{"schema_version":"1.0.0","facility":{"id":"cms-265702","ccn":"265702","name":"Troy Manor","source_name":"TROY MANOR","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":"200 Thompson Drive","city":"Troy","state":"MO","zip":"63379","county_name":"Lincoln County","county_fips":"29113","county_method":"name_match","ssa_county_code":"560","urban":true},"location":{"lat":38.9799,"lon":-90.964,"method":"cms_published_coordinates"},"phone":"6365288446","certification":{"authority":"CMS","ccn":"265702","program":"Medicare and Medicaid","medicare":true,"medicaid":true,"first_approved":"2000-02-22","certified_beds":130,"resides_in_hospital":false,"evidence_class":"VERIFIED","care_compare_url":"https://www.medicare.gov/care-compare/details/nursing-home/265702"},"licenses":[{"state":"MO","authority":"Missouri Department of Health and Senior Services, Section for Long-Term Care Regulation","license_number":"052741","state_facility_id":"05397","license_type":"Skilled nursing facility","status":"active","licensed_beds":130,"capacity_unit":"beds","effective_date":"2025-06-01","expiration_date":"2027-05-31","licensee":"N & R OF TROY, LLC","licensee_entity_type":"Limited Liability Company","certification_status":"Medicare/Medicaid","ccn":"265702","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":130,"licensed_beds":130,"avg_residents_per_day":97.9},"ownership_type":"For profit - Corporation","ownership_class":"for_profit","legal_business_name":"N & R OF TROY LLC","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":1},"health_inspection":{"value":2},"quality_measures":{"value":3},"long_stay_qm":{"value":3},"short_stay_qm":{"footnote":"2"},"staffing":{"value":1},"universe":"cms_certified_nursing_homes"},"staffing":{"nurse_aide_hprd":1.59105,"lpn_hprd":0.63773,"rn_hprd":0.23242,"licensed_hprd":0.87016,"total_nurse_hprd":2.46121,"weekend_total_nurse_hprd":2.14386,"weekend_rn_hprd":0.16054,"pt_hprd":0.00912,"nursing_turnover_pct":43.5,"rn_turnover_pct":50,"administrators_left":3,"case_mix_index":1.02087,"case_mix_index_ratio":0.72389,"case_mix_total_nurse_hprd":2.82378,"adjusted_total_nurse_hprd":3.3733,"source":"Payroll-Based Journal (PBJ), as published by CMS"},"health_survey_score":{"cycle1_date":"2026-06-04","cycle1_deficiencies":10,"cycle1_score":80,"cycle2_date":"2024-04-09","cycle23_deficiencies":29,"cycle23_score":272,"total_weighted_score":128},"cms_penalty_counts":{"fines":2,"fine_total":104685,"payment_denials":2,"total":4},"chain":{"id":"cms-chain-290","cms_chain_id":"290","name":"JAMES & JUDY LINCOLN"},"operator_id":"op-n-and-r-of-troy-llc","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/265702","provenance":[{"source_id":"cms_provider_info","source_record_id":"265702","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=265702&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":"265702","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=265702&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":"05397","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":9,"health_count":6,"fire_count":3,"complaint_count":4,"latest_date":"2026-06-04","latest_standard_health":"2026-06-04","earliest_date":"2020-10-28","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":108,"health_count":66,"fire_count":42,"open_count":0,"actual_harm_count":3,"immediate_jeopardy_count":2,"serious_count":5,"complaint_count":14,"by_severity":{"potential":99,"minimal":4,"actual_harm":3,"immediate_jeopardy":2},"by_scope_severity":{"F":19,"E":60,"D":20,"C":2,"G":3,"K":2,"B":2},"by_concept":{"emergency_preparedness":5,"environment_life_safety":39,"food_nutrition":12,"infection_prevention":4,"resident_rights":20,"clinical_care":18,"medication":4,"staffing":5,"administration":1},"type_ids":["cms-e0039","cms-k0345","cms-k0712","cms-k0211","cms-k0311","cms-k0324","cms-k0353","cms-k0363","cms-k0374","cms-k0920","cms-k0923","cms-k0100","cms-f0812","cms-f0880","cms-f0628","cms-f0657","cms-f0677","cms-f0761","