Below 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 Ozarks Methodist Manor, The during CMS and state inspections, most recent first.
A resident with Alzheimer's disease and known behavioral issues became combative during toileting care and bent a CMT's finger back, after which the CMT bent the resident's fingers back and made a retaliatory comment. A CNA witnessed this interaction, believed it could be abuse, but did not report it to a nurse or management at the time, instead discussing it later with another CNA and only informing an LPN the following day. As a result, the allegation was not reported to facility leadership or to the State Survey Agency within the required two-hour timeframe, despite staff interviews confirming they understood that suspected abuse must be reported immediately.
A resident with cognitive impairment and multiple medical conditions had $40 taken from their wallet without consent after returning from the hospital. The money, which was typically given weekly for personal use, was confirmed present by the guardian and then left unattended in the resident's room. When a family member arrived shortly after, the money was missing. Despite an internal investigation and staff interviews, the facility was unable to determine what happened to the funds, resulting in a deficiency for failing to protect the resident from misappropriation.
Two residents in the facility experienced significant weight loss, with one losing 9.60% in a month and another 19.38% over five months. The facility failed to notify the RD or update care plans to address these changes. Observations and staff interviews revealed inadequate communication and documentation regarding the residents' nutritional status, leading to unaddressed weight loss and poor intake.
The facility failed to maintain RN coverage for at least eight consecutive hours daily, affecting all 58 residents. Staffing sheets showed no RN coverage on several dates, confirmed by interviews with staff. The facility had more LPNs than RNs, leading to scheduling issues.
The facility failed to ensure the Dietary Manager met the required training and certification, affecting all 58 residents receiving meals. The DM, employed for two years, was not certified and had not completed Serv-Safe courses. Despite being enrolled in classes since 2023, she struggled to finish them. The RD, aware of the DM's lack of certification, spent limited time precepting her in the facility.
The facility did not conduct an annual review of its Infection Prevention and Control Program (IPCP), leading to outdated policies and disorganization in the IPCP binder. Interviews revealed that the IPCP had not been reviewed since June, and there was no documentation of recent reviews. This oversight risked adverse events for all 58 residents.
The facility did not ensure a clean environment as bathroom exhaust vents in shared and private bathrooms were found covered in dust, dirt, and debris. The Environmental Services staff confirmed the vents had not been cleaned in two months, contrary to the facility's policy of weekly dusting and quarterly vacuuming.
The facility failed to transmit completed MDS assessments to CMS within the required time frames for several residents, due to a misunderstanding of transmission requirements by the ADON/MDSC and DON. The facility's policy did not address MDS data transmission, contributing to the oversight. Residents affected had diagnoses such as dementia, PTSD, and anxiety disorder.
The facility failed to develop comprehensive care plans for three residents, neglecting to include necessary interventions for conditions such as schizophrenia, bipolar disorder, intellectual disability, skin lesions, catheter use, and hospice care. Interviews with staff confirmed these omissions, highlighting inconsistencies in care plan development.
The facility failed to develop comprehensive care plans for several residents, omitting critical diagnoses, treatments, and interventions. A resident's care plan lacked documentation for schizophrenia, bipolar disorder, and intellectual disability, as well as antipsychotic medication use. Another resident's care plan did not address a skin lesion or urinary catheter management. Additionally, a resident admitted to hospice care did not have a corresponding care plan. Staff interviews confirmed these omissions and the need for complete care plans.
The facility failed to serve meals consecutively to all residents at the same table, resulting in a resident being left without a meal while their tablemates ate. This occurred on two separate occasions, with the resident having to wait for staff to notice the oversight. The Dietary Manager was unaware of the dining room protocols and admitted there was no training for staff serving meals.
A facility failed to complete a significant change assessment within 14 days for a resident admitted to hospice care. The resident, with a history of heart disease, diabetes, and myocardial infarction, began hospice care, but no significant change MDS assessment was conducted. The MDS Coordinator was unaware of the hospice admission, and the DON confirmed the assessment should have been completed.
A resident at an LTC facility developed a pressure ulcer on the right heel, which deteriorated due to the facility's failure to update the care plan and implement appropriate interventions. Despite being at high risk for pressure ulcers, the resident's care plan was not updated to include necessary interventions such as floating heels or using a Broda chair. The ulcer progressed from Stage 3 to Stage 4, with exposed bone and tendon, due to inadequate documentation and inconsistent application of care strategies.
