"Gas, Vacuum, and Electrical Systems Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-f0881":{"code":"F-0881","title":"Implement a program that monitors antibiotic use.","category":"Infection Control Deficiencies","concept":"infection_prevention","concept_label":"Infection prevention"},"cms-f0882":{"code":"F-0882","title":"Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.","category":"Infection Control Deficiencies","concept":"infection_prevention","concept_label":"Infection prevention"},"cms-f0578":{"code":"F-0578","title":"Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.","category":"Resident Rights Deficiencies","concept":"resident_rights","concept_label":"Resident rights & abuse/neglect"},"cms-f0656":{"code":"F-0656","title":"Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.","category":"Resident Assessment and Care Planning Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0689":{"code":"F-0689","title":"Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.","category":"Quality of Life and Care Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0883":{"code":"F-0883","title":"Develop and implement policies and procedures for flu and pneumonia vaccinations.","category":"Infection Control Deficiencies","concept":"infection_prevention","concept_label":"Infection prevention"},"cms-f0637":{"code":"F-0637","title":"Assess the resident when there is a significant change in condition","category":"Resident Assessment and Care Planning Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0695":{"code":"F-0695","title":"Provide safe and appropriate respiratory care for a resident when needed.","category":"Quality of Life and Care Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0698":{"code":"F-0698","title":"Provide safe, appropriate dialysis care/services for a resident who requires such services.","category":"Quality of Life and Care Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0732":{"code":"F-0732","title":"Post nurse staffing information every day.","category":"Nursing and Physician Services Deficiencies","concept":"staffing","concept_label":"Staffing & supervision"},"cms-f0580":{"code":"F-0580","title":"Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.)  that affect the resident.","category":"Resident Rights Deficiencies","concept":"resident_rights","concept_label":"Resident rights & abuse/neglect"},"cms-f0600":{"code":"F-0600","title":"Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.","category":"Freedom from Abuse, Neglect, and Exploitation Deficiencies","concept":"resident_rights","concept_label":"Resident rights & abuse/neglect"},"cms-k0281":{"code":"K-0281","title":"Install proper backup exit lighting.","category":"Egress Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0372":{"code":"K-0372","title":"Ensure smoke barriers are constructed to a 1 hour fire resistance rating.","category":"Smoke Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0741":{"code":"K-0741","title":"Have posted \"No-smoking\" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.","category":"Miscellaneous Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0920":{"code":"K-0920","title":"Ensure proper usage of power strips and extension cords.","category":"Gas, Vacuum, and Electrical Systems Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0923":{"code":"K-0923","title":"Have proper medical gas storage and administration areas.","category":"Gas, Vacuum, and Electrical Systems Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0347":{"code":"K-0347","title":"Properly provide smoke detection systems in areas open to corridors.","category":"Smoke Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-f0584":{"code":"F-0584","title":"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.","category":"Resident Rights Deficiencies","concept":"resident_rights","concept_label":"Resident rights & abuse/neglect"},"cms-f0625":{"code":"F-0625","title":"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.","category":"Resident Rights Deficiencies","concept":"resident_rights","concept_label":"Resident rights & abuse/neglect"},"cms-f0658":{"code":"F-0658","title":"Ensure services provided by the nursing facility meet professional standards of quality.","category":"Resident Assessment and Care Planning Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0677":{"code":"F-0677","title":"Provide care and assistance to perform activities of daily living for any resident who is unable.","category":"Quality of Life and Care Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0758":{"code":"F-0758","title":"Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.","category":"Pharmacy Service Deficiencies","concept":"medication","concept_label":"Medication management"},"cms-f0761":{"code":"F-0761","title":"Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.","category":"Pharmacy