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 Village Care Center Inc during CMS and state inspections, most recent first.
A cognitively impaired resident with dementia, chronic pain, and behavioral symptoms became agitated, cried, and attempted to disrobe while staff were providing toileting and dressing care. An RN used a raised and harsh tone, grabbed the resident’s forearm, made demeaning comments including comparing the resident’s behavior to that of a baby, and threatened to tell the resident’s spouse about the disrobing. When a CMT offered to stay with the still-upset resident to calm them, the RN refused and instead took the resident to the dining room so others could see the behavior, reportedly jerking the wheelchair back and forth and making comments likening the resident to a “bucking bronc” or “ride’em cowgirl.” The facility’s investigation, supported by multiple witness statements and the RN’s own account, substantiated verbal abuse and inappropriate physical handling that did not follow the resident’s care plan for calm, reassuring approaches to dementia-related behaviors.
The facility did not ensure that the Dietary Manager had the necessary certifications or knowledge of required qualifications for the role. The DM had not completed or enrolled in any dietary manager certification courses and was unaware of the certification requirements. The facility also lacked a policy specifying the qualifications for the DM position, and the Administrator confirmed the DM was serving in an interim capacity while recruitment for a qualified candidate continued.
Staff failed to maintain food safety and sanitation standards by not recording or acting on low dishwasher and refrigeration temperatures, not washing hands between tasks, and not labeling or sealing food items. The kitchen was observed to be unclean and in disrepair, and food storage practices were inadequate, with missing dates and spoiled items present.
Two residents, both cognitively intact and independent, were found with medications at their bedside without proper assessment, care plan documentation, or physician's orders authorizing self-administration. Staff interviews confirmed that medications should not be left in resident rooms without appropriate authorization and assessment.
The facility did not use the correct, current SNFABN form to notify two residents about Medicare coverage and potential financial liability, instead providing an outdated form. The facility also lacked a policy for ABN use, and the Administrator confirmed that the responsible Social Services staff member was new and should have used the correct forms.
Staff did not provide complete perineal care or adequate morning hygiene for two dependent residents, including not separating and cleaning all skin folds, reusing the same area of a wipe on different skin areas, and failing to offer oral care or wash the face and hands before breakfast. Interviews confirmed staff were aware of proper procedures but did not follow them.
Staff did not consistently follow proper procedures for using a mechanical lift during transfers of two residents who required maximum assistance, resulting in the lift being operated with its legs closed instead of open as required by facility policy and manufacturer guidelines. This failure was observed multiple times and confirmed by staff interviews, affecting residents with significant physical and cognitive impairments.
Staff did not follow proper procedures for oxygen administration for three residents, including leaving excess oxygen tubing on the floor, not dating tubing, and failing to fill humidifier bottles with distilled water. Interviews confirmed that these actions were not in line with facility policy or physician orders, resulting in improper respiratory care.
The facility did not properly assess, document, or obtain physician orders for bed rail use for three residents with mobility impairments and multiple diagnoses. Bed rails were installed without complete assessments, including missing bed measurements and resident size documentation, and were not consistently addressed in care plans. Staff interviews confirmed that physical therapy recommended bed rails without performing required assessments, and the administrator acknowledged the lack of necessary documentation and care planning.
The facility did not ensure that all nurse aides completed or were enrolled in a state-approved training and competency evaluation program within four months of hire, as required by policy and regulations. This was confirmed through employee record review and administrator interview.
Staff failed to maintain a medication error rate below 5%, with three errors out of 25 opportunities involving two residents. Errors included not measuring topical medication doses, improper hand hygiene, incorrect administration of nasal spray, use of the wrong eye drops, and failure to follow proper eye drop technique, as confirmed by both the CMT and DON.
Staff did not consistently use PPE or follow infection control protocols during high-contact care activities, blood glucose monitoring, and insulin administration. For example, a resident with a suprapubic catheter and wound dressing received care without staff donning required gowns and gloves, and hand hygiene was not performed as per policy. In other cases, staff failed to wear gloves when obtaining blood sugar samples and did not clean insulin pen ports with alcohol wipes before attaching needles, despite being aware of the correct procedures.