A facility failed to ensure physician progress notes were documented in the EMR for a resident with multiple diagnoses, including severe cognitive impairment. Staff interviews revealed ongoing issues with obtaining and placing these notes into resident records, resulting in incomplete documentation.
A facility failed to conduct an ongoing review for antibiotic stewardship for a resident who received multiple antibiotics over several months. The resident, admitted with acute vaginitis and UTI, was prescribed various antibiotics, but their use was not properly logged or reviewed as required by the facility's policy. The DON, responsible for the antibiotic stewardship program, acknowledged the oversight, and the Administrator confirmed the need for adherence to guidelines.
The facility did not accurately post daily nurse staffing information, failing to document the resident census, nurse licensing status, and actual hours worked. Key staff, including the DON and Administrator, were unaware of these requirements.
Failure to Timely Report Witnessed Allegation of Possible Abuse
Penalty
Summary
The facility failed to ensure that an allegation of possible abuse was reported immediately to management and within two hours to the State Survey Agency as required by policy. A cognitively impaired resident with Alzheimer's disease, known verbal and physical behaviors, and a care plan addressing potential physical aggression and resistance to care was involved. During toileting and incontinence care, the resident became combative and bent a CMT's finger back. In response, the CMT bent the resident's fingers back and stated, "you like that" or "how does that feel," which a CNA witnessed and believed could be abuse. The CNA who witnessed the incident did not report it to a nurse or management at the time it occurred. Instead, the CNA discussed the event with another CNA later during a lunch break and was advised to report it to the LPN. The CNA went home after the shift and did not report the allegation until the following day during the next shift, resulting in the facility notifying the DON, Administrator, and State Survey Agency the day after the alleged abuse occurred. Interviews with multiple staff, including CNAs, CMTs, nurses, the DON, and the Administrator, confirmed that staff were aware of the requirement to report suspected abuse immediately, and the DON and Administrator stated they expected all staff to report allegations of abuse without delay.
Failure to Safeguard Resident Funds Resulting in Misappropriation
Penalty
Summary
Facility staff failed to protect a resident from misappropriation of personal funds when $40 was taken from the resident's wallet without their knowledge or consent. The resident, who had diagnoses including mild cognitive impairment, general anxiety disorder, major depressive disorder, traumatic brain injury, and a history of falls, typically received $40 weekly from the facility for personal use, which was then given to a family member for purchases and outings. The resident's care plan did not address concerns related to maintaining or safeguarding their money. On the day of the incident, the resident returned from the hospital accompanied by their guardian, who confirmed the presence of $40 in the resident's wallet. The wallet was placed on a table in the resident's room by a CNA after the resident showed the money to the guardian. Shortly after the guardian left, the resident's family member arrived and discovered the money was missing from the wallet. Multiple staff, including CNAs and an LPN, were present in the area during this time, and the wallet was left unattended in the resident's room for a period. Interviews with staff and the resident indicated that no one witnessed the removal of the money, and the resident could not recall when the money disappeared. The facility conducted an investigation, including interviews and statements from staff, the resident, the guardian, and the family member. The investigation was unable to determine what happened to the money, and the funds were not recovered. The incident was reported to the Ombudsman and local police, but the facility's failure to ensure the resident's money was safeguarded and accounted for resulted in a deficiency related to the misappropriation of resident property.
Failure to Address Significant Weight Loss in Residents
Penalty
Summary
The facility failed to adequately address significant weight loss and poor intake for two residents, leading to a deficiency in nutritional care. Resident #14 experienced a severe weight loss of 9.60% in less than a month, with no documented notification to the Registered Dietitian (RD) or physician regarding the weight loss or reduced meal intake. The resident's care plan was not updated to reflect these changes, and there was no evidence of a nutritional assessment being conducted to address the weight loss. Observations showed the resident was not consuming adequate amounts of food, and staff interviews revealed a lack of communication and documentation regarding the resident's nutritional status. Resident #228 experienced a weight loss of 19.38% over five months, with similar issues of inadequate documentation and communication. The resident's care plan was not updated to reflect the significant weight loss until several months later, and there was no evidence that the RD was notified of the weight loss. The resident's nutritional status was not reassessed, and there were no documented interventions to address the weight loss until the resident was admitted to hospice services. Interviews with staff indicated a lack of awareness and action regarding the resident's nutritional needs. The facility's policies on weight assessment and intervention were not followed, as significant weight changes were not promptly communicated to the RD or addressed in the residents' care plans. The RD was not made aware of the residents' weight loss in a timely manner, and there was a lack of multidisciplinary effort to address the nutritional deficiencies. The deficiency highlights a failure in the facility's processes for monitoring and addressing residents' nutritional needs, leading to unaddressed weight loss and poor intake for the affected residents.
