Above average — CMS composite of the measures below.
A standard survey is most likely before around November 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 Heritage Hall Nursing Center during CMS and state inspections, most recent first.
Staff failed to document physician-ordered wound and topical treatments for four residents, including those with wounds, edema, and chronic conditions. Missing documentation included wound cleansers, dressings, ace wraps, and topical medications, with some residents reporting not receiving care as ordered. The DON and administrator confirmed that all treatments should be documented in the electronic health record, but could not explain the lapses.
Staff failed to follow the facility TB testing policy for multiple employees, with several staff members receiving late second-step TSTs, one staff member lacking documentation of the second test, and another having the first test given on the start date rather than before employment. Interviews showed the BOM, Employee Experience Coordinator, and administrator were aware of the testing process but did not track or verify that TB screening was completed and documented on time.
Resident funds were not properly separated from facility operating funds for three residents. One resident had a large credit balance tied to Medicaid-related payments that the BOM kept in the operating account while waiting to verify surplus status, and two discharged residents had private pay credit balances left in the operating account after payments were deposited. The BOM said the money belonged to the residents, no refunds had been made, and there was no written authorization to hold the funds.
Inaccurate MDS Medication Coding: Facility staff failed to accurately code medications on MDS assessments for multiple residents. A resident’s MDS listed an anticoagulant when the POS showed Clopidogrel, and several other residents’ MDSs listed anticoagulants when the POS showed Aspirin 81 mg, which staff identified as an antiplatelet. Another resident’s MDS incorrectly listed antianxiety, antipsychotic, and antidepressant medications even though the POS had no orders for those drug classes. The MDS Coordinator and DON acknowledged the errors, and the administrator stated the MDS Coordinator was responsible for accurate completion.
Outside Waste Dumpster Left Open: Facility staff failed to keep the outside waste dumpster lids closed when not in use. Observations showed the dumpster lids open with waste inside on multiple occasions, and a Dietary Aide was seen disposing of trash and walking away without closing the lids. The dietary manager, maintenance director, and administrator all stated the lids should be closed after use, but there was no policy related to outside waste container maintenance and no clear evidence that staff training included this instruction.
The facility failed to employ a full-time qualified dietitian or nutrition professional, relying instead on a part-time consultant RD. The dietary manager lacked necessary qualifications and certification, having missed the exam due to staffing issues. This deficiency potentially affects all 87 residents.
Facility staff failed to properly thaw frozen meat, store food to prevent contamination, and reheat pureed food to safe temperatures, risking food-borne illness. Observations showed improper thawing methods, undated and improperly stored food items, and inadequate reheating of pureed foods. Despite training, staff did not adhere to food safety protocols.
Facility staff failed to provide necessary ADL care for two residents, resulting in inadequate personal hygiene. One resident wore the same clothes for several days without receiving scheduled showers, while another, on hospice care, was not properly groomed or showered. Staff interviews revealed confusion over responsibilities, contributing to the deficiency.
Failure to Document Physician-Ordered Treatments for Multiple Residents
Penalty
Summary
Facility staff failed to document physician-ordered treatments for four residents, as evidenced by interviews and record reviews. The facility's Wound Treatment Management policy requires that all treatments be documented on the Treatment Administration Record (TAR) or in the electronic health record. However, multiple instances were identified where staff did not document the administration of prescribed treatments, including topical medications, wound cleansers, and dressings, on specific dates for each resident. One resident with a gluteal cleft wound did not have documentation for hydrocortisone cream and Dakin's solution treatments on several occasions. Another resident with a right gluteus wound and osteoarthritis lacked documentation for Voltaren gel applications as ordered. A third resident with lymphedema, cellulitis, and localized edema was missing documentation for wound care procedures, ace wrap applications, and topical steroid cream on multiple dates. The fourth resident, who had a history of stroke, edema, and wounds, also had missing documentation for ace wrap applications and wound care treatments. Interviews with the administrator and DON confirmed that all treatments are expected to be documented in the electronic health record, and if a treatment is not given, the reason should be recorded. Both were unable to explain why staff failed to document the treatments, and one resident reported not receiving leg treatments even after requesting them.
