Pacific Care Center
105 South Sixth Street · Pacific, MO · 63069 · 6362714222
118 certified beds For profit - Limited Liability company Chain: James & Judy Lincoln
Why this verdict
- Staffing levels are well below research benchmarks for safe care.
- No federal fines or payment denials in CMS’s 3-year window.
- Inspection results have improved across recent cycles.
The composite number cleared 70 points, but Recommended is gated: inspection record below the Recommended bar; staffing below the Recommended bar. That rule is part of the published method.
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Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.
Red flags
RN staffing in the bottom 10% nationally
0.20 registered-nurse hours per resident per day, vs a 0.58 national median and 0.75 benchmark.
Total nurse staffing below 3.0 hours per resident-day
3.00 reported hours vs the 3.48 minimum CMS's own staffing study recommends.
65% of nursing staff left within a year
High turnover disrupts continuity of care; the national median is 45%.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 1 of 5 Inspections: 3 of 5 Staffing: 1 of 5 Quality measures: 1 of 5
| Total nurse hours / resident-day | 3.00 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.20 | 0.55–0.75 |
| Weekend hours / resident-day | 2.64 | ≈ weekday level |
| Nursing turnover / year | 65% | median 45% |
| Fines (3-yr window) | none |
Inspection citations (35 in the current record)
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Potential for harm · D February 12, 2026
Post a list of names, addresses, and telephone numbers of all pertinent State agencies and advocacy groups and a statement that the resident may file a complaint with the State Survey Agency.
Corrected March 23, 2026 · Resident Rights
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Potential for harm · E February 12, 2026
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected March 23, 2026 · Resident Assessment and Care Planning
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Potential for harm · D February 12, 2026
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Corrected March 23, 2026 · Quality of Life and Care
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Potential for harm · E February 12, 2026
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Corrected March 23, 2026 · Nursing and Physician Services
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Potential for harm · E February 12, 2026
Ensure medication error rates are not 5 percent or greater.
Corrected March 23, 2026 · Pharmacy Service
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Potential for harm · E February 12, 2026
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 March 23, 2026 · Pharmacy Service
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Potential for harm · E February 12, 2026
Provide and implement an infection prevention and control program.
Corrected March 23, 2026 · Infection Control
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Potential for harm · E February 12, 2026
Implement a program that monitors antibiotic use.
Corrected March 23, 2026 · Infection Control
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Potential for harm · D February 12, 2026 · found via complaint
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 March 23, 2026 · Resident Rights
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Potential for harm · E July 26, 2024
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Corrected September 6, 2024 · Resident Rights
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Potential for harm · E July 26, 2024
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.
Corrected September 6, 2024 · Resident Rights
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Potential for harm · E July 26, 2024
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected September 6, 2024 · Resident Assessment and Care Planning
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Potential for harm · E July 26, 2024
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.
Corrected September 6, 2024 · Quality of Life and Care
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Potential for harm · E July 26, 2024
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected September 6, 2024 · Pharmacy Service
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Potential for harm · D July 26, 2024
Dispose of garbage and refuse properly.
Corrected September 6, 2024 · Nutrition and Dietary
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Potential for harm · E July 26, 2024
Provide and implement an infection prevention and control program.
Corrected September 6, 2024 · Infection Control
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Potential for harm · E July 26, 2024
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.
Corrected September 6, 2024 · Environmental
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Potential for harm · E July 26, 2024 · found via complaint
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected September 6, 2024 · Quality of Life and Care
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Potential for harm · E July 26, 2024 · found via complaint
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.
Corrected September 6, 2024 · Nursing and Physician Services
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Potential for harm · D May 24, 2024 · found via complaint
Protect each resident from the wrongful use of the resident's belongings or money.
Corrected June 17, 2024 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D April 19, 2024 · found via complaint
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected June 18, 2024 · Resident Assessment and Care Planning
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Potential for harm · D April 19, 2024 · found via complaint
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected June 18, 2024 · Quality of Life and Care
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Potential for harm · D April 19, 2024 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected June 18, 2024 · Quality of Life and Care
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Potential for harm · F April 19, 2024 · found via complaint
Make sure that a working call system is available in each resident's bathroom and bathing area.
Corrected June 18, 2024 · Environmental
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Potential for harm · E February 10, 2023
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected March 27, 2023 · Resident Rights
Showing the 25 most recent. The Safety Report includes every citation with full findings.
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 265337 · certified since December 1, 1988. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.