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 October 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Nhc Healthcare, Joplin during CMS and state inspections, most recent first.
A resident with a catheter and severe cognitive impairment was left hollering for toileting help while staff delayed assistance and told the resident to go in the brief because a Hoyer lift was needed. Two other residents who were dependent on staff for toileting and transfers reported being told to use their briefs when help was not immediately available, and one said the practice was humiliating and embarrassing. Interviews with the DON, administrator, and staff confirmed that residents should not be told to toilet in their briefs and that bedpans or urinals should be offered instead.
Two residents with indwelling urinary catheters had drainage bags placed on low beds and left resting on fall mats on the floor. One resident had Parkinson's disease, dementia, and prostate cancer, and the other had CHF, bacteremia, CKD, and dysphagia; both had severely impaired cognition and needed staff help with transfers and toileting. Staff observations and interviews showed the bags were not kept off the floor or fall mat as required by policy.
A resident with paraplegia, severe cognitive impairment, CKD, HF, and malnutrition had repeated refusals of repositioning, transfers out of bed, and medications documented on the MAR, but staff did not document notifying the DPOA. The chart also showed multiple medication changes from hospice and several new skin issues with new orders, yet no documented DPOA notification. Interviews with the responsible party, CMT, LPN, DON, and administrator confirmed expectations for notification and documentation were not met.
A resident’s privacy curtain remained visibly soiled with dried brown substance after stool splashed onto it during incontinent care, and the resident said staff did not clean or replace it even after repeated requests. The resident was on hospice, cognitively intact, and dependent on others for bed positioning; staff interviews confirmed soiled privacy curtains should be removed and replaced, but the curtain was still observed in the room on multiple occasions.
Surveyors found multiple food storage failures, including open items without dates, food stored in loose or partially closed containers, expired items, and food placed near non-food items or under condensation trays. In the kitchen dry storage, walk-in refrigerator, hydration room refrigerator, and B Hall refrigerator, staff observed unlabeled or undated foods, items that should have been refrigerated after opening left at room temperature, and food with visible spoilage concerns such as potatoes with eyes and items on the floor. Staff interviews showed inconsistent knowledge about labeling, dating, sealing, and discarding food items.
The facility failed to keep code status documentation consistent across the EHR, POS, care plans, face sheets, and hard-copy binders for three residents. One resident had documentation showing both DNR and full code, another had DNR in some records but full code in a physician note and face sheet, and a third had full code on the face sheet and care plan but a signed DNR order in the code status binder. Staff gave conflicting accounts of where code status information was kept and how it was accessed, and the DON acknowledged that contradictory code status documentation was a problem.
Failure to document and offer pneumococcal vaccines to three residents on admission. Records for two residents with multiple chronic conditions and one resident with acute infection and weakness lacked evidence that immunization status was assessed, vaccines were offered or given, or outside vaccine history was documented. The DON confirmed the missing documentation, and staff gave inconsistent accounts of who was responsible for offering and administering the vaccines.
Failure to Support Resident Activity Preferences: A resident who was cognitively intact and identified going outside, fresh air, and gardening as very important did not receive consistent access to preferred activities. Records showed the resident’s care plan and assessments reflected outdoor and gardening preferences, but the garden club was cancelled due to heat without an alternate time, and the resident reported being told to go out only with smokers or only with staff. Staff gave inconsistent statements about whether the resident could go outside independently, and the AD confirmed no alternative gardening time was provided.
Medication error rate exceeded the 5% threshold after two insulin administration errors were observed in 25 opportunities. An LPN administered insulin to two residents with diabetes using insulin pens without first priming the pen, despite facility policy requiring priming before dialing the dose. The residents had sliding scale insulin orders, and the LPN stated he/she did not prime the pen and was unsure about the correct technique.
An LPN administered insulin to two residents without priming the insulin pens first. One resident had type 2 DM and received a total of 9 units after a BG of 196 mg/dL, and another resident with type 2 DM and severely impaired cognition received 12 units after a BG of 374 mg/dL. Facility policy required priming the pen with 2 units before giving the ordered dose, and the LPN stated he/she did not prime the pen.
