{"schema_version":"1.0.0","facility":{"id":"cms-265688","ccn":"265688","name":"The Living Center","source_name":"LIVING CENTER, THE","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":"2506 Linden Tree Parkway","city":"Marshall","state":"MO","zip":"65340","county_name":"Saline County","county_fips":"29195","county_method":"name_match","ssa_county_code":"970","urban":false},"location":{"lat":39.0939,"lon":-93.215,"method":"cms_published_coordinates"},"phone":"6608869676","certification":{"authority":"CMS","ccn":"265688","program":"Medicare and Medicaid","medicare":true,"medicaid":true,"first_approved":"1997-11-25","certified_beds":99,"resides_in_hospital":false,"evidence_class":"VERIFIED","care_compare_url":"https://www.medicare.gov/care-compare/details/nursing-home/265688"},"licenses":[{"state":"MO","authority":"Missouri Department of Health and Senior Services, Section for Long-Term Care Regulation","license_number":"054112","state_facility_id":"21791","license_type":"Skilled nursing facility","status":"active","licensed_beds":99,"capacity_unit":"beds","effective_date":"2026-09-08","expiration_date":"2026-12-31","licensee":"MARSHALL SNF OPCO LLC","licensee_entity_type":"Limited Liability Company","certification_status":"Medicare/Medicaid","ccn":"265688","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":99,"licensed_beds":99,"avg_residents_per_day":65.2},"ownership_type":"Non profit - Corporation","ownership_class":"non_profit","legal_business_name":"FITZGIBBON HEALTH SERVICES","flags":{"ccrc":false,"abuse_icon":false,"high_performing":false,"inspection_over_2y":true,"changed_ownership_12mo":false,"resident_family_council":"Both","sprinklers_all_areas":"Yes"},"ratings":{"overall":{"value":3},"health_inspection":{"value":3},"quality_measures":{"value":2},"long_stay_qm":{"value":2},"short_stay_qm":{"value":2},"staffing":{"value":4},"universe":"cms_certified_nursing_homes"},"staffing":{"nurse_aide_hprd":2.45556,"lpn_hprd":1.01658,"rn_hprd":0.47823,"licensed_hprd":1.49481,"total_nurse_hprd":3.95037,"weekend_total_nurse_hprd":3.47878,"weekend_rn_hprd":0.19422,"pt_hprd":0.06701,"nursing_turnover_pct":38.2,"rn_turnover_pct":11.1,"administrators_left":0,"case_mix_index":1.13792,"case_mix_index_ratio":0.80689,"case_mix_total_nurse_hprd":3.14755,"adjusted_total_nurse_hprd":4.85739,"source":"Payroll-Based Journal (PBJ), as published by CMS"},"health_survey_score":{"cycle1_date":"2024-07-18","cycle1_deficiencies":7,"cycle1_score":48,"cycle2_date":"2023-02-09","cycle23_deficiencies":12,"cycle23_score":186,"total_weighted_score":82.5},"cms_penalty_counts":{"fines":0,"fine_total":0,"payment_denials":0,"total":0},"operator_id":"op-fitzgibbon-health-services","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/265688","provenance":[{"source_id":"cms_provider_info","source_record_id":"265688","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=265688&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":"265688","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=265688&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":"21791","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":8,"health_count":5,"fire_count":3,"complaint_count":2,"latest_date":"2026-07-28","latest_standard_health":"2024-07-18","earliest_date":"2019-07-25","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":70,"health_count":28,"fire_count":42,"open_count":3,"actual_harm_count":2,"immediate_jeopardy_count":0,"serious_count":2,"complaint_count":4,"by_severity":{"potential":67,"actual_harm":2,"minimal":1},"by_scope_severity":{"D":11,"G":2,"F":15,"E":41,"C":1},"by_concept":{"resident_rights":5,"clinical_care":11,"infection_prevention":4,"environment_life_safety":35,"emergency_preparedness":8,"food_nutrition":4,"medication":3},"type_ids":["cms-f0580","cms-f0742","cms-f0880","cms-f0689","cms-k0712","cms-k0100","cms-k0222","cms-k0311","cms-k0363","cms-k0372","cms-k0923","cms-e0004","cms-f0812","cms-f0638","cms-f0758","cms-f0602","cms-e0006","cms-e0015","cms-e0026","cms-e0034","cms-k0353","cms-k0918","cms-e0020","cms-k0131","cms-k0211","cms-k0321","cms-k0374","cms-k0711","cms-k0741","cms-k0761","cms-k0920","cms-k0921","cms-f0697","cms-f0558","cms-f0658","cms-f0677","cms-f0700","cms-f0804","cms-f0909","cms-f0695","cms-e0018","cms-k0161","cms-k0911","cms-f0759","cms-f0883","cms-f0604","cms-f0690"],"evidence_class":"VERIFIED"},"penalty_summary":{"count":0,"fines":0,"fine_total":0,"payment_denials":0},"ownership_summary":{"disclosures":7,"organizations":2,"individuals":5,"not_available":false}},"row":{"id":"cms-265688","ccn":"265688","name":"The