Service Deficiencies","concept":"medication","concept_label":"Medication management"},"cms-f0801":{"code":"F-0801","title":"Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.","category":"Nutrition and Dietary Deficiencies","concept":"food_nutrition","concept_label":"Food, nutrition & hydration"},"cms-f0583":{"code":"F-0583","title":"Keep residents' personal and medical records private and confidential.","category":"Resident Rights Deficiencies","concept":"resident_rights","concept_label":"Resident rights & abuse/neglect"},"cms-f0636":{"code":"F-0636","title":"Assess the resident completely in a timely manner  when first admitted, and then periodically, at least every 12 months.","category":"Resident Assessment and Care Planning Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0638":{"code":"F-0638","title":"Assure that each resident’s assessment is updated at least once every 3 months.","category":"Resident Assessment and Care Planning Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0641":{"code":"F-0641","title":"Ensure each resident receives an accurate assessment.","category":"Resident Assessment and Care Planning Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0577":{"code":"F-0577","title":"Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.","category":"Resident Rights Deficiencies","concept":"resident_rights","concept_label":"Resident rights & abuse/neglect"},"cms-k0500":{"code":"K-0500","title":"Meet other general requirements that are deficient.","category":"Services Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0761":{"code":"K-0761","title":"To conduct inspection, testing and maintenance of fire doors by qualified individuals.","category":"Miscellaneous Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0914":{"code":"K-0914","title":"Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.","category":"Gas, Vacuum, and Electrical Systems Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0925":{"code":"K-0925","title":"Ensure that sources of ignition are removed from patients receiving respiratory therapy.","category":"Gas, Vacuum, and Electrical Systems Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-f0623":{"code":"F-0623","title":"Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.","category":"Resident Rights Deficiencies","concept":"resident_rights","concept_label":"Resident rights & abuse/neglect"},"cms-f0680":{"code":"F-0680","title":"Ensure the activities program is directed by a qualified professional.","category":"Quality of Life and Care Deficiencies","concept":"clinical_care","concept_label":"Clinical care"}},"penalties":[{"id":"cms-265663-pen-f90650","type":"fine","type_label":"Civil money penalty (fine)","date":"2024-10-02","amount":8018,"fine_id":"90650","evidence_class":"VERIFIED","source_record_id":"265663|Fine|90650"}],"state_actions":[],"record_urls":{"cms_provider_info":"https://data.cms.gov/provider-data/api/1/datastore/query/4pq5-n9py/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=265663&conditions%5B0%5D%5Boperator%5D=%3D","cms_ownership":"https://data.cms.gov/provider-data/api/1/datastore/query/y2hd-n93e/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=265663&conditions%5B0%5D%5Boperator%5D=%3D","cms_health_deficiencies":"https://data.cms.gov/provider-data/api/1/datastore/query/r5ix-sfxw/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=265663&conditions%5B0%5D%5Boperator%5D=%3D","cms_fire_safety_deficiencies":"https://data.cms.gov/provider-data/api/1/datastore/query/ifjz-ge4w/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=265663&conditions%5B0%5D%5Boperator%5D=%3D","cms_penalties":"https://data.cms.gov/provider-data/api/1/datastore/query/g6vv-u9sr/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=265663&conditions%5B0%5D%5Boperator%5D=%3D","cms_inspection_dates":"https://data.cms.gov/provider-data/api/1/datastore/query/svdt-c123/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=265663&conditions%5B0%5D%5Boperator%5D=%3D"},"compact_keys":{"t":"deficiency_type_id","ss":"scope_severity_code","sl":"severity_level (1–4)","cs":"correction_status","cd":"correction_date","cmp":"complaint","std":"standard survey","ic":"infection control","idr":"under IDR","iidr":"under IIDR","tv":"tag version"},"benchmarks":{"state":{"key":"MO","overall_rating":2.6,"health_inspection_rating":2.8,"qm_rating":2.9,"staffing_rating":2.2,"avg_residents_per_day":73.1,"cycle1_health_deficiencies":11.4,"cycle1_fire_deficiencies":6,"nurse_aide_hprd":2.26,"lpn_hprd":0.68,"rn_hprd":0.46019,"licensed_hprd":1.14,"total_nurse_hprd":3.39922,"weekend_total_nurse_hprd":2.96333,"weekend_rn_hprd":0.32,"pt_hprd":0.04,"nursing_turnover_pct":56.9,"rn_turnover_pct":50,"administrators_left":0.7,"case_mix_index":1.34706,"fines":0.8,"fine_amount":36774,"processing_note":"CMS