Staff failed to follow hand hygiene and EBP requirements during resident care. During incontinent care for a resident with severe cognitive impairment and bowel/bladder incontinence, a CMT used contaminated gloves across soiled and clean body areas, changed gloves without hand hygiene, and applied barrier cream without changing gloves. Staff also provided peri-care and catheter care for a resident with an indwelling catheter while wearing gloves but no gown, despite the facility’s EBP policy requiring gown and glove use for catheter care and other high-contact activities.
A resident with an unstageable pressure ulcer on the coccyx did not receive proper care and monitoring at the facility. Staff failed to follow physician orders, did not update treatment after a wound clinic visit, and neglected to complete weekly wound assessments. The resident's condition deteriorated, resulting in an infection that required hospitalization.
Failure to Provide Dignified Toileting Assistance
Penalty
Summary
The facility failed to provide adequate assistance with toileting needs in a manner that promoted dignity, respect, and individuality for three residents. Facility policy required residents to be treated with dignity and respect, to receive prompt toileting assistance, and to be offered alternative interventions such as bedpans or urinals when needed. The cited deficiency involved residents who were dependent on staff for toileting and transfers, yet were told or left to go in their incontinence briefs instead of receiving timely toileting assistance or an alternative toileting method. One resident with Parkinson's disease, dementia, anxiety, prostate cancer, an indwelling urinary catheter, and dependence on staff for transfers and toileting was observed repeatedly hollering that he/she had to go. Staff were heard and seen delaying assistance while medication preparation continued, and a CNA told the resident to go ahead and go into the brief because a Hoyer lift was needed for transfer. The resident continued to cry out that he/she had already pooped in the pants, was ashamed, and needed help. Staff later provided perineal and catheter care, but only after the resident had remained distressed and incontinent in the room. A second resident with a fractured left leg, prior hip replacement, multiple fractures, heart failure, high blood sugar, and moderate dementia was documented as dependent on staff for transfers and toileting and always incontinent of urine and bowel. During interview, the resident stated staff told him/her to urinate in the incontinence brief and that staff could not get him/her up fast enough when needing the bathroom. The resident said waiting depended on how busy staff were and that a dry brief was more comfortable than a wet one. A third resident with spinal stenosis, lumbar stenosis, and a history of falls was documented as always incontinent of bowel and bladder and needing substantial assistance with toileting and two staff for transfer to the toilet. During resident council, the resident stated there were never two people available to help, that staff told him/her to go ahead and just go in the brief because they could not find help, and that this was humiliating and embarrassing. Interviews with the DON, administrator, and multiple staff confirmed that residents should not be told to go in their briefs and that bedpans or urinals should be offered instead, but the observed and reported care for these residents did not reflect that practice.
Improper urinary catheter bag placement
Penalty
Summary
The facility failed to provide appropriate catheter care for two residents with indwelling urinary catheters when staff placed catheter drainage bags on low beds and allowed the bags to rest on fall mats on the floor. The facility policy stated that urinary drainage bags were to be kept off the floor and below the level of the bladder. The report identified this issue as affecting two of four sampled residents with catheters in a census of 79. One resident had Parkinson's disease, dementia, anxiety, and prostate cancer, with severely impaired cognition, an indwelling urinary catheter, bowel incontinence, and dependence on staff for transfers and toileting. The resident's physician ordered indwelling catheter care every shift, but the care plan did not address the catheter or catheter care. On multiple observations, the resident was lying in a low bed while the catheter bag with dark urine rested on the fall mat on the floor. Even after staff performed catheter care and lowered the bed, the catheter bag remained on the fall mat. A second resident had congestive heart failure, bacteremia, muscle weakness, chronic kidney disease, anxiety, and dysphagia, with severely impaired cognition, an indwelling urinary catheter, bowel incontinence, and partial/moderate assistance needed for transfers and toileting. The care plan did not address the catheter, toileting, or personal care. Observations showed the catheter bag lying on the fall mat while the resident was in bed and again after staff moved the resident from a Broda chair to the bed. During interviews, staff stated the bag should be hooked to the side of the bed and kept below the bladder, and several staff said it should not touch the floor or fall mat.