Inadequate RN Coverage in Facility
Penalty
Summary
The facility failed to consistently have a registered nurse (RN) on duty for at least eight consecutive hours a day, seven days a week, between July 4, 2024, and December 30, 2024. This deficiency was identified through a review of the facility's staffing sheets, which revealed that there was no RN coverage on several specific dates within this period. Interviews with the Central Supply, Human Resources Director, Director of Nursing, and the Administrator confirmed the lack of RN coverage on these days. The facility had more licensed practical nurses than registered nurses, which contributed to the inability to schedule an RN for the required hours, affecting all 58 residents residing in the facility.
Dietary Manager Lacks Required Certification
Penalty
Summary
The facility failed to ensure that the Dietary Manager (DM) met the required training, certification, and/or experience as mandated by state regulations. The DM, who had been employed at the facility for two years, was not certified and had not completed any Serv-Safe courses. Although she had been enrolled in classes since 2023, she had not been able to complete them. The Registered Dietitian (RD), who was aware of the DM's lack of certification, was present at the facility two days a month for approximately 16 hours, spending most of her time precepting the DM in her courses. This deficiency had the potential to affect all 58 residents who received meals in the facility.
Failure to Review and Update Infection Prevention Program
Penalty
Summary
The facility failed to conduct an annual review and update of its Infection Prevention and Control Program (IPCP), which is necessary to align with changing national standards. This deficiency was identified through a review of the facility's Infection Prevention binder, which was found to be disorganized with policy pages out of order or missing. The binder contained outdated policies, including a COVID-19 prevention policy from March 2020 and undated documents that did not specify the frequency of IPCP reviews. Interviews with the Infection Preventionist and the Administrator revealed that the IPCP policies had not been reviewed since June, and there was no documentation to confirm when the last review occurred. The Administrator was uncertain about the review process and could not provide evidence of the IPCP being discussed in quality assurance meetings. This oversight had the potential to increase the risk of adverse events, including the development of antibiotic-resistant organisms, affecting all 58 residents in the facility.
Failure to Maintain Clean Bathroom Vents
Penalty
Summary
The facility failed to maintain a clean and homelike environment for residents by not ensuring the cleanliness of bathroom exhaust fan vents. Observations revealed that the exhaust vents in the shared bathrooms of several residents were covered in layers of fuzzy, gray dust, dirt, and debris. Additionally, the exhaust vent in a private bathroom was found to be covered in stringy cobweb-like fibers and similar debris. During interviews, the Environmental Services/Plant Director and Assistant confirmed the unclean state of the vents and acknowledged that they needed vacuuming. It was noted that the vents were last cleaned approximately two months prior, despite the facility's policy requiring weekly dusting and quarterly vacuuming of vents.
Failure to Transmit MDS Assessments Timely
Penalty
Summary
The facility failed to ensure that completed Minimum Data Set (MDS) assessments were transmitted to the Centers for Medicare and Medicaid Services (CMS) system within the required time frames for four residents. The facility's policy did not address the transmission of MDS data to the CMS system, which contributed to the oversight. The CMS 2024 Resident Assessment Instrument (RAI) Manual requires that comprehensive assessments be transmitted electronically within 14 days of the Care Plan Completion Date, and all other MDS assessments within 14 days of the MDS Completion Date. However, the facility did not adhere to these requirements for several residents, including those with diagnoses such as dementia, PTSD, anxiety disorder, and depression. The Assistant Director of Nursing/MDS Coordinator (ADON/MDSC) was responsible for completing the MDS, while the Director of Nursing (DON) was responsible for signing and transmitting the assessments. The ADON/MDSC was under the impression that comprehensive or quarterly assessments should not be submitted to prevent unauthorized access to residents' protected health information, and was unaware that all completed assessments needed to be transmitted. Similarly, the DON believed that only entry, prospective payment system (PPS), and discharge assessments needed to be transmitted, and was not aware of the requirement to transmit initial, annual, or significant change assessments. This misunderstanding led to the failure to transmit the required assessments for the residents in question.