State and US Averages"},"nation":{"key":"NATION","overall_rating":3,"health_inspection_rating":2.8,"qm_rating":3.7,"staffing_rating":3,"avg_residents_per_day":85.7,"cycle1_health_deficiencies":9.2,"cycle1_fire_deficiencies":4.4,"nurse_aide_hprd":2.35,"lpn_hprd":0.86,"rn_hprd":0.69164,"licensed_hprd":1.55,"total_nurse_hprd":3.90085,"weekend_total_nurse_hprd":3.43303,"weekend_rn_hprd":0.48,"pt_hprd":0.07,"nursing_turnover_pct":45.3,"rn_turnover_pct":42.5,"administrators_left":0.5,"case_mix_index":1.41025,"fines":0.9,"fine_amount":30351,"processing_note":"CMS State and US Averages"}},"geo":{"state":{"code":"MO","name":"Missouri"},"county":{"fips":"29027","name":"Callaway County"},"zip":"65251","city":"Fulton"},"related":{"same_operator":[],"same_operator_total":0,"same_chain":[{"id":"cms-265123","ccn":"265123","name":"Lebanon North Nursing & Rehab","address":"596 Morton Road","city":"Lebanon","state":"MO","zip":"65536","beds":180,"overall":1,"inspections":21,"last_inspection":"2026-07-15","deficiencies":77,"serious":11,"ij":0,"open":1,"fines_total":263670,"status":"active","universe":"cms","licensed_beds":180,"state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"]},{"id":"cms-265160","ccn":"265160","name":"Lewis & Clark Gardens","address":"1221 Boones Lick Road","city":"Saint Charles","state":"MO","zip":"63301","beds":142,"overall":1,"inspections":18,"last_inspection":"2026-04-01","deficiencies":95,"serious":4,"ij":3,"open":0,"fines_total":139916,"status":"active","universe":"cms","licensed_beds":142,"state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"]},{"id":"cms-265161","ccn":"265161","name":"Wilson's Creek Nursing & Rehab","address":"3403 West Mt Vernon","city":"Springfield","state":"MO","zip":"65802","beds":172,"overall":5,"inspections":6,"last_inspection":"2025-08-14","deficiencies":31,"serious":2,"ij":1,"open":0,"fines_total":0,"status":"active","universe":"cms","licensed_beds":172,"state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"]},{"id":"cms-265181","ccn":"265181","name":"Warrenton Manor","address":"65 State Hwy Aa","city":"Wright City","state":"MO","zip":"63390","beds":120,"overall":2,"inspections":11,"last_inspection":"2026-05-07","deficiencies":60,"serious":0,"ij":0,"open":0,"fines_total":0,"status":"active","universe":"cms","licensed_beds":120,"state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"]},{"id":"cms-265209","ccn":"265209","name":"New Madrid Living Center","address":"1050 Dawson Road","city":"New Madrid","state":"MO","zip":"63869","beds":112,"overall":5,"inspections":7,"last_inspection":"2025-09-18","deficiencies":17,"serious":1,"ij":0,"open":0,"fines_total":8824,"status":"active","universe":"cms","licensed_beds":112,"state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"]},{"id":"cms-265225","ccn":"265225","name":"St James Living Center","address":"415 Sidney Street","city":"Saint James","state":"MO","zip":"65559","beds":90,"overall":4,"inspections":10,"last_inspection":"2025-11-17","deficiencies":65,"serious":1,"ij":1,"open":0,"fines_total":14069,"status":"active","universe":"cms","licensed_beds":90,"state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"]},{"id":"cms-265239","ccn":"265239","name":"Hermitage Nursing & Rehab","address":"18599 First Street","city":"Hermitage","state":"MO","zip":"65668","beds":120,"overall":2,"inspections":8,"last_inspection":"2026-05-11","deficiencies":32,"serious":3,"ij":1,"open":0,"fines_total":102470,"abuse":true,"status":"active","universe":"cms","licensed_beds":120,"state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"]},{"id":"cms-265249","ccn":"265249","name":"Maries Manor","address":"174 Ballpark Road","city":"Vienna","state":"MO","zip":"65582","beds":98,"overall":3,"inspections":7,"last_inspection":"2025-12-09","deficiencies":36,"serious":0,"ij":0,"open":0,"fines_total":0,"status":"active","universe":"cms","licensed_beds":98,"state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"]}],"same_chain_total":54,"same_site_review":[],"nearby":[{"id":"cms-265581","ccn":"265581","name":"Kingdom Care Senior Living","address":"811 Center Street","city":"Fulton","state":"MO","zip":"65251","beds":36,"overall":3,"inspections":8,"last_inspection":"2026-04-15","deficiencies":36,"serious":0,"ij":0,"open":0,"fines_total":0,"status":"active","universe":"cms","licensed_beds":36,"state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"],"distance_km":0.9},{"id":"cms-265760","ccn":"265760","name":"Fulton Manor Care Center","address":"520 Manor Drive","city":"Fulton","state":"MO","zip":"65251","beds":52,"overall":1,"inspections":12,"last_inspection":"2026-06-15","deficiencies":72,"serious":0,"ij":0,"open":0,"fines_total":0,"abuse":true,"status":"active","universe":"cms","licensed_beds":52,"state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"],"distance_km":1}]}}