Failure to Notify DPOA of Medication Changes, Refusals of Care, and New Skin Issues
Penalty
Summary
The facility failed to notify Resident #19’s DPOA of multiple changes in condition, medication changes, and repeated refusals of care. Resident #19 was readmitted with paraplegia, mild dementia with anxiety, chronic kidney disease, heart failure, and moderate protein-calorie malnutrition. The quarterly MDS showed severe cognitive impairment, an indwelling catheter, dependence for toileting hygiene, bathing, dressing, and transfers, and bowel incontinence. The care plan directed staff to document all refusals and inform the physician and representative, and to get the resident up out of bed daily for one hour. Record review showed repeated documentation that the resident refused or was not administered ordered repositioning every two to three hours and daily transfers out of bed, with no documentation that the DPOA was contacted. These refusals occurred across multiple dates over several months and included numerous missed repositioning attempts and missed daily out-of-bed transfers. Staff also documented medication refusals, including routine nighttime medications, without documenting notification to the DPOA. Interviews confirmed that staff marked refusals on the MAR, destroyed refused medications, and notified the nurse, but did not contact the DPOA for these refusals. The record also showed several medication and treatment changes and new skin issues without documented DPOA notification. Hospice orders changed medications such as Colace to senna, fesoterodine to tolterodine, hydrocodone and hydroxyzine to PRN use, and discontinued a multivitamin, but the resident was only documented as aware of the plan. New orders were also placed for bisacodyl suppository and hyoscyamine, skin prep for red spots on the right foot, nystatin powder for red, peeling skin on the inner right thigh, and CeraVe lotion for small red bumps on the back, again without documented notification to the DPOA. The resident’s responsible party stated staff had not notified them of all order changes and expected contact for any change in condition, change in orders, or refusals of care.
Soiled privacy curtain remained in resident room
Penalty
Summary
The facility failed to provide a sanitary and comfortable environment when a resident’s privacy curtain remained soiled with dried, smeared brown substance after an episode of explosive diarrhea during incontinent care. Resident #55 was admitted to the facility, received hospice services, and had diagnoses including breathing disorders with dependence on supplemental oxygen, chronic kidney disease, heart disease, congestive heart failure, irregular heart function, severe obesity, diabetes, pain, dementia, and anxiety. The resident’s quarterly MDS dated 06/18/26 showed the resident was cognitively intact and dependent on others for positioning in bed, and the care plan noted terminal diagnosis/hospice and limited bed mobility with assistance for positioning for comfort. During interview, the resident stated the stool had splashed onto the privacy curtain about four months earlier and that staff did not clean it at the time or after the resident pointed it out more than once. Observation on multiple dates showed the curtain still had four areas of dried, smeared brown substance at knee/calf level on the side facing the resident’s bed. Staff interviews confirmed that a soiled privacy curtain should be removed and sent to laundry, with a clean replacement available, and that nursing staff could seek help from housekeeping or maintenance if needed. The facility did not present a policy specific to the cleaning of privacy curtains.