The facility failed to maintain a safe, clean, and comfortable environment, with multiple areas showing chipped paint, exposed wood, and damaged sheetrock. Additionally, the only drinking fountain was non-functional, and the staff was unaware of the requirement to maintain it.
The facility failed to maintain accurate and individualized care plans for three residents, leading to multiple falls, improper medication management, and dietary non-compliance. Staff were unaware of necessary care plan updates, resulting in inadequate resident care.
A resident with a history of falls, severe cognitive impairment, and medication use for anxiety and pain sustained three falls within a week, resulting in a hematoma. The resident's care plan was not updated to include new interventions, and the resident's room was far from the nurses' station, increasing the risk of further falls.
Verbal Abuse and Rough Handling of Cognitively Impaired Resident During Care
Penalty
Summary
The deficiency involves the facility’s failure to protect a cognitively impaired resident from mental and physical abuse during the provision of care. The resident had dementia, chronic kidney disease, anemia, diabetes, anxiety disorder, chronic back pain that could worsen with movement, and a history of recent hospitalization for altered mental status. The resident’s care plan directed staff to approach slowly and calmly with clear instructions, to give space and perform cares later if the resident became overwhelmed or upset, to use gentle reassurance, reduce noise and distractions, and to keep the resident’s routine consistent. The care plan also instructed staff to monitor for nonverbal signs of pain and for acute changes from baseline dementia behaviors. On the day of the incident, the resident was observed in a common area attempting to disrobe and refusing medications. RN A and another nurse placed the resident in a wheelchair and transported the resident to the room, where RN A, a CNA, and a CMT were involved in toileting and dressing. Witness accounts and the facility’s investigation documented that the resident was yelling, crying, and repeatedly attempting to remove clothing while staff were providing care in the bathroom. During this time, RN A used a raised, harsh, or firm tone, grabbed the resident’s forearm while telling the resident to stop and “knock it off,” and made demeaning statements, including calling or referring to the resident as a baby in response to crying and biting behavior. RN A also verbally threatened to call the resident’s spouse to report that the resident was trying to be naked in front of everyone, which a witness described as causing the resident to cry more. After toileting and dressing, the resident remained visibly upset and continued trying to disrobe. A CMT offered to stay with the resident to help calm the resident, but RN A declined and stated that the resident needed to go to the dining room so others, including management, could see the behaviors RN A had to deal with. While transporting the resident in the wheelchair, a witness reported that RN A shook or jerked the wheelchair forward and backward several times and made a comment likening the resident to a “bucking bronc,” while RN A acknowledged making a similar “ride’em cowgirl” remark during wheelchair maneuvering. The facility’s investigation, based on multiple consistent witness statements and RN A’s own statements, concluded that RN A used demeaning and humiliating language, raised and harsh tones, threats of public shaming, and physical handling inconsistent with safe and respectful standards, including jerking the wheelchair and grabbing the resident’s forearm, which caused emotional distress to the resident even though no physical injury was identified on assessment. The facility’s abuse policy defined abuse as willful infliction of injury, unreasonable confinement, intimidation, or punishment resulting in physical harm, pain, or mental anguish, and included mental abuse such as humiliation, harassment, threats of punishment, or deprivation. The policy required immediate removal of a resident from a harmful environment and prompt reporting of suspected abuse. In this incident, the actions attributed to RN A—demeaning language, threats to involve the resident’s spouse to shame the resident for disrobing, refusal to allow a staff member to remain with the resident to calm them, and intentional public exposure of the resident’s distressed behavior in the dining room—were determined by the facility’s investigation to constitute verbal abuse and inappropriate physical handling. These actions did not follow the resident’s individualized care plan strategies for managing behavioral symptoms and dementia-related distress and resulted in the substantiated finding of abuse.
