Below average — CMS composite of the measures below.
A standard survey is most likely before around August 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 Life Care Center Of Cape Girardeau during CMS and state inspections, most recent first.
Several dependent residents did not receive adequate assistance with hydration, as water was placed out of reach and staff failed to regularly offer or help with fluids. One resident developed severe dehydration and a UTI, requiring hospital care. Staff interviews confirmed inconsistent adherence to hydration protocols, and care plans lacked clear instructions for assisting with drinking.
A resident was found unresponsive and staff initiated CPR and called EMS, despite the hospice record indicating a DNR order and documented consent for no resuscitation. Facility records showed conflicting code status orders, and staff interviews revealed incomplete documentation, lack of verification, and confusion regarding the resident’s wishes. The inconsistent system for documenting and communicating code status led to the initiation of CPR against the resident’s documented DNR preference.
A resident was found unresponsive, and staff initiated CPR based on a report sheet indicating full code status, but stopped after discovering a DNR order in the electronic medical record. Multiple code status changes were documented without proper authorization or communication with the resident, family, or physician. Staff relied on inconsistent sources for code status, leading to confusion and failure to provide basic life support as directed by the resident's wishes and orders.
A resident who was cognitively intact submitted a written request for all medical records and a copy of an internal investigation to the DON, but did not receive access to the records within the required 24-hour period. Staff provided conflicting accounts about the handling of the request, and there was no documentation of follow-up or clarification. The facility lacked a policy for medical records requests, resulting in the resident not receiving timely access.
A resident with a renal transplant did not receive 11 out of 14 scheduled doses of tacrolimus, an immunosuppressant, over a seven-day period due to staff not administering the medication as ordered. Despite timely pharmacy deliveries and the availability of home medication, staff documented the medication as unavailable and did not follow procedures for medication management and communication.
Two residents in an LTC facility experienced unmanaged pain due to the unavailability of prescribed medications, including Norco. Despite having orders for pain assessment and medication administration, the facility ran out of Norco and failed to provide alternatives, leading to severe pain and distress for the residents. Interviews with staff revealed issues with medication supply and communication with the pharmacy.
A resident with multiple health issues did not receive the required physician visits as per facility policy. The resident's family arranged an outside appointment due to the lack of visits, but the facility insisted on using their physician, who had not yet seen the resident. Staff interviews revealed that the new facility physician only saw newly admitted residents, leaving the resident without the mandated care.
A resident requiring a Hoyer lift for transfers was left waiting for transportation after a medical appointment. Due to miscommunication and lack of available transport, the resident was manually transferred into a personal car by staff, causing significant pain and anxiety. The resident was left in a soiled brief for hours, highlighting a failure in ensuring a safe environment free from accident hazards.
A resident with multiple medical conditions and a history of pressure ulcers developed new pressure ulcers due to the facility's failure to conduct timely skin assessments and provide necessary treatment. Despite being at high risk, the resident's care plan lacked specific skin care orders, and staff did not follow the facility's policy for reporting and addressing skin changes. The DON was unaware of the resident's condition, highlighting a breakdown in communication and care processes.
A resident with morbid obesity was not provided with a bariatric bed upon re-admission to the facility, despite weighing 290 lbs and the facility's policy requiring a bariatric bed for residents over 250 lbs. The resident experienced a fall from the standard-sized bed during care, increasing their fear of falling and affecting their mobility. Staff interviews revealed the resident had previously used a larger bed and had requested a bariatric bed, but this was not addressed.
A cognitively impaired resident was sent unescorted in a cab to the ER instead of an ambulance after a medical issue. The resident required assistance with all ADLs and had a cognitive communication deficit. LPN A mistakenly called a cab and did not verify the resident's cognitive status or arrange for an escort. The facility lacked a policy on safe transportation.
Failure to Provide Adequate Hydration Assistance
Penalty
Summary
The facility failed to ensure sufficient fluid intake for residents by not providing fresh, easily accessible water at bedside, and not assisting or cueing residents who required help with hydration. Observations and interviews revealed that multiple residents who were dependent on staff for activities of daily living, including drinking, had water placed out of their reach and did not receive regular assistance or offers of fluids. One resident was observed with cracked and peeling lips, unable to reach or hold a water cup, and reported not being offered water or assistance despite being very thirsty. Another resident, also fully dependent, stated that while water was filled, staff did not offer drinks between meals or at night, and the water cup was placed where the resident could not access it without help. A third resident, who required some assistance with ADLs but could feed themselves, also had water placed far out of reach. Staff interviews confirmed that while there was an expectation for CNAs to offer water during every room entry and bed check, this was not consistently happening. A registered nurse reported having raised concerns about CNAs not performing hydration duties to management multiple times, with no resulting change. The DON was unaware of the hydration issues and stated that staff should be offering fluids regularly to those unable to drink independently. Medical records showed that one resident was sent to the emergency department with severe dehydration and a urinary tract infection, returning with ongoing issues. Care plans for the affected residents indicated their dependence on staff for hydration and risk for dehydration, but observations and interviews demonstrated that these needs were not being met. Documentation and care plans lacked specific instructions regarding assistance with drinking, contributing to the deficiency.