Improper Food Storage and Expired Items in Kitchen and Hydration Refrigerators
Penalty
Summary
The facility failed to store food in a manner that protected it from possible contamination and failed to dispose of expired or improperly labeled food items. In the dry storage area, surveyors observed a partial package of rotini pasta taped shut with no open date, a brown cardboard box of lasagna noodles with a loose-fitting lid, loose unopened bags of white bread mix with no expiration date, and loose unopened sleeves of saltine crackers stored next to trash bags and a first aid kit. In the walk-in refrigerator, surveyors observed a tray holding water condensation directly above an open container of celery, an open package of turkey lunchmeat received on 06/26/25 with no open date, cheese slices in a reusable container with no date, and an open container of pimento cheese received on 07/10/25 with no open date. Surveyors also observed multiple food storage problems in the back dry storage area and hydration refrigerators. In the back dry storage area, three open containers of Hershey syrup on hydration carts were at room temperature even though the packaging stated refrigerate after opening, a box of potatoes had nine potatoes with visible eyes, an onion was on the floor, another onion was loose on the floor under the shelf, and brown sugar and flour were stored in reusable containers with lids partially off. In the hydration room refrigerator, items were stored without resident names or dates, including hot dogs, sausages, chili, raw vegetables in liquid, leftover food overflowing from a Styrofoam container, baked beans, a cinnamon roll, fruit, and a bag of loose burritos in the freezer. Expired items were also present, including watermelon with a best-by date of 07/24/25 and an unopened bottle of peach iced tea with a best-by date of 06/25/25. Additional observations in the B Hall refrigerator showed a cup of Jello with no resident name or date, a carafe of apple juice with no date, a Burger King bag with no resident name or date, and an ice cream container in the freezer with a resident name but no date. Staff interviews showed inconsistent understanding of food storage requirements. Some staff stated that items in hydration refrigerators should be labeled and dated, that open items should be discarded after three days, that food under condensation trays should be covered, that condiments should be returned to the refrigerator after use, and that food on the floor or potatoes with eyes should be thrown away. The dietary manager stated that opened items should be dated and secured shut, open items are disposed of after three days, and items without a name or date should be thrown out.
Contradictory Code Status Documentation
Penalty
Summary
The facility failed to ensure that each resident’s code status was clearly and consistently documented across the medical record and facility documentation. Survey review found contradictory code status information for three residents, with entries in the EHR, physician orders, care plans, advance directive records, face sheets, and code status binders that did not match each other. For one resident, the record showed a change from DNR to full code in a progress note, a current physician order for full code, and the resident stated he/she was now full code; however, the advance directive notebook contained a signed healthcare DPOA indicating lifesaving measures and DNR decisions if incapacitated, and the face sheet and sign-out book still showed DNR. For a second resident, the EHR showed DNR and the current POS and care plan also showed DNR, but a physician note identified the resident as full code, while the face sheet and sign-out book at the nurses’ station showed full code. For a third resident, the face sheet showed full code, the care plan stated full code with resuscitation honored through 120 days, and the quarterly care conference note documented that the spouse signed a DNR order and nursing was notified; the code status binder in the SSD office contained a signed OHDNR order from the resident’s POA and attending physician. Staff interviews showed inconsistent understanding of where code status information was kept and how it was accessed. Some staff reported it was in the electronic chart, others said it was on a daily report sheet, in a hard-copy book at the nurses’ station, in a drawer, or in the SSD office binder. The DON and Administrator also gave differing descriptions of where the code status information was located, and the DON stated that contradictory code status information between the face sheet and the code status book was a problem.
Failure to Document and Offer Pneumococcal Vaccinations
Penalty
Summary
The facility failed to have processes in place to ensure each resident was offered a pneumococcal immunization unless medically contraindicated or already immunized. Review of the facility policy showed residents were to be assessed for pneumococcal vaccine eligibility prior to or upon admission, offered the vaccine series when indicated within 30 days of admission, and have vaccine education and documentation entered into the medical record. However, for Residents #9 and #49, both admitted in July 2025 with diagnoses including Parkinson's disease, heart disease, chronic kidney disease, Type 2 diabetes, severe dementia with psychotic disturbance, congestive heart failure, oxygen dependence, and obesity, the records did not document that vaccines were offered or given on admission, and there was no documentation of vaccines received outside the facility prior to admission. For Resident #91, admitted in July 2025 with acute cystitis without hematuria, klebsiella pneumoniae, and muscle weakness, the record also lacked immunization information and did not show that vaccines were offered or administered. During interviews, the DON stated there was no documentation in the admission records for immunizations being offered or administered for these residents. Staff interviews showed inconsistent understanding of who was responsible for offering and administering vaccines, with one LPN stating the SSD offers vaccines during admission, another stating the admitting charge nurse offers them, and the DON and Administrator stating the admitting nurse should offer the flu and pneumococcal vaccines and document administration or refusal. Resident #91 also stated he/she was not offered any vaccinations upon admission.