Living Center","types":["skilled_nursing_facility","nursing_home"],"status":"active","state":"MO","city":"Marshall","zip":"65340","county_fips":"29195","county_name":"Saline County","address":"2506 Linden Tree Parkway","beds":99,"residents":65.2,"ownership":"non_profit","operator_id":"op-fitzgibbon-health-services","operator_name":"Fitzgibbon Health Services","lat":39.0939,"lon":-93.215,"overall":3,"health_rating":3,"staffing_rating":4,"qm_rating":2,"nurse_hprd":3.95,"turnover":38.2,"inspections":8,"last_inspection":"2026-07-28","deficiencies":70,"serious":2,"ij":0,"open":3,"penalties":0,"fines_total":0,"deficiency_type_ids":["cms-f0580","cms-f0742","cms-f0880","cms-f0689","cms-k0712","cms-k0100","cms-k0222","cms-k0311","cms-k0363","cms-k0372","cms-k0923","cms-e0004","cms-f0812","cms-f0638","cms-f0758","cms-f0602","cms-e0006","cms-e0015","cms-e0026","cms-e0034","cms-k0353","cms-k0918","cms-e0020","cms-k0131","cms-k0211","cms-k0321","cms-k0374","cms-k0711","cms-k0741","cms-k0761","cms-k0920","cms-k0921","cms-f0697","cms-f0558","cms-f0658","cms-f0677","cms-f0700","cms-f0804","cms-f0909","cms-f0695","cms-e0018","cms-k0161","cms-k0911","cms-f0759","cms-f0883","cms-f0604","cms-f0690"],"universe":"cms","licensed_beds":99,"state_license":"MO 054112","state_actions":0,"state_serious":0,"last_changed":"2026-11-07T00:15:24.640Z"},"operator":{"id":"op-fitzgibbon-health-services","name":"Fitzgibbon Health Services","legal_name":"FITZGIBBON HEALTH SERVICES","facility_count":1,"states":["MO"],"match_method":"exact_normalized_legal_name","evidence_class":"CORROBORATED"},"ownership":[{"owner_id":"org-fitzgibbon-health-services","owner_type":"organization","owner_name":"Fitzgibbon Health Services","role":"direct_owner","role_raw":"5% OR GREATER DIRECT OWNERSHIP INTEREST","percentage":100,"percentage_raw":"100%","association_date":"1995-07-06"},{"owner_id":"org-john-fitzgibbon-memorial-hospital-inc","owner_type":"organization","owner_name":"John Fitzgibbon Memorial Hospital Inc","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"1995-07-05"},{"owner_type":"individual","owner_name":"Delma Hearting","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2022-05-01","owner_name_raw":"HEARTING, DELMA"},{"owner_type":"individual","owner_name":"Darin Haug","role":"officer_director","role_raw":"CORPORATE DIRECTOR","percentage_raw":"NOT APPLICABLE","association_date":"2015-05-01","owner_name_raw":"HAUG, DARIN"},{"owner_type":"individual","owner_name":"Angela Littrell","role":"officer_director","role_raw":"CORPORATE OFFICER","percentage_raw":"NOT APPLICABLE","association_date":"2018-09-01","owner_name_raw":"LITTRELL, ANGELA"},{"owner_type":"individual","owner_name":"Darin Haug","role":"managing_employee","role_raw":"W-2 MANAGING EMPLOYEE","percentage_raw":"NOT APPLICABLE","association_date":"2015-05-01","owner_name_raw":"HAUG, DARIN"},{"owner_type":"individual","owner_name":"Angela Littrell","role":"managing_employee","role_raw":"W-2 MANAGING EMPLOYEE","percentage_raw":"NOT APPLICABLE","association_date":"2014-06-02","owner_name_raw":"LITTRELL, ANGELA"}],"inspections":[{"id":"cms-265688-20260728-health","ccn":"265688","date":"2026-07-28","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Complaint"],"cycles":[1],"footnotes":[],"derived_from_citations":false,"kind":"complaint","deficiency_count":3,"max_severity_level":2,"open_count":3,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0580","ss":"D","sl":2,"cs":"plan_of_correction","cd":"2026-09-11","cmp":1},{"t":"cms-f0742","ss":"D","sl":2,"cs":"plan_of_correction","cd":"2026-09-11","cmp":1},{"t":"cms-f0880","ss":"D","sl":2,"cs":"plan_of_correction","cd":"2026-09-11","cmp":1}]},{"id":"cms-265688-20250709-health","ccn":"265688","date":"2025-07-09","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-f0689","ss":"G","sl":3,"cs":"past_noncompliance","cd":"2025-06-28","cmp":1}]},{"id":"cms-265688-20240718-fire","ccn":"265688","date":"2024-07-18","domain":"fire","authority":"CMS / state survey agency","survey_types":["Fire Safety