Grand River Health Care

118 Trenton Road · Chillicothe, MO · 64601 · 6606460353

60 certified beds For profit - Corporation Chain: James & Judy Lincoln

Why this verdict

  • Carries CMS’s abuse warning icon.
  • Inspectors found immediate jeopardy — danger of serious harm or death — in the most recent cycle (1 citation).
  • Inspection record is far worse than the national median (deficiency count and severity).
  • Federal penalties on record: $68,226 in fines in the last 24 months.

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Red flags

CMS abuse warning

CMS flags this facility with its abuse icon: cited for abuse that caused harm in the past year, or potential harm in the past two years.

1 immediate-jeopardy citation in the most recent inspection cycle

Immediate jeopardy is the most serious finding an inspector can make: a situation likely to cause serious injury, harm, or death.

4 abuse-related citations at the actual-harm level

Inspectors cited failures in the abuse-prevention rules (F600–F610) that resulted in actual harm to a resident.

$68,226 in federal fines in the last 24 months

2 fines — CMS fines are reserved for verified, serious non-compliance.

Total nurse staffing below 3.0 hours per resident-day

2.92 reported hours vs the 3.48 minimum CMS's own staffing study recommends.

91% of nursing staff left within a year

High turnover disrupts continuity of care; the national median is 45%.

Score breakdown

Inspection record 30% of score 24
Serious harm & abuse 20% 12
Staffing 20% 48
Federal penalties 15% 33
Trend 10% 69
Context 5% 100

Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.

CMS ratings & staffing

Overall: 1 of 5 Inspections: 1 of 5 Staffing: 1 of 5 Quality measures: 4 of 5

Total nurse hours / resident-day2.923.48 min · 4.1 strong
RN hours / resident-day0.540.55–0.75
Weekend hours / resident-day2.80≈ weekday level
Nursing turnover / year91%median 45%
Fines (3-yr window)2 · $68,226

Inspection citations (60 in the current record)

  • Immediate jeopardy · J January 9, 2026 · found via complaint

    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

    Corrected January 27, 2026 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · D January 9, 2026 · found via complaint

    Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

    Corrected January 27, 2026 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · D November 21, 2025 · found via complaint

    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

    Corrected November 30, 2025 · Freedom from Abuse, Neglect, and Exploitation

  • Actual harm · G March 25, 2025 · found via complaint

    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

    Corrected April 22, 2025 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · D March 25, 2025 · found via complaint

    Protect each resident from the wrongful use of the resident's belongings or money.

    Corrected April 22, 2025 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · D March 25, 2025 · found via complaint

    Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

    Corrected April 22, 2025 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · E February 27, 2025

    Reasonably accommodate the needs and preferences of each resident.

    Corrected April 7, 2025 · Resident Rights

  • Potential for harm · E February 27, 2025

    Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.

    Corrected April 7, 2025 · Resident Rights

  • Potential for harm · E February 27, 2025

    Honor the resident's right to manage his or her financial affairs.

    Corrected April 7, 2025 · Resident Rights

  • Potential for harm · E February 27, 2025

    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.

    Corrected April 7, 2025 · Resident Rights

  • Potential for harm · E February 27, 2025

    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

    Corrected April 7, 2025 · Resident Assessment and Care Planning

  • Potential for harm · E February 27, 2025

    Ensure services provided by the nursing facility meet professional standards of quality.

    Corrected April 7, 2025 · Resident Assessment and Care Planning

  • Potential for harm · D February 27, 2025

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Corrected April 7, 2025 · Quality of Life and Care

  • Potential for harm · E February 27, 2025

    Provide enough food/fluids to maintain a resident's health.

    Corrected April 7, 2025 · Quality of Life and Care

  • Potential for harm · E February 27, 2025

    Provide safe and appropriate respiratory care for a resident when needed.

    Corrected April 7, 2025 · Quality of Life and Care

  • Potential for harm · E February 27, 2025

    Ensure medication error rates are not 5 percent or greater.

    Corrected April 7, 2025 · Pharmacy Service

  • Potential for harm · E February 27, 2025

    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.

    Corrected April 7, 2025 · Pharmacy Service

  • Potential for harm · E February 27, 2025

    Provide and implement an infection prevention and control program.

    Corrected April 7, 2025 · Infection Control

  • Potential for harm · E February 27, 2025 · found via complaint

    Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

    Corrected April 7, 2025 · Resident Rights

  • Potential for harm · D February 27, 2025 · found via complaint

    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

    Corrected April 7, 2025 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · F February 27, 2025 · found via complaint

    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

    Corrected April 7, 2025 · Nutrition and Dietary

  • Actual harm · G December 16, 2024 · found via complaint

    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

    Corrected January 10, 2025 · Freedom from Abuse, Neglect, and Exploitation

  • Actual harm · G December 5, 2024 · found via complaint

    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

    Corrected December 27, 2024 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · D December 5, 2024 · found via complaint

    Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

    Corrected December 27, 2024 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · D September 11, 2024 · found via complaint

    Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.

    Corrected October 11, 2024 · Freedom from Abuse, Neglect, and Exploitation

Showing the 25 most recent. The Safety Report includes every citation with full findings.

Federal penalties

DateTypeAmount / length
January 9, 2026Fine$41,615
December 5, 2024Fine$26,611
December 5, 2024Payment Denial2 days

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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 265480 · certified since January 8, 1992. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.