cms-f0804","cms-f0655","cms-f0760","cms-f0732","cms-f0600","cms-f0609","cms-f0610","cms-f0584","cms-f0557","cms-f0689","cms-e0004","cms-e0041","cms-k0921","cms-k0222","cms-k0355","cms-k0372","cms-k0741","cms-k0911","cms-f0561","cms-f0679","cms-f0700","cms-f0725","cms-f0728","cms-f0909","cms-f0558","cms-f0656","cms-f0695","cms-f0805","cms-f0623","cms-f0625","cms-k0291","cms-k0918","cms-k0161","cms-k0321","cms-k0932","cms-e0036","cms-f0604","cms-f0692","cms-f0814","cms-f0658","cms-f0688","cms-f0730","cms-f0759","cms-f0803","cms-f0806","cms-f0849","cms-f0580","cms-f0698","cms-f0800"],"evidence_class":"VERIFIED"},"penalty_summary":{"count":4,"fines":2,"fine_total":104685,"payment_denials":2,"latest_date":"2024-10-03"},"ownership_summary":{"disclosures":5,"organizations":1,"individuals":4,"not_available":false}},"row":{"id":"cms-265702","ccn":"265702","name":"Troy Manor","types":["skilled_nursing_facility","nursing_home"],"status":"active","state":"MO","city":"Troy","zip":"63379","county_fips":"29113","county_name":"Lincoln County","address":"200 Thompson Drive","beds":130,"residents":97.9,"ownership":"for_profit","operator_id":"op-n-and-r-of-troy-llc","operator_name":"N & R of Troy LLC","chain_id":"cms-chain-290","chain_name":"James & Judy Lincoln","lat":38.9799,"lon":-90.964,"overall":1,"health_rating":2,"staffing_rating":1,"qm_rating":3,"nurse_hprd":2.46,"turnover":43.5,"inspections":9,"last_inspection":"2026-06-04","deficiencies":108,"serious":5,"ij":2,"open":0,"penalties":4,"fines_total":104685,"deficiency_type_ids":["cms-e0039","cms-k0345","cms-k0712","cms-k0211","cms-k0311","cms-k0324","cms-k0353","cms-k0363","cms-k0374","cms-k0920","cms-k0923","cms-k0100","cms-f0812","cms-f0880","cms-f0628","cms-f0657","cms-f0677","cms-f0761","cms-f0804","cms-f0655","cms-f0760","cms-f0732","cms-f0600","cms-f0609","cms-f0610","cms-f0584","cms-f0557","cms-f0689","cms-e0004","cms-e0041","cms-k0921","cms-k0222","cms-k0355","cms-k0372","cms-k0741","cms-k0911","cms-f0561","cms-f0679","cms-f0700","cms-f0725","cms-f0728","cms-f0909","cms-f0558","cms-f0656","cms-f0695","cms-f0805","cms-f0623","cms-f0625","cms-k0291","cms-k0918","cms-k0161","cms-k0321","cms-k0932","cms-e0036","cms-f0604","cms-f0692","cms-f0814","cms-f0658","cms-f0688","cms-f0730","cms-f0759","cms-f0803","cms-f0806","cms-f0849","cms-f0580","cms-f0698","cms-f0800"],"universe":"cms","licensed_beds":130,"state_license":"MO 052741","state_actions":0,"state_serious":0,"last_changed":"2026-11-07T00:15:24.640Z"},"operator":{"id":"op-n-and-r-of-troy-llc","name":"N & R of Troy LLC","legal_name":"N & R OF TROY LLC","facility_count":2,"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":"2008-01-01","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":"2008-01-01","owner_name_raw":"LINCOLN, JUDY"},{"owner_id":"org-ltc-management-services-llc","owner_type":"organization","owner_name":"Ltc Management Services LLC","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2008-01-01"},{"owner_type":"individual","owner_name":"James Lincoln","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2008-01-01","owner_name_raw":"LINCOLN, JAMES"},{"owner_type":"individual","owner_name":"Janice Conover","role":"managing_employee","role_raw":"W-2 MANAGING EMPLOYEE","percentage_raw":"NOT APPLICABLE","association_date":"2004-06-01","owner_name_raw":"CONOVER, JANICE"}],"inspections":[{"id":"cms-265702-20260604-fire","ccn":"265702","date":"2026-06-04","domain":"fire","authority":"CMS / state survey agency","survey_types":["Fire Safety 