Standard"],"cycles":[1],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":8,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-k0100","ss":"E","sl":2,"cs":"corrected","cd":"2024-08-30","std":1,"tv":"New"},{"t":"cms-k0222","ss":"E","sl":2,"cs":"corrected","cd":"2024-08-30","std":1,"tv":"New"},{"t":"cms-k0311","ss":"E","sl":2,"cs":"corrected","cd":"2024-08-30","std":1,"tv":"New"},{"t":"cms-k0363","ss":"E","sl":2,"cs":"corrected","cd":"2024-08-30","std":1,"tv":"New"},{"t":"cms-k0372","ss":"E","sl":2,"cs":"corrected","cd":"2024-08-30","std":1,"tv":"New"},{"t":"cms-k0712","ss":"F","sl":2,"cs":"corrected","cd":"2024-08-30","std":1,"tv":"New"},{"t":"cms-k0923","ss":"E","sl":2,"cs":"corrected","cd":"2024-08-30","std":1,"tv":"New"},{"t":"cms-e0004","ss":"C","sl":1,"cs":"corrected","cd":"2024-08-30","std":1,"tv":"New"}]},{"id":"cms-265688-20240718-health","ccn":"265688","date":"2024-07-18","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Standard"],"cycles":[1],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":4,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0602","ss":"D","sl":2,"cs":"past_noncompliance","cd":"2024-06-26","std":1},{"t":"cms-f0638","ss":"E","sl":2,"cs":"corrected","cd":"2024-08-30","std":1},{"t":"cms-f0758","ss":"E","sl":2,"cs":"corrected","cd":"2024-08-30","std":1},{"t":"cms-f0812","ss":"F","sl":2,"cs":"corrected","cd":"2024-08-30","std":1}]},{"id":"cms-265688-20230209-fire","ccn":"265688","date":"2023-02-09","domain":"fire","authority":"CMS / state survey agency","survey_types":["Fire Safety Standard"],"cycles":[2],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":23,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-e0004","ss":"F","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-e0006","ss":"F","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-e0015","ss":"F","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-e0020","ss":"E","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-e0026","ss":"F","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-e0034","ss":"F","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-k0100","ss":"E","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-k0131","ss":"E","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-k0211","ss":"E","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-k0222","ss":"E","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-k0311","ss":"F","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-k0321","ss":"E","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-k0353","ss":"F","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-k0363","ss":"E","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-k0372","ss":"E","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-k0374","ss":"E","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-k0711","ss":"E","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-k0712","ss":"F","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-k0741","ss":"E","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-k0761","ss":"E","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-k0918","ss":"F","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-k0920","ss":"E","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"},{"t":"cms-k0921","ss":"E","sl":2,"cs":"corrected","cd":"2023-03-25","std":1,"tv":"New"}]},{"id":"cms-265688-20230209-health","ccn":"265688","date":"2023-02-09","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Standard"],"cycles":[2],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":11,"max_severity_level":3,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0697","ss":"G","sl":3,"cs":"corrected","cd":"2023-04-10","std":1},{"t":"cms-f0558","ss":"E","sl":2,"cs":"corrected","cd":"2023-03-25","std":1},{"t":"cms-f0658","ss":"E","sl":2,"cs":"corrected","cd":"2023-03-25","std":1},{"t":"cms-f0677","ss":"E","sl":2,"cs":"corrected","cd":"2023-03-25","std":1},{"t":"cms-f0689","ss":"E","sl":2,"cs":"corrected","cd":"2023-03-25","std":1},{"t":"cms-f0695","ss":"D","sl":2,"cs":"corrected","cd":"2023-03-25","std":1},{"t":"cms-f0700","ss":"E","sl":2,"cs":"corrected","cd":"2023-03-25","std":1},{"t":"cms-f0804","ss":"E","sl":2,"cs":"corrected","cd":"2023-03-25","std":1},{"t":"cms-f0812","ss":"F","sl":2,"cs":"corrected","cd":"2023-03-25","std":1},{"t":"cms-f0880","ss":"E","sl":2,"cs":"corrected","cd":"2023-04-10","std":1},{"t":"cms-f0909","ss":"E","sl":2,"cs":"corrected","cd":"2023-03-25","std":1}]},{"id":"cms-265688-20190725-fire","ccn":"265688","date":"2019-07-25","domain":"fire","authority":"CMS / state survey agency","survey_types":["Fire Safety