Deficiencies in Comprehensive Care Planning for Residents
Penalty
Summary
The facility failed to develop comprehensive care plans for three residents, leading to deficiencies in addressing their medical and psychological needs. For one resident, the care plan did not include necessary interventions for schizophrenia, bipolar disorder, intellectual disability, or the use of antipsychotic medication. Despite the resident's diagnoses and the recommendations from the Pre-Admission Screening and Resident Review (PASARR), the care plan lacked measurable goals and interventions related to these conditions. Interviews with the Social Services Director, MDS Coordinator, and Director of Nursing confirmed that these diagnoses and medication side effects should have been included in the care plan. Another resident's care plan was deficient in addressing skin lesions and the use of an indwelling urinary catheter. The resident had severely impaired cognition, open skin lesions, and used a catheter, but the care plan did not include interventions for these issues. Observations noted a large scabbed area on the resident's chin and the presence of a catheter, yet the care plan lacked strategies for monitoring and managing these conditions. The Assistant Director of Nursing/MDS Coordinator acknowledged the missing information and the need for these issues to be included in the care plan. A third resident, who was admitted to hospice care, did not have hospice services included in their care plan. Despite a physician's order for hospice admission and the resident being cognitively intact, the care plan failed to reflect the receipt of hospice services. The Assistant Director of Nursing admitted to inconsistencies in care plan development and recognized that hospice services should have been incorporated into the care plan, detailing the facility's responsibilities and interventions.
Incomplete Care Plans for Residents
Penalty
Summary
The facility failed to develop comprehensive care plans for six residents, which included necessary measurable goals and interventions. For Resident 231, the care plan did not document diagnoses of schizophrenia, bipolar disorder, or intellectual disability, nor did it include the use of antipsychotic medication and its side effects. Despite recommendations from the PASRR/ID assessment for services like physical therapy and drug therapy monitoring, these were not incorporated into the care plan. Interviews with the Social Services Director, MDS Coordinator, and Director of Nursing confirmed the expectation that these diagnoses and treatments should be included in the care plan. Resident 11's care plan was also incomplete, lacking documentation for a skin lesion on his chin and the use of a moisture barrier, as well as the management of an indwelling urinary catheter. Observations noted the presence of a scabbed area on the resident's chin, and the EMR indicated the lesion was being monitored, but this was not reflected in the care plan. The Assistant Director of Nursing acknowledged the missing information and the need for the care plan to include monitoring and physician notification for changes in the skin lesion. For Resident 10, the care plan did not address the resident's admission to hospice care, despite a physician's order and the resident's significant change in status MDS indicating hospice care. The Assistant Director of Nursing admitted to inconsistencies in care plan documentation and recognized the need for hospice care to be included in the care plan, outlining the facility's responsibilities and interventions.
Failure to Serve Meals Consecutively at Resident Tables
Penalty
Summary
The facility failed to uphold the dignity and respect of its residents during meal service by not serving all residents at the same table consecutively. On two separate occasions, a resident was left without a meal while their tablemates were served, leading to the resident feeling forgotten and hungry. On the first occasion, three residents at a table were served their meals at 5:25 P.M., but the fourth resident was not served until 5:43 P.M., despite raising their hand to get the staff's attention. On the second occasion, the same resident was again left without a meal while their tablemates were served at 12:22 P.M., and was only served at 12:30 P.M. when a staff member noticed the oversight. The Dietary Manager, responsible for meal service, was unaware of the dining room protocols and admitted that there was no training for staff serving meals. This lack of awareness and training contributed to the oversight, resulting in the resident being left without a meal on multiple occasions. The facility's policy, which states that meals should be provided to all residents sitting at the table at the same time, was not followed, leading to the deficiency in treating residents with dignity and respect.
Failure to Complete Significant Change Assessment for Hospice Admission
Penalty
Summary
The facility failed to complete a significant change assessment within 14 days for a resident who was admitted to hospice services. The resident, who had a history of hypertensive heart disease, diabetes, and myocardial infarction, began hospice care on November 20, 2024. However, the facility did not conduct a significant change Minimum Data Set (MDS) assessment following this change in the resident's condition. The last MDS assessment was a quarterly one completed on November 12, 2024. During interviews, the MDS Coordinator stated she was unaware of the resident's transition to hospice care, and the Director of Nursing confirmed that a significant change MDS should have been completed within 14 days of the resident's change to hospice care.
