Mitchell County Hospital Health Systems Ltcu — nursing home in Beloit, KS

Facility type: Nursing home · SNF / NF
CMS provider type: Medicare and Medicaid
Certified beds: 36 CMS-certified beds (not state-licensed beds)
Licensed beds: State licensure is issued by the state survey agency. State license records are not yet ingested for this facility; the federal CMS certification is shown instead.
Average residents per day: 32.5 CMS, MDS-derived
CMS Certification Number: 175505
Certification status: Active CMS certification Verified
First approved (Medicare/Medicaid): Sep 1, 2008
Ownership type: Government - County
Operator (legal business name): Mitchell County Hospital Health Systems
CMS chain: Not part of a CMS-reported chain
Phone: (785) 738-9590
Resident & family council: Resident
Sprinklers in all required areas: Yes
Official profile: Medicare Care Compare ↗

Inspection record · CMS window

Verified

Inspections

6

latest Feb 6, 2025

Citations

38

14 health · 24 fire

Harm or worse

0

no immediate jeopardy

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J·	K·	L·
Actual harm	G·	H·	I·
Potential harm	D15	E7	F16
Minimal	A·	B·	C·

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.

CMS Five-Star ratings

Federal · CMS

Overall

Health inspections

Staffing

Quality measures

Penalties · about the last 3 years

Fines

0

$0

Payment denials

0

Latest

—

Federal certification

Federal · CMS

Authority: Centers for Medicare & Medicaid Services (CMS), surveyed by the state survey agency
CCN: 175505
Program: Medicare and Medicaid
Medicare (SNF): Certified
Medicaid (NF): Certified
Certified beds: 36
First approved: Sep 1, 2008
Located in a hospital: Yes
Status: Active CMS certification as of CMS release Oct 1, 2026
Evidence: Verified

State license

State licensure is issued by the state survey agency. State license records are not yet ingested for this facility; the federal CMS certification is shown instead. State coverage for Kansas.

Federal certification and the state license are different records. A nursing home is licensed by the state and, separately, certified by CMS to bill Medicare and/or Medicaid. We link them by the CCN when the state publishes it; otherwise by exact address, house number and street, or exact name within the same ZIP, and label that link as inferred. Never by name alone.

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.

Date	Domain	Survey types	Citations	Most severe	Open
Feb 6, 2025	Fire safety	Fire Safety Standard	9	Potential harm	—	Open →
Feb 6, 2025	Health	Health Standard	2	Potential harm	—	Open →
May 31, 2023	Fire safety	Fire Safety Standard	10	Potential harm	—	Open →
May 31, 2023	Health	Health Standard	8	Potential harm	—	Open →
Nov 22, 2021	Fire safety	Fire Safety Standard	5	Potential harm	—	Open →
Nov 22, 2021	Health	Health Standard	4	Potential harm	—	Open →

Enforcement

Penalties

Civil money penalties and denials of payment for new admissions, as published by CMS (about the last three years). Amounts may change on appeal.

No fines or payment denials in the CMS Penalties file for this CCN.

Scope × severity

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J·	K·	L·
Actual harm	G·	H·	I·
Potential harm	D15	E7	F16
Minimal	A·	B·	C·

