Below average — CMS composite of the measures below.
The next survey window likely opens around December 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Chariton Specialty Care during CMS and state inspections, most recent first.
Failure to Follow PEG Tube Medication Orders: A resident with a feeding tube and intact cognition received crushed hydralazine mixed with liquid Tussin through a PEG tube even though the physician order required 60 mL water flushes before and after medication administration. An LPN used 30 mL flushes instead, and the NP and DON confirmed the order was misread and that an order was needed to mix the medications together.
Failure to provide restorative ambulation and transfer services. A resident with stroke, gait abnormalities, muscle weakness, and a history of falls was supposed to receive walk-to-dine, sit-to-stand, Omnicycle, and ROM restorative services after PT discharge. Instead, the resident reported staff had not helped him walk to meals for weeks and was using a wheelchair, while observations showed self-propulsion to the dining room and staff interviews confirmed the restorative program was not being documented or consistently completed.
A sample meal was observed to be served at room temperature, with a cold slice of cheese on a well-done hamburger, while cold side dishes were appropriately chilled. A resident with intact cognition reported dissatisfaction with meal quality and inconsistency with menu adherence. The facility did not ensure food was served at an acceptable temperature during one of three meals reviewed.
The facility failed to develop personalized care plans for four residents receiving psychotropic medications, omitting required target behaviors for monitoring. Despite physician's orders specifying behaviors like tearfulness, aggression, and suicidal ideations, these were not included in the care plans. The Assistant Director of Nursing confirmed that care plans should include such details, as per facility policy.
The facility failed to maintain proper sanitation and glove use during lunch service. The Dietary Services Manager (DSM) used the same gloves for multiple tasks without changing them, compromising cleanliness. The DSM did not perform hand hygiene before placing new gloves and left pie slices uncovered. Despite acknowledging the issue, the DSM was unsure of the correct procedure. The actions violated the facility's policy and the 2022 FDA Food Code, leading to a deficiency in food handling practices.
The facility failed to provide a Notice of Medicare Non-Coverage (NOMNC) to two residents in a timely manner. One resident did not receive the NOMNC at all, while another received it only one day before the end of Medicare services, instead of the required two days. The Administrator confirmed the expectation for NOMNCs to be issued at least two days prior to discharge.
A facility failed to complete a Significant Change MDS Assessment within the required timeframe for a resident who enrolled in hospice care. The assessment was completed 26 days after the hospice admission, exceeding the 14-day requirement. The delay occurred because the MDS Coordinator was on vacation, and the facility did not utilize their Regional MDS Coordinator to ensure timely completion.
A resident with intact cognition and multiple medical conditions, including heart failure and diabetes, was not provided with tubigrips as per physician's orders to manage edema. Despite the care plan and physician's order requiring tubigrips to be applied twice daily, staff failed to apply them in the morning, as confirmed by observations and staff interviews. The resident did not refuse the treatment, and there was no documentation of refusal in the records.
The facility failed to follow the posted menu and serve appropriate portions for residents on pureed diets. The Dietary Services Manager (DSM) did not measure the total volume of pureed foods, leading to uncertainty about portion sizes. The DSM was unfamiliar with the volume method until recently and did not follow the menu accurately, using fewer slices of bread than required. The administrator expected adherence to the volume method and menu, which was not met.
Two residents with urinary catheters were at risk of UTIs due to improper infection control practices. A CNA failed to perform hand hygiene and change gloves during catheter care for one resident, while another resident's catheter tubing was observed dragging on the floor. Additionally, a CNA used a cloth hospital gown instead of a disposable isolation gown during catheter care. These actions were not in compliance with the facility's infection control policies.
