Average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
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 Northwood Hills Care Center during CMS and state inspections, most recent first.
The facility failed to ensure that three nurse aides completed CNA training and obtained certification within four months of employment. NA I, NA P, and NA Q were not certified, with NA I providing direct care despite failing the skills test. The DON and Administrator acknowledged the requirement for certification within four months and the need to remove uncertified aides from the floor.
The facility failed to maintain food safety and sanitation standards, with issues in food storage, labeling, and dishwasher operation. Observations showed unclean ice machine vents, outdated food, and improper dishwasher temperature checks. Staff interviews revealed confusion over cleaning responsibilities and a lack of training in using sanitizer test strips.
The facility failed to maintain a clean and homelike environment, with deficiencies observed in shower rooms, sitting areas, and resident bathrooms. Residents reported unclean conditions, including black mold and broken tiles in shower rooms, and grime buildup and urine odors in bathrooms. Staff interviews revealed that cleaning routines were not effectively addressing these issues, and temporary repairs were insufficient. A contractor was needed for a permanent solution.
The facility failed to provide written transfer notices to residents or their representatives for hospital transfers, affecting four residents. Notices were either not documented as provided or not sent, despite being prepared. Staff typically notified families by phone, but written notices were not mailed, contrary to federal regulations.
The facility failed to provide bed-hold notices to four residents upon their transfer to the hospital, as required by their policy. Interviews and record reviews showed that the necessary written information regarding the duration of the bed hold and the reserve bed payment policy was not communicated to the residents or their representatives. Staff typically notified families by phone about the transfer but did not include bed-hold information.
The facility did not adhere to approved menus and serving sizes, affecting residents' nutritional needs. Dietary staff used incorrect portion sizes and did not follow recipes for pureed meals, relying on personal judgment instead. The Registered Dietician confirmed that staff should follow menu guidelines, but inconsistencies in meal preparation were observed.
The facility failed to maintain food at safe and appetizing temperatures, with hot foods served below the required 135°F and cold foods above 41°F. Residents reported meals as consistently cold and unpalatable. Staff interviews revealed a lack of knowledge about proper food temperatures, and the facility's policy on food temperature control was not followed.
The facility failed to maintain an effective infection control program by not screening staff for TB as required and improperly handling residents' cigarettes. Four staff members did not complete the TB skin test before resident contact, and staff counted cigarettes by touching them with bare hands, causing resident discomfort. The facility's DON and Administrator acknowledged these deficiencies.
A resident with multiple mental health diagnoses was spoken to in a threatening manner by a staff member, who informed the resident that staff had the right to press assault charges after an incident where the resident pinched and swung at a nursing aide. The facility's policy emphasizes treating residents with dignity and respect, and staff interviews indicated that threatening residents with charges is inappropriate.
The facility failed to provide trauma-informed care for two residents with PTSD, as staff did not identify, assess, or care plan for their specific needs. One resident, a Vietnam War Veteran, exhibited aggressive behaviors, but the care plan lacked interventions for PTSD triggers. Another resident with PTSD and other mental health conditions showed anxiety and resistive behaviors, yet staff were unaware of the PTSD diagnosis. The facility lacked a policy on Trauma Informed Care, leading to a deficiency in managing residents with trauma-related conditions.
The facility failed to follow standards of practice for bed rail use for two residents, neglecting timely assessments, physician orders, and informed consent. One resident with quadriplegia had grab bars without documented alternatives or risk assessments, while another cognitively impaired resident used a grab bar without documented consent. Staff interviews revealed inconsistencies in policy implementation.
The facility failed to accommodate the food allergies and preferences of two residents. One resident, allergic to carrots, continued to receive them despite communicating the allergy. Another resident's family requested no red dye products, but the resident was still served Kool-Aid with red dye. Staff interviews revealed a lack of awareness and communication regarding these dietary needs.