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-e0039","ss":"F","sl":2,"cs":"corrected","cd":"2026-07-15","std":1,"tv":"New"},{"t":"cms-k0100","ss":"D","sl":2,"cs":"corrected","cd":"2026-07-15","std":1,"tv":"New"},{"t":"cms-k0211","ss":"E","sl":2,"cs":"corrected","cd":"2026-07-15","std":1,"tv":"New"},{"t":"cms-k0311","ss":"E","sl":2,"cs":"corrected","cd":"2026-07-15","std":1,"tv":"New"},{"t":"cms-k0324","ss":"E","sl":2,"cs":"corrected","cd":"2026-07-15","std":1,"tv":"New"},{"t":"cms-k0345","ss":"F","sl":2,"cs":"corrected","cd":"2026-07-15","std":1,"tv":"New"},{"t":"cms-k0353","ss":"E","sl":2,"cs":"corrected","cd":"2026-07-15","std":1,"tv":"New"},{"t":"cms-k0363","ss":"E","sl":2,"cs":"corrected","cd":"2026-07-15","std":1,"tv":"New"},{"t":"cms-k0374","ss":"E","sl":2,"cs":"corrected","cd":"2026-07-15","std":1,"tv":"New"},{"t":"cms-k0712","ss":"F","sl":2,"cs":"corrected","cd":"2026-07-15","std":1,"tv":"New"},{"t":"cms-k0920","ss":"E","sl":2,"cs":"corrected","cd":"2026-07-15","std":1,"tv":"New"},{"t":"cms-k0923","ss":"E","sl":2,"cs":"corrected","cd":"2026-07-15","std":1,"tv":"New"}]},{"id":"cms-265702-20260604-health","ccn":"265702","date":"2026-06-04","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Standard"],"cycles":[1],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":10,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0628","ss":"E","sl":2,"cs":"corrected","cd":"2026-07-15","std":1},{"t":"cms-f0655","ss":"D","sl":2,"cs":"corrected","cd":"2026-07-15","std":1},{"t":"cms-f0657","ss":"E","sl":2,"cs":"corrected","cd":"2026-07-15","std":1},{"t":"cms-f0677","ss":"E","sl":2,"cs":"corrected","cd":"2026-07-15","std":1},{"t":"cms-f0760","ss":"D","sl":2,"cs":"corrected","cd":"2026-07-15","std":1},{"t":"cms-f0761","ss":"E","sl":2,"cs":"corrected","cd":"2026-07-15","std":1},{"t":"cms-f0804","ss":"E","sl":2,"cs":"corrected","cd":"2026-07-15","std":1},{"t":"cms-f0812","ss":"F","sl":2,"cs":"corrected","cd":"2026-07-15","std":1},{"t":"cms-f0880","ss":"F","sl":2,"cs":"corrected","cd":"2026-07-15","std":1},{"t":"cms-f0732","ss":"C","sl":1,"cs":"corrected","cd":"2026-07-15","std":1}]},{"id":"cms-265702-20250514-health","ccn":"265702","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":3,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0600","ss":"D","sl":2,"cs":"past_noncompliance","cd":"2025-05-05","cmp":1},{"t":"cms-f0609","ss":"D","sl":2,"cs":"past_noncompliance","cd":"2025-05-05","cmp":1},{"t":"cms-f0610","ss":"D","sl":2,"cs":"corrected","cd":"2025-06-11","cmp":1}]},{"id":"cms-265702-20241119-health","ccn":"265702","date":"2024-11-19","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":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0804","ss":"E","sl":2,"cs":"corrected","cd":"2024-12-16","cmp":1}]},{"id":"cms-265702-20241003-health","ccn":"265702","date":"2024-10-03","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Complaint"],"cycles":[2],"footnotes":[],"derived_from_citations":false,"kind":"complaint","deficiency_count":8,"max_severity_level":3,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0600","ss":"G","sl":3,"cs":"corrected","cd":"2024-11-11","cmp":1},{"t":"cms-f0557","ss":"D","sl":2,"cs":"corrected","cd":"2024-11-11","cmp":1},{"t":"cms-f0584","ss":"E","sl":2,"cs":"corrected","cd":"2024-11-11","cmp":1},{"t":"cms-f0609","ss":"D","sl":2,"cs":"corrected","cd":"2024-11-11","cmp":1},{"t":"cms-f0610","ss":"D","sl":2,"cs":"corrected","cd":"2024-11-11","cmp":1},{"t":"cms-f0689","ss":"D","sl":2,"cs":"corrected","cd":"2024-11-11","cmp":1},{"t":"cms-f0804","ss":"E","sl":2,"cs":"corrected","cd":"2024-12-16","cmp":1},{"t":"cms-f0880","ss":"E","sl":2,"cs":"corrected","cd":"2024-12-16","cmp":1}]},{"id":"cms-265702-20240409-fire","ccn":"265702","date":"2024-04-09","domain":"fire","authority":"CMS / state survey agency","survey_types":["Fire Safety