By concept

Date	Tag	Deficiency	Scope / severity	Correction
Feb 6, 2025	K-0293	Have properly located and lighted "Exit" signs. Egress Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Apr 11, 2025
Feb 6, 2025	K-0321	Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. Smoke Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Apr 11, 2025
Feb 6, 2025	K-0343	Have a fire alarm with audible and visual signals that transmits the alarm automatically to notify emergency forces in event of fire. Smoke Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Apr 11, 2025
Feb 6, 2025	K-0345	Have approved installation, maintenance and testing program for fire alarm systems. Smoke Deficiencies · Environment & life safety	E · Potential harm Pattern	Corrected Apr 11, 2025
Feb 6, 2025	K-0353	Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Apr 11, 2025
Feb 6, 2025	K-0511	Have properly installed electrical wiring and gas equipment. Services Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Apr 11, 2025
Feb 6, 2025	K-0712	Have simulated fire drills held at unexpected times. Miscellaneous Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Apr 11, 2025
Feb 6, 2025	K-0771	Ensure that smoke control systems are tested and documented in accordance with established engineering principles. Miscellaneous Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Apr 11, 2025
Feb 6, 2025	K-0918	Have generator or other power source capable of supplying service within 10 seconds. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Apr 11, 2025
Feb 6, 2025	F-0700	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. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Mar 25, 2025
Feb 6, 2025	F-0882	Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. Infection Control Deficiencies · Infection prevention	E · Potential harm Pattern	Corrected Mar 25, 2025
May 31, 2023	K-0222	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. Egress Deficiencies · Environment & life safety	E · Potential harm Pattern	Corrected Aug 8, 2023
May 31, 2023	K-0345	Have approved installation, maintenance and testing program for fire alarm systems. Smoke Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Aug 8, 2023
May 31, 2023	K-0353	Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Environment & life safety	E · Potential harm Pattern	Corrected Aug 8, 2023
May 31, 2023	K-0372	Ensure smoke barriers are constructed to a 1 hour fire resistance rating. Smoke Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Aug 8, 2023
May 31, 2023	K-0712	Have simulated fire drills held at unexpected times. Miscellaneous Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Aug 8, 2023
May 31, 2023	K-0753	Have restrictions on the use of highly flammable decorations. Miscellaneous Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Aug 8, 2023
May 31, 2023	K-0761	To conduct inspection, testing and maintenance of fire doors by qualified individuals. Miscellaneous Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Aug 8, 2023
May 31, 2023	K-0911	Meet requirements for the installation and maintenance of electrical systems. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Aug 8, 2023
May 31, 2023	K-0914	Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety	E · Potential harm Pattern	Corrected Aug 8, 2023
May 31, 2023	K-0918	Have generator or other power source capable of supplying service within 10 seconds. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Aug 8, 2023
May 31, 2023	F-0610	Respond appropriately to all alleged violations. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Jun 29, 2023
May 31, 2023	F-0656	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Jun 29, 2023
May 31, 2023	F-0657	Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. Resident Assessment and Care Planning Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Jun 29, 2023
May 31, 2023	F-0689	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Jun 29, 2023
May 31, 2023	F-0692	Provide enough food/fluids to maintain a resident's health. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Jun 29, 2023
May 31, 2023	F-0744	Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Jun 29, 2023
May 31, 2023	F-0756	Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. Pharmacy Service Deficiencies · Medication management	D · Potential harm Isolated	Corrected Jun 29, 2023
May 31, 2023	F-0758	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. Pharmacy Service Deficiencies · Medication management	D · Potential harm Isolated	Corrected Jun 29, 2023
Nov 22, 2021	E-0023	Establish policies and procedures for medical documentation. Emergency Preparedness Deficiencies · Emergency preparedness	F · Potential harm Widespread	Corrected Dec 22, 2021
Nov 22, 2021	E-0024	Establish policies and procedures for volunteers. Emergency Preparedness Deficiencies · Emergency preparedness	F · Potential harm Widespread	Corrected Dec 22, 2021
Nov 22, 2021	K-0225	Have stairways and smokeproof enclosures used as exits that meet safety requirements. Egress Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Dec 22, 2021
Nov 22, 2021	K-0345	Have approved installation, maintenance and testing program for fire alarm systems. Smoke Deficiencies · Environment & life safety	E · Potential harm Pattern	Corrected Dec 22, 2021
Nov 22, 2021	K-0353	Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Environment & life safety	E · Potential harm Pattern	Corrected Dec 22, 2021
Nov 22, 2021	F-0625	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. Resident Rights Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Dec 16, 2021
Nov 22, 2021	F-0684	Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Dec 16, 2021
Nov 22, 2021	F-0756	Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. Pharmacy Service Deficiencies · Medication management	D · Potential harm Isolated	Corrected Dec 16, 2021
Nov 22, 2021	F-0758	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. Pharmacy Service Deficiencies · Medication management	D · Potential harm Isolated	Corrected Dec 16, 2021

“Corrected” does not erase a citation: the historical finding stays listed with its disposition. Narrative statements of deficiencies are not part of the CMS dataset; see Care Compare for the official inspection report.

Five-Star ratings

Federal · CMS

Overallstate 3.1

Health inspectionsstate 2.9

Staffingstate 3.5

Quality measuresstate 3.3

Long-stay QM

Short-stay QMNot rated

CMS ratings apply to CMS-certified nursing homes only and are relative within each state. They are not a guarantee of any individual resident’s experience.