Failure to Ensure CNA Certification Within Four Months
Penalty
Summary
The facility failed to ensure that three nurse aides, identified as NA I, NA P, and NA Q, completed a certified nurse aide (CNA) training program and obtained certification within four months of employment. The facility's policy requires that nurse aides meet training requirements, including a state-approved training and competency program, and be certified within four months of employment. However, NA P was rehired as a Non-Certified Aide in Training and had no completion date for the training class. NA Q completed the training class but was not certified as a CNA, and NA I completed the training but failed the skills portion of the certification test. Observations and interviews revealed that NA I was providing direct care to residents despite not being certified, as they had failed the skills portion of the test and had not rescheduled it due to distance and cost. LPN R confirmed that NA P had moved to an activities position, NA I was rescheduling the test, and NA Q had failed the knowledge portion of the test but had rescheduled it. The Director of Nursing and the Administrator both acknowledged that nurse aides should be certified within four months and should not work on the floor if certification is not obtained within that timeframe.
Facility Fails to Maintain Food Safety and Sanitation Standards
Penalty
Summary
The facility failed to ensure proper food storage, preparation, and service, leading to potential contamination risks. Observations revealed that the ice machine vents, air vents, and a standing fan were not kept free of lint, debris, and grime. Additionally, the facility did not label and date refrigerated food properly, nor did it dispose of outdated food. The kitchen's cleanliness was compromised with visible grease and grime on walls and dead bugs in light fixtures. Interviews with dietary staff indicated a lack of clarity regarding cleaning responsibilities, with maintenance and dietary staff unsure of their specific duties. The facility also failed to adhere to food labeling and handling standards. Observations in the walk-in cooler showed unlabeled and outdated food items, such as a tub of salsa-like substance without a date and tuna casserole and shredded chicken with expired use-by dates. Interviews with dietary aides and the dietary manager revealed inconsistencies in understanding the proper labeling and storage of prepared foods, with some staff unaware of the correct expiration timelines. Furthermore, the facility did not ensure the dishwasher operated at the recommended temperature and chemical solution levels. Staff were unfamiliar with the use of sanitizer test strips and the required minimum temperatures for the dishwasher's wash and rinse cycles. The dietary manager and registered dietician were also unaware of the correct procedures for testing and logging dishwasher temperatures and sanitizer levels. This lack of training and knowledge among staff contributed to the failure to maintain proper sanitation standards in the kitchen.
Facility Fails to Maintain Clean and Safe Environment
Penalty
Summary
The facility failed to maintain a clean and homelike environment, as evidenced by multiple deficiencies observed in the shower rooms, sitting areas, and resident bathrooms. The shower rooms were reported by residents to be unclean, with black mold and broken tiles present. Observations confirmed these reports, revealing loose tiles, a dark substance lining the baseboards, and insecure grab bars. Residents expressed concerns about the cleanliness and safety of these areas, with some noting that the conditions had persisted for several years. In the sitting areas of the 200/400 halls, blankets were used to absorb water leakage from the shower rooms, and the baseboards were detached, exposing a corroded substance. The resident bathrooms were also found to be inadequately cleaned, with grime buildup on sinks and mirrors, and a strong odor of urine in some toilet areas. Residents reported that the staff did not clean these areas frequently enough, and observations confirmed the presence of grime and odors. Interviews with staff, including CNAs, CMTs, and the housekeeping manager, revealed that while daily cleaning routines were in place, they were not effectively addressing the issues. The maintenance director acknowledged attempts to repair the showers and baseboards, but these were only temporary solutions. The administrator confirmed that a contractor was needed for a more permanent remodel, which was scheduled to begin in December.