Failure to Ensure Accurate and Consistent Code Status Documentation and Communication
Penalty
Summary
The facility failed to ensure an accurate and consistent system was in place to direct staff when to initiate basic life support, including CPR, in accordance with physician orders and the resident’s advance directives. A resident was found unresponsive and without respirations by staff, who initiated CPR and called emergency medical services (EMS) and hospice. The resident’s facility medical record contained a full code status order, but there was no documentation of the resident’s wishes or consent for this status. In contrast, the hospice record at the facility showed the resident’s consent and an order for do not resuscitate (DNR), with documentation of a conversation reflecting the resident’s choice for DNR. Multiple inconsistencies were found in the documentation and communication of the resident’s code status. The admission paperwork was incomplete, and the baseline care plan did not address the code status. Staff interviews revealed confusion and lack of verification regarding the resident’s wishes, with some staff relying on incomplete or missing documentation in the electronic medical record (PCC) and others referencing the hospice binder, which was not always readily accessible. There was no documented contact with the resident, family, or physician to properly authorize a change from DNR to full code, despite conflicting information between facility and hospice records. Staff statements indicated that the process for documenting and communicating code status was inconsistent, with reliance on verbal reports, incomplete paperwork, and assumptions based on typical hospice practices. The hospice binder, which contained the resident’s DNR documentation, was not always in its designated location, further contributing to the confusion. The lack of a clear, unified, and accessible record of the resident’s code status led to the initiation of CPR against the resident’s documented wishes as per the hospice record.
Failure to Ensure Accurate Code Status Documentation and Communication
Penalty
Summary
The facility failed to ensure an accurate and consistent system was in place to direct staff when to initiate basic life support, including CPR, for a resident. On the morning of the incident, a phlebotomist reported to the nurse's station that a resident would not wake up. An LPN and CNA responded, found the resident pulseless, and checked the report sheet, which indicated the resident was a full code. The LPN began CPR while the CNA checked the electronic medical record, which showed the resident as DNR. CPR was stopped after a few compressions, and 911 was not called. There was confusion among staff regarding the resident's code status due to discrepancies between the report sheet and the electronic medical record. Review of the resident's medical record revealed multiple changes in code status during their stay, including an initial DNR signed by the spouse, a full code signed by the resident upon readmission, and a subsequent DNR order with no documentation or authorization for the change. There was no evidence of contact with the resident, family, or physician to obtain proper authorization for the code status change. The care plan did not reflect the changes in code status, and there was no documentation of the rationale or process for the most recent change. Interviews with staff and the resident's spouse indicated the resident was alert and oriented at the time of the full code order and capable of making their own decisions. Staff reported inconsistent practices for verifying code status, with some relying on outdated report sheets and others on the electronic medical record. The process for changing code status was not followed, as an LPN changed the status based on a phone call without verifying consent or notifying the physician, resident, or family. This lack of a consistent and accurate system led to confusion and failure to provide appropriate life support measures in accordance with the resident's wishes and documented orders.
Failure to Provide Timely Access to Resident Medical Records
Penalty
Summary
The facility failed to provide a resident timely access to their medical records after a written request was made. The resident, who was cognitively intact and listed as their own responsible party, submitted a written request to the DON for all medical records and a copy of an internal investigation. The request was acknowledged by staff, as documented in a nursing note, but the records were not provided within the required 24-hour timeframe. Interviews with the DON and Administrator revealed confusion and lack of clarity regarding the handling of the request. The DON initially stated the request was sent to the legal department, but later retracted this, admitting there were no emails or documentation of such action. The Administrator and DON both gave conflicting accounts about whether the request included medical records or only the internal investigation, and there was no documentation in the resident's progress notes or facility records to confirm any follow-up or clarification with the resident. The facility did not have a policy regarding medical records requests available for review. Documentation provided by the facility did not mention the medical records request, and staff interviews indicated a lack of consistent process for handling such requests. As a result, the resident did not receive access to their medical records in a timely manner, as required.