Standard"],"cycles":[2],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":15,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-e0004","ss":"F","sl":2,"cs":"corrected","cd":"2024-05-20","std":1,"tv":"New"},{"t":"cms-e0039","ss":"F","sl":2,"cs":"corrected","cd":"2024-05-20","std":1,"tv":"New"},{"t":"cms-e0041","ss":"F","sl":2,"cs":"corrected","cd":"2024-05-20","std":1,"tv":"New"},{"t":"cms-k0100","ss":"E","sl":2,"cs":"corrected","cd":"2024-05-20","std":1,"tv":"New"},{"t":"cms-k0222","ss":"E","sl":2,"cs":"corrected","cd":"2024-05-20","std":1,"tv":"New"},{"t":"cms-k0311","ss":"E","sl":2,"cs":"corrected","cd":"2024-05-20","std":1,"tv":"New"},{"t":"cms-k0353","ss":"F","sl":2,"cs":"corrected","cd":"2024-05-20","std":1,"tv":"New"},{"t":"cms-k0355","ss":"E","sl":2,"cs":"corrected","cd":"2024-05-20","std":1,"tv":"New"},{"t":"cms-k0363","ss":"E","sl":2,"cs":"corrected","cd":"2024-05-20","std":1,"tv":"New"},{"t":"cms-k0372","ss":"E","sl":2,"cs":"corrected","cd":"2024-05-20","std":1,"tv":"New"},{"t":"cms-k0712","ss":"F","sl":2,"cs":"corrected","cd":"2024-05-20","std":1,"tv":"New"},{"t":"cms-k0741","ss":"E","sl":2,"cs":"corrected","cd":"2024-05-20","std":1,"tv":"New"},{"t":"cms-k0911","ss":"E","sl":2,"cs":"corrected","cd":"2024-05-20","std":1,"tv":"New"},{"t":"cms-k0920","ss":"E","sl":2,"cs":"corrected","cd":"2024-05-20","std":1,"tv":"New"},{"t":"cms-k0921","ss":"F","sl":2,"cs":"corrected","cd":"2024-05-20","std":1,"tv":"New"}]},{"id":"cms-265702-20240409-health","ccn":"265702","date":"2024-04-09","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Complaint","Health Standard"],"cycles":[2,3],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":17,"max_severity_level":4,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0880","ss":"K","sl":4,"cs":"corrected","cd":"2024-05-20","std":1},{"t":"cms-f0558","ss":"D","sl":2,"cs":"corrected","cd":"2024-05-20","std":1},{"t":"cms-f0561","ss":"E","sl":2,"cs":"corrected","cd":"2024-05-20","std":1},{"t":"cms-f0656","ss":"D","sl":2,"cs":"corrected","cd":"2024-05-20","std":1},{"t":"cms-f0677","ss":"E","sl":2,"cs":"corrected","cd":"2024-05-20","cmp":1,"std":1},{"t":"cms-f0679","ss":"E","sl":2,"cs":"corrected","cd":"2024-05-20","std":1},{"t":"cms-f0689","ss":"E","sl":2,"cs":"corrected","cd":"2024-05-20","cmp":1,"std":1},{"t":"cms-f0695","ss":"D","sl":2,"cs":"corrected","cd":"2024-05-20","std":1},{"t":"cms-f0700","ss":"E","sl":2,"cs":"corrected","cd":"2024-05-20","std":1},{"t":"cms-f0725","ss":"E","sl":2,"cs":"corrected","cd":"2024-05-20","std":1},{"t":"cms-f0728","ss":"E","sl":2,"cs":"corrected","cd":"2024-05-20","std":1},{"t":"cms-f0760","ss":"D","sl":2,"cs":"corrected","cd":"2024-05-20","std":1},{"t":"cms-f0805","ss":"D","sl":2,"cs":"corrected","cd":"2024-05-20","std":1},{"t":"cms-f0812","ss":"E","sl":2,"cs":"corrected","cd":"2024-05-20","std":1},{"t":"cms-f0909","ss":"E","sl":2,"cs":"corrected","cd":"2024-05-20","std":1},{"t":"cms-f0623","ss":"B","sl":1,"cs":"corrected","cd":"2024-05-20","std":1},{"t":"cms-f0625","ss":"B","sl":1,"cs":"corrected","cd":"2024-05-20","std":1}]},{"id":"cms-265702-20201028-fire","ccn":"265702","date":"2020-10-28","domain":"fire","authority":"CMS / state survey agency","survey_types":["Fire Safety Standard"],"cycles":[3],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":15,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-k0161","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1,"tv":"New"},{"t":"cms-k0222","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1,"tv":"New"},{"t":"cms-k0291","ss":"F","sl":2,"cs":"corrected","cd":"2020-12-10","std":1,"tv":"New"},{"t":"cms-k0321","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1,"tv":"New"},{"t":"cms-k0353","ss":"F","sl":2,"cs":"corrected","cd":"2020-12-10","std":1,"tv":"New"},{"t":"cms-k0363","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1,"tv":"New"},{"t":"cms-k0372","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1,"tv":"New"},{"t":"cms-k0374","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1,"tv":"New"},{"t":"cms-k0712","ss":"F","sl":2,"cs":"corrected","cd":"2020-12-10","std":1,"tv":"New"},{"t":"cms-k0741","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1,"tv":"New"},{"t":"cms-k0918","ss":"F","sl":2,"cs":"corrected","cd":"2020-12-10","std":1,"tv":"New"},{"t":"cms-k0920","ss":"F","sl":2,"cs":"corrected","cd":"2020-12-10","std":1,"tv":"New"},{"t":"cms-k0923","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1,"tv":"New"},{"t":"cms-k0932","ss":"D","sl":2,"cs":"corrected","cd":"2020-12-10