Failure to Provide Written Transfer Notices
Penalty
Summary
The facility failed to ensure that residents or their representatives were notified in writing of each transfer to a hospital, as required by federal regulations. This deficiency was identified for four residents. For Resident #81, the notice of transfer was addressed to the resident's representative and signed by facility staff, but there was no signature or indication that the notice was actually provided to the representative. Similarly, for Resident #67, the notice was addressed and signed by staff, but again, there was no evidence that it was provided to the representative. Resident #45, who was their own responsible party, was transferred to the hospital without any documented written notice of the transfer. The Director of Nursing confirmed that no transfer notification was sent for this resident. Resident #12 was transferred to the emergency room, and while a notice was prepared, there was no signature or indication that it was provided to the representative. Interviews with facility staff revealed that the standard practice was to notify the family or guardian by phone of the reason for the transfer, but no written information was mailed. The Administrator stated that the transfer notice should be faxed to the guardian or sent with the resident, indicating a discrepancy between the facility's policy and actual practice. This lack of proper documentation and communication regarding resident transfers to hospitals constitutes a failure to comply with federal regulations, which require timely written notification to residents and their representatives.
Failure to Provide Bed-Hold Notices Upon Hospital Transfer
Penalty
Summary
The facility failed to provide bed-hold notices to four residents upon their transfer to the hospital, as required by their policy. The policy mandates that a bed-hold notice be given upon admission and again at the time of transfer to the hospital or during a therapeutic leave. However, for Residents #81, #67, #45, and #12, there was no documentation or evidence that such notices were provided at the time of their hospital transfers. This oversight was confirmed through interviews and record reviews, which showed that the necessary written information regarding the duration of the bed hold and the reserve bed payment policy was not communicated to the residents or their representatives. Interviews with facility staff, including the Director of Nursing and a Registered Nurse, revealed that the standard practice was to notify the family or guardian by phone about the reason for the transfer, but not about the bed-hold policy. The Administrator acknowledged that the bed-hold policy should have been faxed to the guardian or sent with the resident, but this was not done. The lack of documentation and communication regarding the bed-hold policy for these residents indicates a failure to adhere to the facility's established procedures.
Failure to Follow Approved Menus and Serving Sizes
Penalty
Summary
The facility failed to adhere to approved menus and serving sizes, compromising the nutritional needs of residents. Observations revealed that dietary staff did not follow the specified portion sizes for mechanically altered and pureed meals. For instance, on a specific date, residents were supposed to receive two-fifths of a cup of pureed ham and one-half cup of pureed vegetables, but staff used one-third cup scoops instead. Additionally, staff did not measure portion sizes for regular diets, such as spaghetti and meat sauce, relying instead on visual estimation. Interviews with dietary staff indicated a lack of adherence to menu guidelines, with staff often relying on personal experience rather than consulting the menu or recipes. The facility also lacked a policy for preparing pureed meals, and staff did not use recipes for pureeing food. Dietary staff used inconsistent methods, such as varying amounts of gravy and broth, to achieve the desired consistency for pureed meals. The Registered Dietician confirmed that staff should follow menu spreadsheets for serving sizes and that pureed meals should include all menu items, such as bread, which was not being served. The absence of standardized recipes and reliance on staff judgment rather than established guidelines contributed to the deficiency in meeting residents' nutritional needs.
Deficiency in Food Temperature and Palatability
Penalty
Summary
The facility failed to ensure that food served to residents was palatable and maintained at safe and appetizing temperatures. Observations revealed that food temperatures were consistently below the required standards, with hot foods such as ham, scalloped potatoes, and scrambled eggs measuring significantly below the minimum 135 degrees Fahrenheit. Cold foods like yogurt were also not maintained at the required temperatures, measuring above the 41 degrees Fahrenheit guideline. The food was described as mushy, cool, and lacking flavor, with residents reporting that meals were consistently cold and unpalatable. Interviews with residents and staff highlighted ongoing issues with food quality and temperature. Residents, who were cognitively intact and independent with eating, expressed dissatisfaction with the meals, describing them as cold and unappetizing. Staff interviews revealed a lack of knowledge regarding the correct food temperatures and procedures for maintaining them. Dietary aides admitted to not knowing the required temperatures for food service, and the Director of Nursing was unaware of the complaints about cold food. The facility's policy on food temperature control was not adhered to, as evidenced by the test tray temperatures and resident complaints. The policy required hot foods to be held at a minimum of 135 degrees Fahrenheit and cold foods at or below 41 degrees Fahrenheit. However, the food served was consistently outside these parameters, and staff were not adequately trained or informed about the necessary standards. The dietary manager and registered dietician acknowledged the issues with food temperatures and the need for improvement in maintaining the required standards.