Failure to Administer Transplant Medication as Ordered
Penalty
Summary
Facility staff failed to administer tacrolimus, an immunosuppressant medication prescribed for a resident with a history of renal transplant, as ordered by the physician. The resident, who had multiple complex diagnoses including chronic kidney disease, heart failure, and pulmonary hypertension, had a standing order for tacrolimus 1 mg twice daily. Despite the order allowing use of home medication until the pharmacy supply arrived, the medication was not administered for 11 out of 14 scheduled doses over a seven-day period. Documentation showed that the pharmacy delivered the medication as scheduled, but staff progress notes repeatedly indicated the medication was unavailable and on order during this time. Interviews revealed that the resident’s spouse brought in the home supply of tacrolimus, but it was returned the next day with staff stating it was not needed. The Director of Nursing stated that staff are expected to notify the pharmacy when refills are needed and to document the use and storage of home medications. The pharmacy confirmed timely delivery of the medication, and the transplant nephrologist emphasized the importance of not missing doses of tacrolimus for transplant patients. The failure to administer the medication as ordered was not due to pharmacy delay, but rather a breakdown in facility processes for medication management and communication.
Inadequate Pain Management for Residents
Penalty
Summary
The facility failed to provide adequate pain management for two residents, resulting in significant discomfort and distress. Resident #1, who had multiple fractures and chronic pain syndrome, was not administered prescribed pain medications, including Norco and acetaminophen, for several days. Despite having orders to assess pain levels and administer medications as needed, the facility ran out of Norco and failed to provide alternative pain management solutions. This led to Resident #1 experiencing severe pain, anxiety, and restricted mobility, impacting their daily activities and quality of life. Similarly, Resident #2, with diagnoses including acute kidney failure and chronic obstructive pulmonary disease, also did not receive their prescribed Norco for pain management. The resident reported increased pain levels, anxiety, and a lack of sleep and appetite due to the unavailability of pain medication. The facility's failure to maintain an adequate supply of pain medication and to provide timely alternatives resulted in Resident #2 experiencing significant discomfort and a decline in their overall well-being. Interviews with facility staff, including the DON and various nurses, revealed that the facility had been experiencing issues with medication supply, particularly with Norco. The facility's emergency medication kit was depleted, and there were delays in obtaining refills from the pharmacy. Despite attempts to contact the pharmacy and physicians for alternative solutions, the residents continued to suffer from unmanaged pain, highlighting a breakdown in the facility's pain management protocols and communication with external providers.
Failure to Ensure Required Physician Visits for Resident
Penalty
Summary
The facility failed to ensure that a resident received the required physician visits as per their policy. Resident #3, who was admitted with multiple diagnoses including falls, acute kidney failure, and chronic pain, did not have any documented visits from a physician or care provider. The facility's policy mandates an initial comprehensive visit within 30 days of admission and subsequent visits every 30 days for the first 90 days, followed by at least every 60 days thereafter. However, Resident #3 had not been seen by the facility physician since admission, leading the family to arrange an appointment with an outside primary care provider. Interviews with facility staff revealed that the previous facility physician left on 11/17/24, and the new physician began seeing some residents on 12/10/24, but only newly admitted ones. The facility's Director of Nursing and Administrator confirmed that residents should be seen by a physician every 30 days for the first 90 days after admission. Despite the family's efforts to have Resident #3 seen by an outside physician, the facility insisted that the resident be seen by the facility physician, which had not occurred by the time of the survey.
Failure to Ensure Safe Transfer for Resident Requiring Hoyer Lift
Penalty
Summary
The facility failed to ensure a safe environment free from accident hazards for Resident #1, who required a Hoyer lift for transfers due to muscle weakness, reduced mobility, and a history of falling. The resident's medical records indicated a need for maximal assistance with mobility, but there was no documentation of a lift assessment or a comprehensive care plan addressing transfers or mobility concerns. On the day of the incident, the resident attended an appointment at an infusion center and was left waiting for transportation back to the facility for several hours. Due to transportation issues, the Activities Director (AD) and a Licensed Practical Nurse (LPN) attempted to transport the resident back to the facility in the AD's personal car, despite the resident's need for a Hoyer lift. During the transfer, the resident was folded into the car, causing significant pain and anxiety. The resident screamed in pain and was almost dropped during the transfer, which was described as a traumatic experience. The resident also experienced increased knee and back pain and was left sitting in a urine-soiled brief for several hours. Interviews with staff revealed a lack of communication and understanding of the resident's transfer needs. The facility's Transport Coordinator and outside transportation agency had miscommunications, leading to the resident not being picked up as scheduled. The Director of Nursing and Administrator were unaware of the situation until after the incident occurred. The Administrator acknowledged that appropriate accommodations should have been made to ensure the resident's safe transfer, either by using a mechanical lift or providing suitable transportation.