Dietary Manager Lacks Required Certification and Competency
Penalty
Summary
The facility failed to ensure that the Dietary Manager (DM) possessed the appropriate competencies and skill sets required to carry out the functions of the food and nutrition service. The DM, who had worked at the facility for ten years and served as the DM for one year, reported not having any dietary manager certifications, was unaware of the required certifications for the position, and was not currently enrolled in any certification courses. The DM also indicated a need to coordinate with the facility's contracted dietician, who visits once a month, to make a plan for enrolling in dietary certification classes. The facility did not provide a policy outlining the qualifications for the DM position. The Administrator confirmed that the DM was serving in an interim capacity, acknowledged the need for the DM to complete the required dietary management course, and stated that efforts to fill the position with a qualified candidate had been ongoing.
Failure to Maintain Food Safety and Sanitation Standards in Dietary Services
Penalty
Summary
The facility failed to prepare and serve food in accordance with professional standards for food service safety. Staff did not consistently keep records of dishwasher temperatures and chemical tests, nor did they cease using the dishwasher when temperatures did not meet required levels. There were also missing daily records of refrigerator and freezer temperatures. Observations revealed that staff did not wash hands between tasks or glove changes, and food items were not consistently labeled or dated upon receiving or opening. The kitchen environment was not maintained in a clean and sanitary condition, with visible grime on equipment and areas in disrepair. Multiple observations showed staff using gloved hands to perform various tasks without washing hands in between, such as turning on faucets, handling food, and using oven mitts. Staff also failed to wash hands before donning new gloves or after cleaning workstations. Food storage practices were inadequate, with numerous items in refrigerators and freezers lacking received or opened dates, and some opened items were unsealed, wilted, or browning. Temperature logs for refrigeration units were incomplete for several days, and food items were not properly rotated or discarded when spoiled. Dishwasher temperature logs were missing for multiple days, and recorded temperatures were consistently below required levels for both wash and rinse cycles. Despite these low temperatures, the dishwasher continued to be used, and staff did not consistently switch to hand washing dishes as required by policy. The facility did not provide the requested dishwasher user manual, and there was confusion among staff regarding the correct temperature standards for the dishwasher. Maintenance issues with the hot water heater were noted, but the problem persisted, and the facility's policies for food safety and sanitation were not followed.
Failure to Assess and Authorize Resident Self-Administration of Medications
Penalty
Summary
The facility failed to ensure that staff obtained physician's orders and properly assessed residents for the safe self-administration of medications to be kept at the bedside for two of twelve sampled residents. For one resident, who was cognitively intact and independent with activities of daily living, diclofenac sodium topical gel and Latanoprost eye drops were found on the bedside table. The resident reported being told by staff that these medications could be kept in the room for self-administration. However, the care plan did not reflect the resident's ability to self-administer these medications, and there were no physician's orders authorizing the medications to be kept at bedside for self-administration. For another cognitively intact and independent resident, three pills and Scalpicin cream were observed on the bedside table. The resident stated that the nurse left the items there but was unsure of the reason. The care plan did not address the resident's ability to self-administer these medications, and there were no physician's orders for the medications or for keeping them at bedside. Staff interviews confirmed that medications should not be left in resident rooms without proper orders and assessment, and that any such medications found should be reported and removed unless authorized.
Failure to Use Correct SNFABN Form and Lack of ABN Policy
Penalty
Summary
The facility failed to provide residents with the correct Skilled Nursing Facility Advance Beneficiary Notice of non-coverage (SNFABN) form, which is required to inform residents about their Medicare coverage and potential financial liability for services not covered. Specifically, for two of the twelve sampled residents, the facility used an outdated ABN form (CMS-R-131) that had expired, and this form was signed by the residents. Additionally, the facility did not have a policy in place for the use of ABNs. The Notice of Medicare Non-coverage (NOMNC) was provided and signed, but the correct and current SNFABN form was not utilized. During an interview, the Administrator acknowledged that the Social Services staff member responsible was new to the position and confirmed that the correct forms should have been used.