Standard"],"cycles":[3],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":11,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-e0018","ss":"F","sl":2,"cs":"corrected","cd":"2019-10-11","std":1,"tv":"New"},{"t":"cms-k0161","ss":"E","sl":2,"cs":"corrected","cd":"2019-10-11","std":1,"tv":"New"},{"t":"cms-k0321","ss":"D","sl":2,"cs":"corrected","cd":"2019-10-11","std":1,"tv":"New"},{"t":"cms-k0353","ss":"E","sl":2,"cs":"corrected","cd":"2019-10-11","std":1,"tv":"New"},{"t":"cms-k0363","ss":"E","sl":2,"cs":"corrected","cd":"2019-10-11","std":1,"tv":"New"},{"t":"cms-k0372","ss":"E","sl":2,"cs":"corrected","cd":"2019-10-11","std":1,"tv":"New"},{"t":"cms-k0374","ss":"E","sl":2,"cs":"corrected","cd":"2019-10-11","std":1,"tv":"New"},{"t":"cms-k0712","ss":"F","sl":2,"cs":"corrected","cd":"2019-10-11","std":1,"tv":"New"},{"t":"cms-k0761","ss":"D","sl":2,"cs":"waiver_granted","cd":"2019-08-30","std":1,"tv":"New"},{"t":"cms-k0911","ss":"E","sl":2,"cs":"corrected","cd":"2019-10-11","std":1,"tv":"New"},{"t":"cms-k0920","ss":"E","sl":2,"cs":"corrected","cd":"2019-10-11","std":1,"tv":"New"}]},{"id":"cms-265688-20190725-health","ccn":"265688","date":"2019-07-25","domain":"health","authority":"CMS / state survey agency","survey_types":["Health 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-f0580","ss":"D","sl":2,"cs":"corrected","cd":"2019-10-11","std":1},{"t":"cms-f0604","ss":"D","sl":2,"cs":"corrected","cd":"2019-10-11","std":1},{"t":"cms-f0658","ss":"E","sl":2,"cs":"corrected","cd":"2019-10-11","std":1},{"t":"cms-f0690","ss":"D","sl":2,"cs":"corrected","cd":"2019-10-11","std":1},{"t":"cms-f0758","ss":"D","sl":2,"cs":"corrected","cd":"2019-10-11","std":1},{"t":"cms-f0759","ss":"E","sl":2,"cs":"corrected","cd":"2019-10-11","std":1},{"t":"cms-f0812","ss":"F","sl":2,"cs":"corrected","cd":"2019-10-11","std":1},{"t":"cms-f0880","ss":"E","sl":2,"cs":"corrected","cd":"2019-10-11","std":1},{"t":"cms-f0883","ss":"E","sl":2,"cs":"corrected","cd":"2019-10-11","std":1}]}],"deficiency_types":{"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-f0742":{"code":"F-0742","title":"Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder.","category":"Quality of Life and Care 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-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-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-k0100":{"code":"K-0100","title":"Meet other general requirements.","category":"Construction Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"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-k0311":{"code":"K-0311","title":"Have an enclosure around a vertical opening shaft.","category":"Smoke Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0363":{"code":"K-0363","title":"Install corridor and hallway doors that block smoke.","category":"Smoke 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-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-e0004":{"code":"E-0004","title":"Develop and maintain an Emergency Preparedness Program (EP).","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"cms-f0812":{"code":"F-0812","title":"Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.","category":"Nutrition and Dietary Deficiencies","concept":"food_nutrition","concept_label":"Food, nutrition & hydration"},"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-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-f0602":{"code":"F-0602","title":"Protect each resident from the wrongful use of the resident's belongings or money.","category":"Freedom from Abuse, Neglect, and Exploitation Deficiencies","concept":"resident_rights","concept_label":"Resident rights & abuse/neglect"},"cms-e0006":{"code":"E-0006","title":"Conduct risk assessment and an All-Hazards approach.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"cms-e0015":{"code":"E-0015","title":"Address subsistence needs for staff and patients.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"cms-e0026":{"code":"E-0026","title":"Establish roles under a Waiver declared by secretary.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"cms-e0034":{"code":"E-0034","title":"Provide a means of sharing information on occupancy/needs.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"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-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-e0020":{"code":"E-0020","title":"Establish policies and procedures including evacuation.