Failure to Update Care Plan Leads to Pressure Ulcer Deterioration
Penalty
Summary
The facility failed to provide adequate pressure ulcer care and prevention for a resident, leading to the development and deterioration of a pressure ulcer on the resident's right heel. Initially, the resident was assessed as being at risk for pressure ulcer development, with a Braden Scale score indicating moderate to high risk. Despite this, the care plan was not updated to reflect the new pressure ulcer or to include specific interventions to address the resident's changing condition. The resident's care plan did not incorporate the necessary interventions to manage the pressure ulcer, such as floating heels or using a Broda chair, until several months after the ulcer was first identified. The resident's pressure ulcer was first noted on the right heel, and a treatment plan was initiated. However, the care plan was not updated to include this new development, and the interventions were not adequately documented or implemented. The resident continued to spend significant time in a wheelchair with legs in a dependent position, contributing to the pressure on the wound site. Despite recommendations from the wound care provider to elevate the resident's legs and use Podus boots, these interventions were not consistently applied, and the care plan remained unchanged. As a result of these oversights, the resident's pressure ulcer deteriorated significantly, progressing from a Stage 3 to a Stage 4 ulcer with exposed bone and tendon. The facility staff failed to update the care plan with appropriate interventions in a timely manner, and there was a lack of consistency in implementing the recommended care strategies. The facility's failure to document and update the care plan contributed to the worsening of the resident's condition, highlighting deficiencies in the facility's pressure ulcer management practices.
Incomplete Documentation of Physician Progress Notes
Penalty
Summary
The facility failed to ensure that physician progress notes were documented and available for review in the electronic medical record (EMR) for a resident. The resident, who was admitted with diagnoses including atherosclerotic heart disease, chronic obstructive pulmonary disease, low-tension glaucoma, and osteoporosis, was severely cognitively impaired according to the quarterly Minimum Data Set. During the survey, it was found that there were no physician progress notes documented in the resident's EMR, neither under the Progress Notes tab nor the Miscellaneous tab. Interviews with facility staff revealed that the physician progress notes were not consistently placed into resident records. The Social Service Director confirmed the absence of these notes in the EMR, and the Director of Nursing acknowledged difficulties in obtaining the notes from the physician's dictating company. The Administrator was also unaware of how long this issue had persisted and provided only photo images of the physician's laptop screen as evidence of the notes, which were not available in the EMR. This lack of documentation resulted in incomplete resident records.
Failure in Antibiotic Stewardship Review
Penalty
Summary
The facility failed to conduct an ongoing review for antibiotic stewardship for a resident who received multiple antibiotics over several months. The facility's policy on antibiotic stewardship, revised in December 2016, mandates that all clinical infections treated with antibiotics undergo review by the infection preventionist (IP) or designee. However, the resident was not listed on the Infection Control Line Listing log for antibiotic stewardship review for the months of August, September, November, and December 2024. The log sheets were incomplete, missing critical information such as resident room numbers, dates of labs/pathogen, date/symptoms, and predisposing factors. The resident, admitted with diagnoses including acute vaginitis and urinary tract infection (UTI), was prescribed and administered various antibiotics from August to December 2024. Despite the facility's policy requiring documentation and review of antibiotic regimens, the resident's antibiotic use was not properly logged or reviewed. During interviews, the Director of Nursing (DON), who also served as the IP, acknowledged that the resident should have been on the log and that there was no policy she was aware of for following the McGeer criteria or protocols for reviewing antibiotic stewardship. The Administrator confirmed that the DON was responsible for the antibiotic stewardship program and that guidelines were to be followed for appropriate ordering of antibiotics.
Failure to Accurately Post Daily Nurse Staffing Information
Penalty
Summary
The facility failed to ensure that the daily nurse staffing information was accurately posted to reflect the actual staff hours for the care of 58 residents. Observations from January 6 to January 9 revealed that the Daily Nursing Roster was posted at various times without documenting the daily resident census, the licensing status of the nurses (LPN or RN), or the actual hours worked by the staff. Interviews with the Central Supply and Human Resources Director indicated they were unaware of the requirement to include the resident census and nurse licensing information in the postings. The Director of Nursing, responsible for the postings, was also unaware of the missing documentation. Additionally, the Administrator admitted to not being familiar with the requirements for daily nurse postings.
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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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How nearby facilities compare on the same public inspection record.
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| Ascend At Aurora | 4.7 mi | ★★★★★ | 4 | 0 |
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| Lawrence County Manor | 12.5 mi | ★★★★★ | 14 | 1 |
| Lacoba Homes Inc | 17.9 mi | ★★★★★ | 2 | 0 |
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