Failure to Follow PEG Tube Medication Orders
Penalty
Summary
The nursing facility failed to follow physician orders when administering medications through a feeding tube for a resident with a history of traumatic subdural hemorrhage and intact cognition. The resident had a feeding tube and a care plan for tube feeding with Osmolyte 1.2 calorie. The physician order required flushing the feeding tube with 60 mL of water before and after medication administration, but during observation an LPN crushed hydralazine and mixed it with warm water and liquid Tussin, then shut off the continuous feeding tube, flushed it with 30 mL of warm water, administered the mixed medications through the PEG tube, and flushed again with 30 mL of water before restarting the feeding tube. The MAR showed hydralazine and liquid Tussin were given that morning, and the order administration note indicated the liquid was to be given via PEG tube three times a day for congestion. During interviews, the LPN confirmed the 60 mL flush order but questioned whether an order was needed to mix the medications together. The NP confirmed the order required 60 mL of water before and after medication administration and stated the facility needed an order to slurry the medications together. The DON stated the nurse was new and read the order wrong, thinking it was 60 mL total. The facility's enteral tube feeding policy dated November 2018 did not address flushing before or after medication administration or mixing medications prior to administration into a feeding tube.
Failure to Provide Restorative Ambulation and Transfer Services
Penalty
Summary
The facility failed to ensure restorative nursing services were provided to maintain a resident’s ability to walk and transfer. Resident #20 had diagnoses including stroke, abnormalities of gait and mobility, muscle weakness, lack of coordination, and a history of falls. The resident’s MDS showed a BIMS score of 13, use of a walker and wheelchair, substantial to maximum assistance for transfers, and no walking attempted during the assessment period. The care plan and PT records showed the resident was supposed to receive assistance with transfers and ambulation, including walking 20 to 30 feet with a front wheeled walker and wheelchair follow to meals. PT services from 8/28/25 through 11/18/25 documented goals to safely ambulate and perform functional transfers, and PT discharged the resident after goals were met, recommending a restorative nursing program that included walk-to-dine, sit-to-stand, Omnicycle use, standing exercises, and range of motion activities. Nursing documentation also noted the resident was to ambulate to meals with assist of two staff. During interview, the resident reported staff had not helped him walk to the dining room since before Thanksgiving and that he had been going to meals in his wheelchair. Observation showed the resident self-propelling his wheelchair to meals, and the clinical record lacked documentation that restorative tasks were completed or that the resident was unable to walk to dine. Staff interviews indicated uncertainty about when the resident last walked, that the resident had become unsteady with transfers, and that the restorative tasks were not triggering in the CNA documentation system. The DON confirmed staff had not documented the walk-to-dine restorative program from November through the present date, and the Regional Director of Clinical Services stated there was no documentation that restorative exercises were completed.
Failure to Serve Food at Safe and Appetizing Temperature
Penalty
Summary
During a meal service observation, a sample tray containing a grilled cheeseburger, macaroni salad, and potato salad was provided to the surveyor. The hamburger patty was served well done but at room temperature, and the cheese on the burger was cold, indicating the food was not served at an acceptable temperature. The macaroni salad and potato salad were served cold and had good flavor. Additionally, a resident with intact cognition reported that meals are often not very good and that the facility does not always follow their menus. These findings demonstrate that the facility failed to ensure food was served at a safe and appetizing temperature during one of three meals sampled, as required.
Failure to Include Target Behaviors in Care Plans
Penalty
Summary
The facility failed to develop personalized care plans for four residents, which is a deficiency in meeting the residents' needs. Each of these residents was receiving various psychotropic medications, including antipsychotics, antidepressants, and antianxiety medications. However, the care plans did not include the associated target behaviors that staff were required to monitor, as per physician's orders. This omission was identified during a review of the residents' electronic health records and care plans. Resident #2, with intact cognition, was on antipsychotic and antidepressant medications for conditions including Bipolar Disorder and depression. The care plan did not specify the target behaviors to be monitored, such as tearfulness and self-isolation, despite these being documented in the physician's orders. Similarly, Resident #7, also with intact cognition, was on multiple psychotropic medications for Schizoaffective Disorder and Major Depressive Disorder. The care plan failed to include target behaviors like yelling and aggression, which were noted in the physician's orders and progress notes. Resident #16, with intact cognition, was receiving antianxiety and antidepressant medications for anxiety and depression. The care plan did not list target behaviors such as tearfulness and suicidal ideations, which were part of the monitoring requirements. Lastly, Resident #24, with moderately impaired cognition, was on antipsychotic and antidepressant medications for dementia and depression. The care plan omitted target behaviors like agitation and combativeness, which were documented in the physician's orders. The Assistant Director of Nursing confirmed that care plans should include target behaviors for each medication class, as per the facility's policy on comprehensive person-centered care plans.