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"cms-k0131":{"code":"K-0131","title":"Meet requirements for sections of health care facilities separated by fire resistive construction.","category":"Construction Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0211":{"code":"K-0211","title":"Keep aisles, corridors, and exits free of obstruction in case of emergency.","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-k0374":{"code":"K-0374","title":"Install smoke barrier doors that can resist smoke for at least 20 minutes.","category":"Smoke Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0711":{"code":"K-0711","title":"Provide a written emergency evacuation plan.","category":"Miscellaneous 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-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-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-k0921":{"code":"K-0921","title":"Ensure that testing and maintenance of electrical equipment is performed.","category":"Gas, Vacuum, and Electrical Systems Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-f0697":{"code":"F-0697","title":"Provide safe, appropriate pain management for a resident who requires such services.","category":"Quality of Life and Care Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0558":{"code":"F-0558","title":"Reasonably accommodate the needs and preferences of each resident.","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-f0700":{"code":"F-0700","title":"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.","category":"Quality of Life and Care Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0804":{"code":"F-0804","title":"Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.","category":"Nutrition and Dietary Deficiencies","concept":"food_nutrition","concept_label":"Food, nutrition & hydration"},"cms-f0909":{"code":"F-0909","title":"Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame.","category":"Environmental Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"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-e0018":{"code":"E-0018","title":"Establish procedures for tracking staff and patients during an emergency.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"cms-k0161":{"code":"K-0161","title":"Use approved construction type or materials.","category":"Construction Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0911":{"code":"K-0911","title":"Meet requirements for the installation and maintenance of electrical systems.","category":"Gas, Vacuum, and Electrical Systems Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-f0759":{"code":"F-0759","title":"Ensure medication error rates are not 5 percent or greater.","category":"Pharmacy Service Deficiencies","concept":"medication","concept_label":"Medication management"},"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-f0604":{"code":"F-0604","title":"Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.","category":"Freedom from Abuse, Neglect, and Exploitation Deficiencies","concept":"resident_rights","concept_label":"Resident rights & abuse/neglect"},"cms-f0690":{"code":"F-0690","title":"Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care,  and appropriate care  to prevent urinary tract infections.","category":"Quality of Life and Care Deficiencies","concept":"clinical_care","concept_label":"Clinical care"}},"penalties":[],"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=265688&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=265688&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=265688&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=265688&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=265688&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=265688&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":"29195","name":"Saline County"},"zip":"65340","city":"Marshall"},"related":{"same_operator":[],"same_operator_total":0,"same_chain":[],"same_chain_total":0,"same_site_review":[],"nearby":[{"id":"cms-265508","ccn":"265508","name":"Legendary Health Care Center","address":"809 East Gordon St","city":"Marshall","state":"MO","zip":"65340","beds":92,"overall":1,"inspections":10,"last_inspection":"2026-01-07","deficiencies":74,"serious":2,"ij":1,"open":0,"fines_total":93208,"status":"active","universe":"cms","licensed_beds":92,"state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"],"distance_km":3.1}]}}