Failure to Support Resident Activity Preferences
Penalty
Summary
The facility failed to provide an ongoing program to support residents in their choice of activities based on the comprehensive assessment, care plan, and resident preferences when staff did not provide preferred activities to a resident who repeatedly voiced the importance of routinely getting fresh air. The resident was admitted with diagnoses including subluxation of C1/C2 cervical vertebrae, cervicalgia, spinal stenosis, obstructive and reflux uropathy, and malignant neoplasm of the prostate. The resident’s MDS identified the resident as cognitively intact, independently using a manual wheelchair, and having a very important preference to go outside. Records showed the resident’s activity preferences included gardening, fishing, and being outdoors. The care plan directed staff to assist to and from activities as needed, provide a calendar of events, encourage participation, and provide in-room activities as desired. The resident’s life enrichment assessment also identified gardening as a favorite activity, morning or afternoon as the preferred time, and going outside and getting fresh air as very important. The facility calendar listed outdoor walk and gardening on Tuesdays and outdoor walk on Saturdays, and activity notes showed the resident attended several group activities, including arts and crafts, manicures, balloon toss, ice cream socials, birthday cupcakes, and one outdoor walk. During interviews, the resident stated the only activity he/she enjoyed was the garden club, that the club had not been held because it was too warm, and that he/she did not understand why it could not be held in the morning. The resident also stated that when asking to go outside, staff told him/her he/she could go out with the smokers, despite not smoking and not liking smoke. The resident reported being told at one point that he/she could only go out with staff, which was when smokers went outside, and later stated he/she had not gone outside over the weekend and had not been notified when others went outside. Staff interviews showed inconsistent understanding of whether the resident could go outside independently, whether staff had to be present, and whether residents could go out with smokers. The Activities Director stated gardening club had been cancelled due to heat with no alternative time provided and that the resident could be outside by himself/herself, while the DON and Administrator stated cognitively intact residents could go outside independently and that residents who do not smoke should not have to go outside with smokers.
Medication Pen Administration Errors
Penalty
Summary
Ensure medication error rates are not 5 percent or greater. Based on observation, interview, and record review, the facility had two medication errors in 25 opportunities, resulting in an 8% medication error rate involving two residents. Resident #19 had a diagnosis of type 2 diabetes mellitus and a current order for Novolog U-100 insulin 5 units before meals plus sliding scale coverage. During observation, an LPN performed an AccuCheck showing a blood glucose of 196 mg/dL, determined the resident needed 9 units total, attached a new needle to the insulin pen, and administered the insulin without first priming the pen as required by the facility policy. Resident #3 also had a diagnosis of type 2 diabetes mellitus and received insulin seven days a week. The resident had a sliding scale order for insulin aspart U-100 before meals and at bedtime. During observation, an LPN performed an AccuCheck showing a blood glucose of 374 mg/dL, determined the resident needed 12 units, attached a new needle to the insulin pen, and administered the insulin without first priming the pen. During interview, the LPN stated he/she did not prime the pen and thought maybe he/she was supposed to waste one unit to make sure the insulin came to the end of the needle. Other staff and the DON stated insulin pen administration required priming with two units before dialing the dose, and the Administrator said staff were expected to prime the insulin pen before administering insulin.
Insulin Pens Not Primed Before Administration
Penalty
Summary
The facility failed to ensure residents were free from significant medication errors when an LPN administered insulin from insulin pens without priming the pens first for two residents. Resident #19 had a diagnosis of type 2 diabetes mellitus and was receiving insulin injections seven days a week. During observation, the LPN performed an AccuCheck showing a blood glucose of 196 mg/dL, calculated a total dose of 9 units of Novolog U-100 insulin, attached a new needle to the pen, set the dose meter to 9 units, and administered the insulin without first priming the pen. Resident #3 also had type 2 diabetes mellitus, severely impaired cognition, and was receiving insulin seven days a week. During observation, the LPN performed an AccuCheck showing a blood glucose of 374 mg/dL, calculated a dose of 12 units of insulin aspart U-100, attached a new needle to the pen, set the dose meter to 12 units, and administered the insulin without first priming the pen. The facility policy for insulin administration required priming the pen by dialing up 2 units and pushing the injection button until a drop of insulin appeared at the tip of the needle. In interview, the LPN stated he/she did not prime the pen and thought maybe he/she was supposed to waste one unit to make sure insulin came to the end of the needle. Other staff and the DON stated insulin pens were to be primed with 2 units before administering the ordered dose, and the Administrator stated staff were expected to prime the insulin pen before administration.