Failure to Provide Complete Perineal and Morning Care for Dependent Residents
Penalty
Summary
Staff failed to provide complete perineal care and adequate assistance with activities of daily living (ADLs) for two dependent residents. For one resident with severe cognitive impairment, upper and lower extremity limitations, bowel incontinence, and a suprapubic catheter, staff did not wash their hands before donning gloves, did not separate and clean all skin folds during perineal care, and used the same area of a wipe to clean different areas of the buttocks. Additionally, the resident was not offered or provided oral care, nor were their face and hands washed before being taken to breakfast. For another resident with intact cognition but impaired lower extremities, bowel and bladder incontinence, and multiple chronic conditions, staff did not separate and clean all areas of the skin where urine had touched during a bed bath after the resident urinated. The resident required substantial assistance with all ADLs and was dependent on staff for transfers and hygiene, but the care provided did not meet the facility's policy requirements for thorough perineal care. Interviews with the involved staff confirmed that they did not follow proper procedures for perineal care, including separating and cleaning all skin folds and not reusing the same area of a wipe. The DON also confirmed that staff should have provided oral care, washed the residents' face and hands before breakfast, and ensured all areas exposed to urine or feces were properly cleaned.
Improper Mechanical Lift Use During Resident Transfers
Penalty
Summary
Staff failed to follow proper procedures for using a mechanical lift when transferring two residents, as observed during multiple instances. According to the facility's policy and the manufacturer's guidelines, the legs of the mechanical lift should be in the maximum open position for stability when raising or lowering a resident, and at least two nursing assistants are required for safe operation. However, staff were repeatedly observed raising and lowering residents with the lift's legs in the closed position, contrary to both facility policy and manufacturer instructions. One resident involved had severe cognitive impairment, upper and lower extremity impairments, was dependent on staff for all activities of daily living, and had a suprapubic catheter. The other resident had intact cognitive skills but was dependent on staff for transfers and toileting due to bilateral lower extremity impairment and multiple chronic conditions, including CHF, COPD, diabetes, and renal insufficiency. Both residents required maximum assistance and the use of a mechanical lift for transfers, as documented in their care plans. Interviews with staff confirmed inconsistent understanding and application of the correct procedure for operating the mechanical lift, with some staff stating the legs should be closed during raising or lowering, while others correctly identified that the legs should be open. The Director of Nursing also confirmed that the legs should be open during these operations. These actions and inactions resulted in a failure to ensure the area was free from accident hazards and that adequate supervision and proper techniques were used to prevent accidents during resident transfers.
Failure to Maintain Safe and Appropriate Oxygen Administration Practices
Penalty
Summary
Staff failed to provide proper respiratory care for three residents by not maintaining oxygen tubing and humidifier bottles according to facility policy and physician orders. For one resident with multiple diagnoses including lung and kidney disease, observations revealed that oxygen tubing was not dated, excess tubing was left coiled on the floor, and the humidifier bottle was empty on multiple occasions. Another resident, who was independent with ADLs and had diagnoses such as heart failure and respiratory failure, was observed with excess oxygen tubing coiled on the floor. A third resident with conditions including debility, anemia, and respiratory failure also had excess oxygen tubing coiled on the floor during multiple observations. In one case, the care plan did not include information regarding oxygen use despite physician orders for regular tubing changes and dating. Interviews with staff confirmed that oxygen tubing should not be on the floor, should be stored on the concentrator, and that humidifier bottles should be filled to the appropriate level and checked daily. The facility's own policy required water in the humidifying jar and proper anchoring of tubing to prevent irritation. These failures resulted in improper respiratory care for the affected residents.