Infection Control Deficiencies in TB Screening and Cigarette Handling
Penalty
Summary
The facility failed to maintain an effective infection control program by not screening all staff for tuberculosis (TB) as required. Specifically, four staff members, including two registered nurses, a licensed practical nurse, and a speech therapist, did not complete the first step of the two-step Tuberculin (TB) skin test before having contact with residents. The facility's policy and Missouri state regulations require that new employees and volunteers working ten or more hours per week obtain a Mantoux PPD two-step tuberculin test within one month prior to starting employment. However, the records showed delays in administering and reading the TB tests for these staff members, with some tests being conducted over a month after their hire dates. Additionally, the facility did not adhere to proper infection control practices when staff members counted residents' cigarettes by touching them with bare hands. This practice was observed during multiple instances where staff, including certified nurse aides, handled cigarettes without using hand sanitizer or gloves. Residents expressed discomfort with this practice during a resident council meeting, noting that staff touched their cigarettes eight times per day. Interviews with various staff members, including the housekeeping manager and registered nurses, revealed that staff were aware of the need to use hand sanitizer or gloves but did not consistently follow these practices. The facility's Director of Nursing and Administrator acknowledged the deficiencies in TB testing and cigarette handling practices. They were unaware of the reasons for the delays in TB testing and the improper handling of cigarettes. The Administrator mentioned that staff were required to count cigarettes due to past issues with residents smoking too many or complaints of missing cigarettes, but emphasized that staff should not touch each cigarette and could visually count them instead.
Resident Threatened with Assault Charges by Staff
Penalty
Summary
The facility failed to ensure that a resident was treated with dignity and respect when a staff member spoke to the resident in a threatening manner. The incident involved a resident with multiple diagnoses, including chronic PTSD, generalized anxiety disorder, major depressive disorder, paranoid schizophrenia, dementia, and Alzheimer's disease. The resident was dependent on staff for various needs due to cognitive deficits and physical limitations. According to the resident's care plan, staff were instructed to converse with the resident calmly and intervene as necessary to protect the rights and safety of others. On a specific date, the resident was involved in an incident where they were reported to have pinched and swung at a nursing aide. A registered nurse then approached the resident and informed them that the staff had the right to press assault charges, which was perceived as a threat. Interviews with staff, including the DON and the Administrator, revealed that staff should not threaten residents with assault charges and should instead redirect and notify appropriate personnel of problem behaviors. The nurse involved in the incident believed they were providing educational information rather than making a threat.
Failure to Provide Trauma-Informed Care for Residents with PTSD
Penalty
Summary
The facility failed to provide trauma-informed care for two residents diagnosed with PTSD, as staff did not identify, assess, or care plan for their specific needs related to this condition. Resident #72, who had a history of PTSD as a Vietnam War Veteran, exhibited aggressive behaviors such as hitting staff and throwing objects. Despite these incidents, the resident's care plan was not updated to include interventions or strategies to manage PTSD-related triggers. Interviews with staff revealed a lack of awareness and understanding of the resident's PTSD diagnosis and triggers, indicating a gap in the facility's approach to trauma-informed care. Similarly, Resident #6, who also had a diagnosis of PTSD along with other mental health conditions, did not have a care plan addressing PTSD or its triggers. The resident displayed anxiety and resistive behaviors, yet staff were unaware of the PTSD diagnosis and did not implement specific interventions to address potential triggers. Interviews with staff highlighted a lack of knowledge about the resident's PTSD and the importance of trauma-informed care planning. The facility did not have a policy related to Trauma Informed Care, which contributed to the deficiency in providing appropriate care for residents with PTSD. Staff interviews revealed a general lack of understanding and training regarding trauma-informed care, as well as an absence of documentation and care planning for residents with PTSD. This deficiency indicates a systemic issue in the facility's approach to managing residents with trauma-related conditions.