","std":1,"tv":"New"},{"t":"cms-e0036","ss":"C","sl":1,"cs":"corrected","cd":"2020-12-10","std":1,"tv":"New"}]},{"id":"cms-265702-20201028-health","ccn":"265702","date":"2020-10-28","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Standard"],"cycles":[3],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":27,"max_severity_level":4,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0600","ss":"K","sl":4,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0604","ss":"G","sl":3,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0692","ss":"G","sl":3,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0580","ss":"D","sl":2,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0609","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0610","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0623","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0625","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0656","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0658","ss":"E","sl":2,"cs":"corrected","cd":"2021-01-27","std":1},{"t":"cms-f0677","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0688","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0689","ss":"D","sl":2,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0698","ss":"D","sl":2,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0700","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0725","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0730","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0759","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0800","ss":"D","sl":2,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0803","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0804","ss":"F","sl":2,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0806","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0812","ss":"F","sl":2,"cs":"corrected","cd":"2021-01-27","std":1},{"t":"cms-f0814","ss":"F","sl":2,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0849","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0880","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1},{"t":"cms-f0909","ss":"E","sl":2,"cs":"corrected","cd":"2020-12-10","std":1}]}],"deficiency_types":{"cms-e0039":{"code":"E-0039","title":"Conduct testing and exercise requirements.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"cms-k0345":{"code":"K-0345","title":"Have approved installation, maintenance and testing program for fire alarm systems.","category":"Smoke 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-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-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-k0324":{"code":"K-0324","title":"Provide properly protected cooking facilities.","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-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-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-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-k0100":{"code":"K-0100","title":"Meet other general requirements.","category":"Construction Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"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-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-f0628":{"code":"F-0628","title":"Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.","category":"Resident Rights Deficiencies","concept":"resident_rights","concept_label":"Resident rights & abuse/neglect"},"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-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-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-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-f0655":{"code":"F-0655","title":"Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted","category":"Resident Assessment and Care Planning Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0760":{"code":"F-0760","title":"Ensure that residents are free from significant medication errors.","category":"Pharmacy Service