Failure to Complete Staff TB Screening per Policy
Penalty
Summary
Facility staff failed to implement the infection prevention and control program when seven of 10 staff members reviewed did not have tuberculosis (TB) screening completed in accordance with the facility’s TB Testing Policy. The policy required each employee and volunteer to receive a two-step Mantoux TST, with the first step within one month prior to starting employment and the second step within three to four weeks after employment began, with both tests read 48 to 72 hours after administration. The facility census was 38. Review of personnel records showed multiple staff members had TB testing that was late, incomplete, or not documented as required. CMT B, [NAME] D, LPN G, Homemaker H, and the Employee Experience Coordinator all had second-step TSTs administered outside the required timeframe, and CNA E had documentation of only one TST in the record even though the Employee Experience Coordinator stated a second test had been administered but not documented. CNA F’s record showed the first TST was administered on the start date rather than before employment, and the record did not contain additional TB testing documentation. In several cases, staff responsible for testing stated they did not track the timing of the tests, overlooked that tests were not completed on time, or could not provide additional documentation. During interviews, the Employee Experience Coordinator, the Business Office Manager, and the administrator each acknowledged responsibility for employee TB testing at different times and described the expected process, but also stated they did not know why the tests were late or undocumented. The administrator said he/she did not review new hire TB testing records and believed staff were being tested according to policy, and also stated he/she did not know the second-step TST had to be administered within three weeks after hire. The records and interviews showed the facility did not consistently follow its TB testing policy for new employees and staff.
Resident funds were commingled with facility operating funds and not properly refunded
Penalty
Summary
Facility staff failed to maintain a system that assured a full, complete, and separate accounting of resident personal funds and allowed resident money to be commingled with facility operating funds for three residents. The facility policy required resident funds deposited with the facility to be held, safeguarded, managed, and accounted for as fiduciary funds, with amounts over $50 kept in separate interest-bearing accounts and not commingled with facility funds. The policy also required a full and complete separate accounting for each resident’s personal funds and timely conveyance of funds after discharge or death. For one resident, the accounts receivable aging report showed a current resident liability credit balance of $7,961.30. Transaction records showed multiple resident payments totaling that amount, and MO Healthnet Vendor Notices showed a zero dollar Medicaid surplus amount effective as of February 2024 and for subsequent months. The BOM stated the resident’s payer source had been Medicaid pending until the notices verified Medicaid approval, that the resident’s money was kept in the operating account while the BOM wanted to verify there was no surplus amount, and that the money belonged to the resident. The BOM also stated no refund had been made and there was no written authorization to hold the resident’s money in the facility operating account. For two discharged residents, the accounts receivable aging report showed private pay credit balances of $1,367.50 and $2,100. One resident’s family made a payment that created a credit balance after discharge to home, and the other resident’s lawyer sent a check to pay a statement balance, but the payment was deposited to the operating account and left a credit balance after discharge to home. The BOM stated both amounts belonged to the residents, no refund actions had been taken, and there was no written authorization to hold the money in the facility operating account. The administrator stated the BOM was responsible for resident funds and accounts receivable, should review accounts receivable at least weekly, and should contact the responsible person and refund resident funds, but the administrator did not know why the credit balances had not been refunded.
Inaccurate MDS Medication Coding
Penalty
Summary
Facility staff failed to document a complete and accurate MDS when medications were incorrectly coded for 6 of 14 sampled residents. The report states that the facility’s policy directed staff to complete comprehensive assessments to identify care needs and develop interdisciplinary care plans, and that submitted MDS assessments must accurately represent each resident’s overall clinical status. Review of the records showed that Resident #9’s Significant Change MDS documented an anticoagulant, while the POS showed an order for Clopidogrel Bisulfate 75 mg daily, an antiplatelet medication. Resident #26, Resident #29, Resident #30, and Resident #39 also had MDS assessments that documented anticoagulant use, while their POS records showed Aspirin 81 mg orders, which staff identified as antiplatelet therapy rather than anticoagulant therapy. Resident #15’s Quarterly MDS documented antianxiety, antipsychotic, and antidepressant medications, but the POS did not contain orders for any of those drug classes. During interview, the MDS Coordinator stated the resident received Aricept and had been told it was psychotropic, but acknowledged the resident did not receive antipsychotic, antidepressant, or antianxiety medications and that marking those classes on the MDS was an error. The DON confirmed the resident did not receive those medications and that the MDS was not accurate. The DON also stated Aspirin is not an anticoagulant and should not be coded as one on the MDS, and the administrator stated the MDS Coordinator was responsible for accurate completion of assessments, with corporate nurses reviewing some assessments.
Outside Waste Dumpster Left Open
Penalty
Summary
Facility staff failed to properly contain outdoor waste and refuse to prevent the harboring and/or feeding of rodents and pests when the outside waste dumpster lids were not kept closed when not in actual use. The report states that this issue had the potential to affect all residents, and the facility census was 38.1. Review of facility policies from 08/11/25 through 08/14/25 showed there was no policy related to maintenance of outside waste containers, and the FDA Food Code 2022 requirement for tight-fitting lids, doors, or covers on outside waste receptacles was cited in the report. Observations on 08/11/25, 08/13/25, and 08/14/25 showed the dumpster lids opened with waste inside. On 08/12/25, Dietary Aide C disposed of waste in the outside dumpster and walked away without closing the lids. During interview, the dietary manager stated staff should close the dumpster lids after use and said staff are trained on this requirement. The maintenance director stated the lids should be closed when not in use, but said he/she did not believe anyone had been assigned to monitor the dumpster and did not know if staff had been trained to close the lids after use. The administrator stated all staff are responsible for the maintenance of the outside waste dumpster and should close the lids after use, but also said he/she did not believe instruction to ensure the lids were closed was part of any staff training program.
