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 Ratliff Care Center during CMS and state inspections, most recent first.
The facility did not submit complete and accurate direct care staffing information to CMS for the first fiscal quarter of 2024. The Administrator acknowledged not submitting the required Payroll Based Journal (PBJ) data, despite knowing it should be done quarterly. The facility also lacked a policy for direct care staffing information.
The facility failed to notify residents and their representatives in writing about hospital transfers, as required by policy. Interviews revealed that while verbal communication occurred, there was no documentation of written notification. The Administrator acknowledged the expectation for such notifications.
The facility failed to inform residents and their representatives in writing about the bed hold policy during hospital transfers. Despite the policy requiring written notification upon admission and transfer, there was no documentation for four residents. Interviews revealed confusion among staff about responsibility for the policy, with a RN unsure and a LPN indicating it was handled by Administration or SSD.
The facility failed to assess and obtain informed consent for bed rail use for four residents, despite policy requirements. Observations confirmed bed rails in use without documentation of alternative methods, informed consent, or assessments. Residents had various diagnoses, including dementia and COPD, and were observed using bed rails, but records lacked necessary documentation. The ADON acknowledged the absence of a physician's order or signed consent.
The facility failed to conduct regular inspections of bed frames, mattresses, and bed rails for four residents using bed rails. Despite a policy requiring assessments upon admission and quarterly, no documentation of maintenance assessments was found. Observations confirmed the use of U-shaped assist bar bed rails, and interviews revealed that no official reassessment or physician's order was obtained. The facility lacked a dedicated maintenance person, and duties were divided among employees, with no assessments completed.
Failure to Submit Quarterly Staffing Data to CMS
Penalty
Summary
The facility failed to electronically submit complete and accurate direct care staffing information to the Centers for Medicare and Medicaid Services (CMS) on a quarterly basis, as required. This deficiency was identified during a review of the facility's Payroll Based Journal (PBJ) staffing Data Report for the first fiscal quarter of 2024, covering the period from October 1 to December 31. The facility was found to have triggered a deficiency for not submitting the required data for this quarter. During an interview, the Administrator admitted to not submitting the PBJ information, despite being aware of the quarterly submission requirement. Additionally, the facility did not provide a policy for direct care staffing information, contributing to the deficiency.
Failure to Provide Written Notification for Hospital Transfers
Penalty
Summary
The facility failed to provide written notification to residents and/or their representatives regarding facility-initiated transfers to the hospital. This deficiency was identified for four residents who were transferred to the hospital but did not receive the required written notification. The facility's policy on bed holds mandates that residents and their representatives be informed in writing of any transfers, but this was not adhered to in these cases. Interviews with staff revealed that while verbal communication with families and physicians occurred, and necessary documentation was prepared for the hospital, the written notification to residents or their representatives was not documented. The Social Services Designee mentioned that a transfer form was completed and sent with the resident, and a copy was mailed to the family, but there was no evidence of this in the medical records. The Administrator acknowledged the expectation for written notification but it was not fulfilled in these instances.
Failure to Inform Residents of Bed Hold Policy
Penalty
Summary
The facility failed to inform residents and their representatives in writing about the bed hold policy at the time of transfer to the hospital for four residents. The policy requires that residents or their representatives be notified in writing of the bed hold policy upon admission and at the time of transfer. However, for Residents #4, #9, #30, and #32, there was no documentation indicating that they or their representatives were informed in writing about the bed hold policy when they were transferred to the hospital. This oversight was identified through interviews and record reviews, revealing a lack of compliance with the facility's own policy. Interviews with staff members highlighted a lack of clarity and responsibility regarding the bed hold policy. A Registered Nurse was unsure about the policy, while a Licensed Practical Nurse indicated that the responsibility for the bed hold policy lay with Administration or the Social Service Designee (SSD). The SSD mentioned that the bed hold agreement was signed upon admission, but the Administrator expected that residents and their representatives would be given the bed hold notice at the time of hospital transfer. This discrepancy in understanding and execution contributed to the deficiency identified by the surveyors.
Failure to Assess and Obtain Consent for Bed Rail Use
Penalty
Summary
The facility failed to properly assess and obtain informed consent for the use of bed rails for four residents. The facility's policy requires an assessment for the need and safety of bed rails upon admission, quarterly, and with any change in condition. However, for Residents #7, #25, #28, and #41, there was no documentation of any attempts made with alternative methods prior to the use of bed rails, no informed consent obtained, and no bed rail assessment completed. Observations confirmed the presence of bed rails in use for these residents, despite the lack of documentation. Resident #7, diagnosed with high blood pressure, dementia, anxiety, and depression, was observed with a bed rail in use, but their medical record lacked documentation of alternative methods, informed consent, or a bed rail assessment. Similarly, Resident #25, with multiple diagnoses including COPD, dysphagia, and cancer, was observed with bed rails on both sides of the bed, yet their records also lacked necessary documentation. Resident #28, with dementia and other health issues, was observed with bed rails in use, but again, there was no documentation of assessment or consent. Resident #41, diagnosed with pneumonia, depression, and other conditions, was observed using bed rails and stated they used them to move around in bed. However, their medical record did not include documentation of alternative methods, informed consent, or a bed rail assessment. The Assistant Director of Nursing acknowledged the lack of a physician's order or signed consent and mentioned that a screening tool was used, but no official reassessment was conducted.
Failure to Conduct Regular Bed Rail Inspections
Penalty
Summary
The facility staff failed to conduct regular inspections of bed frames, mattresses, and bed rails for four residents who utilized bed rails. The facility's policy required assessments for the need and safety of side rails upon admission, quarterly, and with any change in condition. However, there was no documentation of maintenance assessments for the bed rails of Residents #7, #25, #28, and #41. Observations confirmed that these residents were using U-shaped assist bar bed rails in the upright position, but no maintenance checks were recorded. Interviews with the residents and staff revealed further deficiencies. Resident #25 and Resident #41 reported using the bed rails to assist with movement in bed. The Assistant Director of Nursing acknowledged the existence of a screening tool for bed rails but admitted that no official reassessment or physician's order was obtained. The facility lacked a dedicated maintenance person, and maintenance duties were divided among other employees, with the Administrator admitting that no assessments had been completed. This lack of regular maintenance and assessment posed a potential risk to resident safety.
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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 Cape Girardeau
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Life Care Center Of Cape Girardeau | 1.9 mi | ★★★★★ | 1 | 0 |
| Chateau Girardeau | 2.4 mi | ★★★★★ | 0 | 0 |
| Lutheran Home, The | 2.5 mi | ★★★★★ | 0 | 0 |
| Fountainbleau Lodge | 3.3 mi | ★★★★★ | 7 | 0 |
| Heartland Care And Rehabilitation Center | 3.4 mi | ★★★★★ | 4 | 0 |
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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.