Improper Sanitation and Glove Use During Lunch Service
Penalty
Summary
The facility failed to maintain proper sanitation and glove use during lunch service, as observed by the State Surveyor. The Dietary Services Manager (DSM) was seen preparing pureed broccoli and pulled pork for residents requiring a pureed diet. During this process, the DSM used gloves but did not change them between tasks, such as obtaining hot water from the coffee maker, handling bread, and using a spatula, which compromised the cleanliness of the gloves. Additionally, the DSM did not perform hand hygiene before placing new gloves on her hands when preparing grilled cheese sandwiches for residents who requested an alternate meal. Throughout the lunch service, the DSM continued to use the same pair of gloves for multiple tasks without changing them, including handling plates, serving utensils, and food items like sandwich buns and pie slices. The DSM also failed to cover the banana cream pie slices, leaving them open to air. Despite performing hand hygiene at certain points, the DSM repeatedly placed new gloves on her hands without washing them, further compromising food safety standards. The DSM acknowledged that the gloves would no longer be clean after touching multiple surfaces and items, but expressed uncertainty about what should have been done differently. The facility's policy, in line with the 2022 FDA Food Code, requires that single-use gloves be used for only one task and changed between tasks to prevent contamination. The DSM's actions were inconsistent with these guidelines, leading to the deficiency in food handling practices.
Failure to Provide Timely Notice of Medicare Non-Coverage
Penalty
Summary
The facility failed to appropriately provide a Notice of Medicare Non-Coverage (NOMNC) to two residents who were receiving skilled care under Medicare A. Resident #35 began receiving skilled care on September 9, 2024, and continued to have Medicare pay for her stay through November 22, 2024. However, the facility was unable to provide documentation that Resident #35 received a NOMNC form, which is required to be delivered at least two calendar days before Medicare-covered services end. Resident #36 began receiving skilled care on July 26, 2024, with Medicare covering his stay through September 11, 2024. The facility provided Resident #36 with a NOMNC form on September 10, 2024, only one day prior to the end of his Medicare services, failing to meet the requirement of delivering the notice at least two days in advance. The Administrator acknowledged the inability to locate the NOMNC for Resident #35 and stated the expectation for NOMNCs to be issued at least two days prior to Medicare discharge.
Failure to Timely Complete Significant Change MDS Assessment
Penalty
Summary
The facility failed to complete a Significant Change Minimum Data Set (MDS) Assessment within the federal guidelines for a resident who experienced a significant change in condition. The resident enrolled in hospice care, which necessitated a Significant Change MDS assessment. However, the assessment was not completed within the required timeframe. The resident's enrollment in hospice care was documented on 9/12/24, but the Assessment Reference Date (ARD) for the Significant Change MDS was not set until 10/3/24, and the assessment was completed on 10/8/24, which was 26 days after the hospice admission. The 2024 Resident Assessment Instrument (RAI) Manual requires that a Significant Change MDS assessment be completed no later than the 14th calendar day after a significant change in the resident's status is determined. The MDS Coordinator was on vacation during the time the resident enrolled in hospice care, and upon her return, she completed the assessment. The facility's policy states that a Significant Change in Status Assessment (SCSA) should be completed within 14 days of the interdisciplinary team determining a significant change. The facility has a Regional MDS Coordinator to ensure timely assessments when the local MDS Coordinator is unavailable, but this protocol was not followed in this instance.