Infection Control Failures During Incontinent Care and Catheter Care
Penalty
Summary
The facility failed to implement an effective infection control program when staff did not complete appropriate hand hygiene during incontinent care for a resident who was readmitted with a diagnosis of stroke with right/dominant side weakness and was severely cognitively impaired. The resident was incontinent of bowel and bladder and required incontinent care. During observation, a CMT and CNA provided care while the resident had a large amount of loose stool present. The CMT cleaned the resident’s coccyx and buttocks, changed gloves without performing hand hygiene, then cleaned the front perineal area and applied protective barrier cream to the groin area without changing gloves. The same contaminated gloves were then used to apply cream to the coccyx and buttocks and remove rolled linens before hand hygiene was performed. The facility’s hand hygiene policy stated that hand hygiene is the primary means to prevent the spread of infections, that it must be performed before and after direct contact with residents, before moving from a contaminated body site to a clean body site during care, and after removing gloves. Staff interviews reflected that hand hygiene should be performed before and after personal care, with glove changes and hand hygiene between soiled and clean steps. The DON and Administrator also stated that staff are expected to wash hands before starting personal care, change gloves and sanitize hands between dirty and clean parts of care, and wash hands after finishing care. The facility also failed to follow Enhanced Barrier Precautions for a resident with an indwelling catheter. The resident had diagnoses including neuromuscular dysfunction of bladder, Parkinson’s disease, heart disease, peripheral vascular disease, chronic kidney disease, PTSD, depression, and Type 2 diabetes, and had orders for catheter care and catheter changes as needed. The facility’s EBP policy stated that EBP are indicated for residents with indwelling medical devices and require gown and glove use during high-contact activities, including hygiene, changing briefs, and device care or use including urinary catheter care. During observation, a CNA provided peri-care and catheter care while wearing gloves but did not don a gown. Staff interviews stated that a gown and gloves should be worn for personal care and catheter care for a resident with a catheter, and the DON and Administrator confirmed that gown and gloves were expected for catheter-related and close-contact care.
Failure to Provide Adequate Pressure Ulcer Care
Penalty
Summary
The facility failed to provide adequate pressure ulcer care and monitoring for a resident with an unstageable pressure ulcer on the coccyx. The staff did not follow physician orders for treatment, failed to update the treatment plan after a visit to the wound clinic, and did not complete a weekly wound assessment. The resident's condition worsened, leading to an infection that required hospitalization. Upon admission, the resident was identified with an unstageable pressure ulcer, and a treatment plan was established, including the application of a Mepilex sacrum dressing. However, the treatment was not consistently documented as completed, and there were multiple instances where the dressing change was not recorded. Additionally, the facility did not update the treatment orders following the resident's visit to a wound clinic, where new instructions were provided. Interviews with staff revealed communication breakdowns and a lack of documentation regarding the resident's care. The wound nurse was absent for several days, and no other nurse was assigned to complete the necessary weekly wound assessments. Furthermore, verbal instructions from the wound clinic were not properly documented or followed, contributing to the inadequate care of the resident's pressure ulcer.
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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 Joplin
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Joplin Gardens | 2.2 mi | ★★★★★ | 6 | 0 |
| Aspire Senior Living Joplin | 3.1 mi | ★★★★★ | 13 | 0 |
| Communities Of Wildwood Ranch | 5.7 mi | ★★★★★ | 0 | 0 |
| Westgate | 5.7 mi | ★★★★★ | 3 | 1 |
| Aspire Senior Living Webb City | 7.2 mi | ★★★★★ | 10 | 0 |
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