Deficiencies in Bed Rail Use and Documentation
Penalty
Summary
The facility failed to adhere to standards of practice regarding the use of bed rails for two residents, Resident #77 and Resident #70. For Resident #77, the facility did not complete timely assessments or reassessments of side rail use, failed to obtain a physician's order prior to the use of side rails, and did not secure full informed consent before implementing side rail use. The resident, who was cognitively intact but dependent on staff for all activities of daily living due to quadriplegia, was observed with grab bars in the up position on multiple occasions. However, the care plan did not address the use of grab bars, and there was no documentation of alternatives attempted or risk versus benefit assessments conducted prior to their use. For Resident #70, the facility also failed to obtain informed consent prior to the use of side rails. The resident, who had severe cognitive impairment and was dependent on staff for most activities, was observed using a grab bar for bed mobility. Although a physician's order was eventually obtained, the facility did not document who provided verbal consent for the use of the grab bar. The care plan included the use of a grab bar for safety and mobility, but the facility did not document a formal reevaluation of the necessity of the side rails. Interviews with various staff members, including nurse assistants, certified nurse assistants, registered nurses, and the Director of Nursing, revealed inconsistencies in the understanding and implementation of policies regarding side rail use. Staff members were unsure about the assessment process for side rails, and there was a lack of clarity about who was responsible for obtaining informed consent and conducting risk assessments. The facility's policy required attempts to use alternatives before installing bed rails, correct installation and maintenance, and regular assessments, but these procedures were not consistently followed for the residents involved.
Failure to Accommodate Resident Food Allergies and Preferences
Penalty
Summary
The facility failed to provide food that accommodated the allergies, intolerances, and preferences of its residents, as evidenced by the experiences of Resident #36 and Resident #38. Resident #36, who was admitted with allergies to penicillin and sulfa antibiotics, reported being allergic to carrots. Despite this, staff continued to serve him cooked carrots, even after he communicated his allergy. The resident's meal ticket listed carrots as an allergy/dislike, but this information was not reflected in the care plan or physician order sheet. Interviews with staff, including CNAs, LPNs, and dietary personnel, revealed a lack of awareness and communication regarding the resident's food allergies and preferences. Resident #38, diagnosed with type II diabetes mellitus, dysphasia, vascular dementia, and Alzheimer's disease, was also affected by the facility's failure to honor food preferences. The resident's family had requested that the resident not be served red dye products, such as Kool-Aid, and instead be given ice water at every meal. Despite these requests being communicated during care plan meetings, the resident continued to receive Kool-Aid with red dye, and water was not consistently provided. Staff interviews indicated that while some were aware of the family's request, others, particularly new staff, were not informed. The facility's policies on food allergies, intolerances, and preferences were not effectively implemented, leading to these deficiencies. The Director of Food and Nutrition Services and other staff members failed to ensure that residents' dietary needs and preferences were accurately documented and communicated. This lack of coordination and communication among staff members resulted in residents receiving food items that did not align with their documented allergies and preferences, compromising their satisfaction and potentially their health.
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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 Humansville
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Big Spring Care Center For Rehab And Healthcare | 0.9 mi | ★★★★★ | 3 | 0 |
| Lake Stockton Healthcare Facility | 14.8 mi | ★★★★★ | 1 | 0 |
| Parkview Health Care Facility | 15.3 mi | ★★★★★ | 0 | 0 |
| Citizens Memorial Healthcare Facility | 15.5 mi | ★★★★★ | 11 | 0 |
| Hermitage Nursing & Rehab | 17.4 mi | ★★★★★ | 13 | 1 |
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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.