Failure to Follow Physician's Orders for Tubigrip Application
Penalty
Summary
The facility failed to adhere to the physician's orders for a resident, resulting in a deficiency. The resident, who had a completely intact cognition as indicated by a BIMS score of 15 out of 15, was observed without the prescribed tubigrips on multiple occasions. The resident's medical history included heart failure, diabetes mellitus, Alzheimer's disease, schizoaffective disorder, depression, left lower limb cellulitis, and an erythematous condition. The physician's order, dated nearly a year prior, required the application of tubigrips to the resident's lower extremities twice daily to manage edema, specifically in the morning and at bedtime. Despite the clear physician's order and care plan, the resident reported that the staff did not apply the tubigrips in the morning as required. Observations confirmed the resident was without the tubigrips, and staff interviews corroborated the oversight. The registered nurse acknowledged the failure to apply the tubigrips and confirmed the resident had not refused them. Additionally, there was no documentation in the progress notes or treatment administration record indicating the resident refused the tubigrips on the days in question. The Assistant Director of Nursing confirmed that the staff should have followed the physician's orders.
Failure to Follow Menu and Portion Control for Pureed Diets
Penalty
Summary
The facility failed to adhere to the posted menu and serve appropriate portions for residents on pureed diets, specifically affecting three residents. During lunch service, the Dietary Services Manager (DSM) prepared pureed meals without measuring the total volume of the food, which is necessary to ensure each resident receives the correct portion size. The DSM pureed broccoli, pulled pork, and banana cream pie, adding unmeasured amounts of liquid and other ingredients, which altered the total volume of the pureed food. This lack of measurement led to uncertainty about whether the residents received the appropriate portion sizes as specified in the menu. The DSM admitted to not being familiar with the volume method for pureed foods until the Registered Dietitian (RD) explained it the day before the observation. Despite this explanation, the DSM did not feel confident in her understanding of the method. Additionally, the DSM did not follow the menu accurately, using only two slices of bread instead of the four required for the pureed pork servings. The facility's administrator expected the dietary staff to use the volume method and adhere to the posted menu, which was not done in this instance.
Infection Control Deficiencies in Catheter Care
Penalty
Summary
The facility failed to implement proper infection control practices for two residents with urinary catheters, leading to potential risks of urinary tract infections (UTIs). Resident #26, who had an indwelling urinary catheter due to urine retention, was observed receiving catheter and perineal care from Staff D, a Certified Nurse Aide (CNA). During the care process, Staff D did not perform hand hygiene or change gloves between handling contaminated items and the resident's catheter, despite having received infection prevention training. This oversight was acknowledged by both Staff D and the Assistant Director of Nursing (ADON), who confirmed that hand hygiene should have been performed between handling the trash and the resident's catheter. Resident #21, who had a suprapubic catheter due to neuromuscular dysfunction and a history of UTIs, was observed with her catheter tubing dragging on the floor while propelling herself in a wheelchair. This was noted on multiple occasions, including in the dining room and hallway. Additionally, Staff F, a CNA, was observed performing catheter care for Resident #21 using a cloth hospital gown instead of a disposable isolation gown, which was not in accordance with the facility's infection control protocols. The Interim Director of Nursing and the Regional Director of Clinical Services acknowledged the misuse of the hospital gown and indicated that Staff F was unaware of the proper gown to use for catheter care. The facility's policies on hand hygiene and the use of personal protective equipment (PPE) were not adhered to during the care of these residents, contributing to the deficiencies observed. The report highlights the lack of compliance with infection control practices, which are critical in preventing infections such as UTIs in residents with urinary catheters. The observations and interviews with staff members revealed gaps in the implementation of these practices, which were not aligned with the facility's established policies.
What surveyors are citing around you — mapped
All 10 risk areas, ranked with evidence
Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 24 citations issued within 25 miles in the last 12 months — including the 1 immediate-jeopardy cases — and tell you exactly what happened, in plain English, matched to your record.
Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
Illustrative
A prioritized, do-first checklist
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Chariton
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Corydon Specialty Care | 19 mi | ★★★★★ | 4 | 0 |
| West Ridge Specialty Care | 21.9 mi | ★★★★★ | 3 | 0 |
| Accura Healthcare Of Knoxville, Llc | 23.2 mi | ★★★★★ | 10 | 1 |
| Southern Hills Specialty Care | 24 mi | ★★★★★ | 7 | 0 |
| Accura Healthcare Of Pleasantville, Llc | 25.2 mi | ★★★★★ | 1 | 0 |
Every risk area ranked, a do-first checklist, and your local survey patterns
Built specifically for Chariton Specialty Care.
100% money-back within 48 hours.
Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.