Failure to Identify and Treat Pressure Ulcers
Penalty
Summary
The facility failed to identify and treat a facility-acquired pressure ulcer for one resident, who was among five sampled residents. The resident, who had a history of pressure ulcers, was at high risk due to multiple medical conditions, including clostridium difficile, diabetes, end-stage renal disease, neurogenic bladder, morbid obesity, anxiety, depression, and cognitive communication deficit. Despite being at risk, the resident's care plan did not include specific orders for skin care or treatment of wounds, and the resident was noted to be resistive to care, often refusing repositioning and hygiene assistance. The facility's policy required weekly skin assessments and immediate reporting of any skin changes by CNAs to nursing staff. However, the resident's skin integrity assessment on 08/19/24 showed only a blanchable area of redness with no further action documented. The resident continued to refuse dialysis and remained in bed, increasing the risk of pressure ulcers. On 08/21/24, a CNA noticed an open wound on the resident's buttocks but did not recall when it was reported to the LPN, who also did not assess the resident's skin during care. The LPN was unaware of the facility's policy on pressure wounds and did not document or notify the physician for treatment orders. By 08/22/24, the resident had multiple open wounds on the buttocks, including areas with yellow slough and necrotic tissue. The DON was not aware of these wounds and expected the nursing staff to conduct weekly assessments and address the resident's high risk for pressure ulcers. The lack of timely assessment and intervention led to the development and progression of pressure ulcers in the resident.
Failure to Provide Appropriate Bed for Bariatric Resident
Penalty
Summary
The facility failed to provide reasonable accommodations for a resident with morbid obesity, resulting in the resident being placed in a standard-sized bed that was not suitable for their needs. The resident, who weighed 290 lbs and had a history of severe obesity, was admitted to the facility and should have been provided with a bariatric bed according to the facility's policy. However, upon re-admission, the resident was placed in a standard-sized bed, which was too small and did not support their independent mobility. The resident experienced a fall from the bed during incontinent care, which heightened their fear of falling and affected their willingness to move independently. Despite the resident's expressed discomfort and fear, no interventions were added to address the issue. Interviews with staff revealed that the resident had previously used a larger bed and had communicated their need for a bariatric bed, but this request was not fulfilled upon their return from the hospital. The facility's Director of Nursing was unaware of the correct weight requirement for a bariatric bed, mistakenly believing it to be 300 lbs instead of the 250 lbs stated in the facility's policy. This oversight contributed to the resident not being provided with the appropriate bed upon re-admission, leading to the deficiency in accommodating the resident's needs and preferences.
Inadequate Supervision During Resident Transportation
Penalty
Summary
The facility failed to provide adequate supervision for a cognitively impaired resident during transportation to the emergency room (ER). The resident, who required assistance with all activities of daily living and had a cognitive communication deficit, was sent unescorted in a city cab instead of an ambulance after experiencing a medical issue with a dislodged PICC line. The Director of Nursing was unaware of the resident's cognitive impairment and expected the staff to either call an ambulance or send an escort with the resident. LPN A, who was responsible for arranging the transportation, mistakenly called a cab instead of an ambulance and did not cancel the cab or arrange for an escort. LPN A did not verify the resident's cognitive status before sending them unescorted. LPN B and the facility's nurse practitioner were not informed of the resident's cognitive impairment and agreed that it was not appropriate to send the resident out unattended. The facility lacked a policy on safe transportation, contributing to the oversight.
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 122 citations issued within 25 miles in the last 12 months — including the 2 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 Cape Girardeau
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Lutheran Home, The | 0.5 mi | ★★★★★ | 0 | 0 |
| Chateau Girardeau | 0.9 mi | ★★★★★ | 0 | 0 |
| Ratliff Care Center | 1.9 mi | ★★★★★ | 0 | 0 |
| Fountainbleau Lodge | 2.9 mi | ★★★★★ | 7 | 0 |
| Heartland Care And Rehabilitation Center | 3.6 mi | ★★★★★ | 4 | 0 |
Every risk area ranked, a do-first checklist, and your local survey patterns
Built specifically for Life Care Center Of Cape Girardeau.
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.