Lack of Qualified Director of Food and Nutrition Services
Penalty
Summary
The facility failed to designate a qualified Director of Food and Nutrition Services, as they did not employ a full-time qualified dietitian or other clinically qualified nutrition professional. The dietary manager (DM) hired on 04/20/23 lacked prior experience in a nursing facility and did not possess the necessary certification or education for the director position. The DM completed a food protection manager course but missed the opportunity to take the final exam due to staffing issues and had not rescheduled or repaid for the exam. The facility relied on a part-time consultant registered dietitian (RD) who visited once a month, and no full-time certified or clinically qualified nutritional staff were employed. Interviews revealed that the DM and the administrator were unaware of the qualifications required for the DM position until early 2024. The DM was enrolled in a course in February 2024 after a delay caused by uncertainty about the appropriate course and the RD's illness, which limited their availability. The administrator confirmed the lack of full-time qualified nutritional staff and the reliance on a part-time consultant RD. The deficiency has the potential to affect all 87 residents of the facility.
Food Safety and Storage Deficiencies
Penalty
Summary
The facility staff failed to adhere to approved methods for thawing frozen meat, which could lead to the growth of food-borne pathogens. Observations revealed a large frozen pork loin and packages of sliced turkey deli meat left to thaw improperly in a food preparation sink and on a countertop, respectively, without running water or refrigeration. Despite the dietary manager and administrator stating that staff were trained to thaw meat in the refrigerator, the cook admitted to placing the meat in the sink and on the counter to thaw. Additionally, the facility staff did not store food items in a manner that prevents contamination and ensures freshness. Observations showed multiple opened and undated food items in both the freezer and refrigerator, including hashbrown patties, sour cream, and liquid eggs, among others. There were also issues with dry goods storage, such as undated containers of cereal and bread stored on the floor. The dietary manager acknowledged the requirement for proper labeling and storage but was unaware of the existing issues. The staff also failed to reheat pureed food to the required temperature, risking food-borne illness. A cook prepared a pureed tuna noodle casserole without checking its internal temperature, which was found to be significantly below the required 165 degrees Fahrenheit. Despite being trained on the necessity of reheating pureed foods to the correct temperature, the cook did not verify the temperature before serving. The dietary manager and administrator confirmed the requirement for temperature checks but were unaware of the lapse in procedure.
Failure to Assist Residents with ADLs
Penalty
Summary
The facility staff failed to provide necessary care and services for residents who were unable to complete their own Activities of Daily Living (ADLs), specifically in maintaining good personal hygiene. This deficiency was observed in two residents, Resident #13 and Resident #17, out of a sample of 14 residents. The facility's policy on ADLs, dated 2023, mandates that care and services should be provided for bathing, dressing, grooming, toileting, and oral care, among other activities. However, the staff did not adhere to these guidelines, resulting in residents not receiving adequate assistance with grooming, clothing changes, and showers. Resident #13, who was assessed with moderate cognitive impairment and required moderate to maximum assistance for various ADLs, was observed wearing the same clothes over several days without receiving a shower as scheduled. Despite being scheduled for showers twice a week, documentation showed only one shower was given, and the resident was observed in the same stained and crumb-covered clothing over multiple days. Interviews with staff revealed a lack of clarity and responsibility regarding the resident's care, with CNAs unsure why the resident's clothes had not been changed. Resident #17, who had severe cognitive impairment and was dependent on staff for ADLs, was also not provided with adequate care. The resident, who was receiving hospice services, was not on the facility's shower list, and there was no documentation of showers being provided. Observations showed the resident with long facial hair and wearing the same clothes over several days, despite expressing a desire not to grow a beard. Interviews with staff, including the DON and CNAs, indicated a misunderstanding of responsibilities between facility staff and hospice staff, leading to a lack of proper hygiene care for the resident.
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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.
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Nursing homes near Centralia
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Pin Oaks Living Center | 13 mi | ★★★★★ | 9 | 0 |
| Monroe Manor | 19.2 mi | ★★★★★ | 0 | 0 |
| Villa At Blue Ridge, The | 19.3 mi | ★★★★★ | 11 | 0 |
| Aspire Senior Living Moberly | 19.7 mi | ★★★★★ | 5 | 1 |
| Columbia Post Acute | 19.7 mi | ★★★★★ | 0 | 0 |
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