Deficiencies","concept":"medication","concept_label":"Medication management"},"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-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-f0609":{"code":"F-0609","title":"Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.","category":"Freedom from Abuse, Neglect, and Exploitation Deficiencies","concept":"resident_rights","concept_label":"Resident rights & abuse/neglect"},"cms-f0610":{"code":"F-0610","title":"Respond appropriately to all alleged violations.","category":"Freedom from Abuse, Neglect, and Exploitation Deficiencies","concept":"resident_rights","concept_label":"Resident rights & abuse/neglect"},"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-f0557":{"code":"F-0557","title":"Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.","category":"Resident Rights Deficiencies","concept":"resident_rights","concept_label":"Resident rights & abuse/neglect"},"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-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-e0041":{"code":"E-0041","title":"Implement emergency and standby power systems.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"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-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-k0355":{"code":"K-0355","title":"Properly select, install, inspect, or maintain portable fire extinguishes.","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-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-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-f0561":{"code":"F-0561","title":"Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.","category":"Resident Rights Deficiencies","concept":"resident_rights","concept_label":"Resident rights & abuse/neglect"},"cms-f0679":{"code":"F-0679","title":"Provide activities to meet all resident's needs.","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-f0725":{"code":"F-0725","title":"Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.","category":"Nursing and Physician Services Deficiencies","concept":"staffing","concept_label":"Staffing & supervision"},"cms-f0728":{"code":"F-0728","title":"Ensure that nurse aides who have worked more than 4 months, are trained and competent; and nurse aides who have worked less than 4 months are enrolled in appropriate training.","category":"Nursing and Physician Services Deficiencies","concept":"staffing","concept_label":"Staffing & supervision"},"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-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-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-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-f0805":{"code":"F-0805","title":"Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.","category":"Nutrition and Dietary Deficiencies","concept":"food_nutrition","concept_label":"Food, nutrition & hydration"},"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-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-k0291":{"code":"K-0291","title":"Install emergency lighting that can last at least 1 1/2 hours.","category":"Egress 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-k0161":{"code":"K-0161","title":"Use approved construction type or materials.","category":"Construction 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-k0932":{"code":"K-0932","title":"Meet other general requirements.","category":"Smoke Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-e0036":{"code":"E-0036","title":"Establish emergency prep training and testing.","category":"Emergency Preparedness Deficiencies","concept":"emergency_preparedness","concept_label":"Emergency preparedness"},"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-f0692":{"code":"F-0692","title":"Provide enough food/fluids to maintain a resident's health.","category":"Quality of Life and Care Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0814":{"code":"F-0814","title":"Dispose of garbage and refuse