Nurse staffing · hours per resident per day

Total nurse staffing4.62

State avg 4.13US avg 3.90

Registered nurse (RN)1.08

State avg 0.73US avg 0.69

Licensed practical nurse0.47

State avg 0.66US avg 0.86

Nurse aide3.07

State avg 2.74US avg 2.35

Weekend total nurse4.01

State avg 3.62US avg 3.43

Reported from Payroll-Based Journal (PBJ) data, as published by CMS. Case-mix adjusted total: 5.42 (case-mix index 1.19).

Staff turnover

Total nursing staff turnover30.6%

State avg 48.0%US avg 45.3%

Registered nurse turnover14.3%

State avg 42.6%US avg 42.5%

Administrators who leftNot reported

State avg 0US avg 1

Health survey score

Cycle 1 standard survey: Feb 6, 2025
Cycle 1 health score: 12
Total weighted score: 17

Operating entity

Mitchell County Hospital Health Systems

CMS legal business name of the certified provider. Operates this facility only.

VerifiedLinked by exact legal name

CMS chain

Not part of a CMS-reported chain.

Ownership disclosures

Disclosures

15

Organizations

1

Individuals

11

Direct & indirect ownership

Owners of record

Name	Type	Role (Carefield group)	CMS role text	Share	Since
Mitchell County Hospital Health Systems	Organization	Direct owner	DIRECT OWNERSHIP INTEREST	not provided	Jul 1, 2005

CMS Ownership file

All disclosed roles

Operator, owners, managers, officers and lenders are distinct roles and are never flattened into one entity. Organizations link across facilities by exact normalized legal name; individuals are listed per facility only.

Name	Type	Role (Carefield group)	CMS role text	Share	Since
Mitchell County Hospital Health Systems	Organization	Direct owner	DIRECT OWNERSHIP INTEREST	not provided	Jul 1, 2005
Janelle Kircher	Individual	Operational / managerial control	MANAGING CONTROL - GOVERNING BODY	not provided	Feb 7, 2023
Christine Marozas	Individual	Operational / managerial control	MANAGING CONTROL - GOVERNING BODY	not provided	Jan 1, 2021
Mitchell County Hospital Health Systems	Organization	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Jul 1, 2005
Nicki Cleveland	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Jun 2, 2015
Leanne Eilert	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Oct 7, 1999
Luigi Gavino	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Jun 26, 2023
Janelle Kircher	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Feb 7, 2023
Christine Marozas	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Jan 1, 2021
Stephanie Simmons	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Nov 18, 2010
Mitchell County Hospital Health Systems	Organization	Trustee	TRUSTEE OF THE SNF	not provided	Jul 1, 2005
Christine Marozas	Individual	Trustee	TRUSTEE OF THE SNF	not provided	Jan 1, 2021
Mitchell County Hospital Health Systems	Organization	Additional disclosable party	ADP OF THE SNF	not provided	Jul 1, 2005
Janelle Kircher	Individual	Additional disclosable party	ADP OF THE SNF	not provided	May 13, 2025
Christine Marozas	Individual	Additional disclosable party	ADP OF THE SNF	not provided	May 13, 2025

No building or property record is linked to this facility yet. Parcel, assessor and building-permit joins will be added only where a valid site match exists.

Coordinates as published by CMS.

Address: 400 W 8th Street, Beloit, KS 67420
ZIP: 67420
County: Mitchell County FIPS 20123
State: Kansas
Urban / rural (CMS): Rural

Within ~25 km

Nearby nursing homes

Facility	Distance	Beds	CMS overall	Last inspection	Citations (window)	Fines
Hilltop Lodge Health and Rehabilitation Center 815 N Independence Avenue, Beloit, KS 67420 CCN 175348	0.2 km	90		Jun 16, 2026	652 IJ	$29k

Source	Record	Facts	Evidence	Source release	Retrieved
CMS Provider Information US-CMS	175505	name, address, phone, certification, certified_beds, ownership_type, legal_business_name, chain	Verified	Oct 1, 2026	Nov 7, 2026
CMS Provider Information US-CMS	175505	ratings, staffing, health_survey_score Five-Star ratings and PBJ staffing apply to the CMS-certified universe only.	Verified	Oct 1, 2026	Nov 7, 2026

Record-level source links for CCN 175505

First seen by Carefield Nov 7, 2026 · last changed Nov 7, 2026. This record as JSON · Report a correction