properly.","category":"Nutrition and Dietary Deficiencies","concept":"food_nutrition","concept_label":"Food, nutrition & hydration"},"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-f0688":{"code":"F-0688","title":"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.","category":"Quality of Life and Care Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0730":{"code":"F-0730","title":"Observe each nurse aide's job performance and give regular training.","category":"Nursing and Physician Services Deficiencies","concept":"staffing","concept_label":"Staffing & supervision"},"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-f0803":{"code":"F-0803","title":"Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.","category":"Nutrition and Dietary Deficiencies","concept":"food_nutrition","concept_label":"Food, nutrition & hydration"},"cms-f0806":{"code":"F-0806","title":"Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.","category":"Nutrition and Dietary Deficiencies","concept":"food_nutrition","concept_label":"Food, nutrition & hydration"},"cms-f0849":{"code":"F-0849","title":"Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.","category":"Administration Deficiencies","concept":"administration","concept_label":"Administration & records"},"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-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-f0800":{"code":"F-0800","title":"Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.","category":"Nutrition and Dietary Deficiencies","concept":"food_nutrition","concept_label":"Food, nutrition & hydration"}},"penalties":[{"id":"cms-265702-pen-d20241003","type":"payment_denial","type_label":"Denial of payment for new admissions","date":"2024-10-03","denial_start":"2024-11-13","denial_days":33,"evidence_class":"VERIFIED","source_record_id":"265702|Payment Denial|2024-11-13"},{"id":"cms-265702-pen-f90651","type":"fine","type_label":"Civil money penalty (fine)","date":"2024-10-03","amount":84256,"fine_id":"90651","evidence_class":"VERIFIED","source_record_id":"265702|Fine|90651"},{"id":"cms-265702-pen-d20240409","type":"payment_denial","type_label":"Denial of payment for new admissions","date":"2024-04-09","denial_start":"2024-05-15","denial_days":5,"evidence_class":"VERIFIED","source_record_id":"265702|Payment Denial|2024-05-15"},{"id":"cms-265702-pen-f90613","type":"fine","type_label":"Civil money penalty (fine)","date":"2024-04-09","amount":20429,"fine_id":"90613","evidence_class":"VERIFIED","source_record_id":"265702|Fine|90613"}],"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=265702&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=265702&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=265702&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=265702&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=265702&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=265702&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":"29113","name":"Lincoln County"},"zip":"63379","city":"Troy"},"related":{"same_operator":[{"id":"mo-dhss-05397","name":"Troy Manor","address":"200 Thompson Dr","city":"Troy","state":"MO","zip":"63379","inspections":0,"deficiencies":0,"serious":0,"ij":0,"open":0,"fines_total":0,"status":"active","universe":"residential","state_actions":0,"state_serious":0,"types":["assisted_living"],"capacity":20,"capacity_unit":"beds"}],"same_operator_total":1,"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-265433","ccn":"265433","name":"Lincoln County Nursing & Rehab","address":"1145 East Cherry Street","city":"Troy","state":"MO","zip":"63379","beds":90,"inspections":12,"last_inspection":"2026-04-16","deficiencies":160,"serious":9,"ij":1,"open":0,"fines_total":259609,"sff":"SFF","abuse":true,"status":"active","universe":"cms","licensed_beds":90,"state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"],"distance_km":0.7},{"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"],"distance_km":22.4}]}}