Failure to Assess, Document, and Care Plan Bed Rail Use
Penalty
Summary
The facility failed to properly assess and document the use of bed rails for three residents, resulting in deficiencies related to resident safety and regulatory compliance. For one resident with cognitive intactness and significant lower extremity impairment, U-shaped bed rails were observed on both sides of the bed. There were no physician's orders for the use of side rails, and the positioning device assessment lacked documentation of bed measurements or the resident's height and weight. Although the care plan noted the use of positioning wands and indicated that risks and benefits were reviewed, the assessment was incomplete. Another resident, also cognitively intact and independent with ADLs but with upper extremity impairment, was observed with a U-shaped rail on the left side of the bed. The care plan reflected the resident's request for a handrail, and an assessment was performed, but again, there were no physician's orders and no documentation of bed measurements or the resident's physical dimensions. The resident reported using the rail due to inability to use one arm. A third resident with multiple diagnoses, including skin cancer and kidney disease, was observed with a U-shaped rail on the left side of the bed. The care plan did not address the use of the positioning bar, and there were no physician's orders for its use. Interviews with staff revealed that physical therapy recommended and placed bed rails but did not perform assessments or measurements, and the administrator confirmed that assessments, physician's orders, and care planning for positioning rails were required but not completed. These actions and omissions led to the cited deficiencies.
Failure to Ensure Nurse Aide Training and Competency Within Required Timeframe
Penalty
Summary
The facility failed to ensure that nurse aides met the minimum qualifications required by federal and state regulations, specifically regarding completion of a state-approved nurse aide training and competency evaluation program within four months of hire. The facility's policy, revised in May 2019, states that nurse aides must complete such training and evaluation, and that those who do not may be terminated or reassigned to non-nursing duties. Despite this policy, a review of the employee list revealed that several nurse aides had been employed for varying lengths of time, but there was no documentation provided to confirm that all had completed or were enrolled in the required training within the specified timeframe. During an interview, the Administrator acknowledged that nurse aides should be enrolled in Certified Nurse Aide (CNA) classes within four months of their hire date. However, the report did not provide evidence that this requirement was consistently met for all nurse aides listed, indicating a lapse in adherence to both facility policy and regulatory requirements. The facility census at the time was 35 residents.
Medication Administration Errors Exceed Acceptable Rate
Penalty
Summary
Facility staff failed to maintain a medication error rate below five percent, as required by policy, resulting in a 12% error rate with three errors out of 25 observed opportunities. The errors involved two residents and were identified through direct observation, interviews, and record reviews. The facility's policies on medication and treatment orders, administering medications, and administering topical medications outline specific procedures for safe and accurate medication administration, including hand hygiene, correct dosing, and adherence to prescriber and manufacturer instructions. For one resident, a Certified Medication Technician (CMT) did not wash hands before or after applying Diclofenac gel, did not measure the correct dose, and applied an unknown amount of the medication. The CMT admitted to not always being able to find the measuring device and acknowledged that the gel should be measured, as confirmed by the Director of Nursing (DON). For another resident, the CMT failed to follow proper procedures for administering Flonase nasal spray and artificial tears. The CMT did not close one nostril during nasal spray administration, used the wrong eye drop (Visine instead of artificial tears), and touched the tip of the dropper to the resident's eyelashes, which is against protocol. The CMT also did not apply lacrimal pressure after administering the eye drops. Both the CMT and DON confirmed these actions were not in accordance with facility policy or manufacturer guidelines.
Failure to Follow Infection Control Protocols and Proper PPE Use
Penalty
Summary
Staff failed to consistently follow infection prevention and control protocols, including the use of personal protective equipment (PPE), hand hygiene, and proper procedures for blood glucose monitoring and insulin administration. Certified Medication Technicians (CMTs) and Certified Nurse Aides (CNAs) did not wear gowns and gloves as required during high-contact care activities for a resident with a suprapubic catheter and a wound dressing. Observations showed that staff did not wash or sanitize their hands before donning gloves, between glove changes, or after providing care, and did not always use PPE when handling bodily fluids or medical devices. Interviews revealed confusion among staff regarding when to use Enhanced Barrier Precautions (EBP) and what PPE was required, with some staff believing gowns and gloves were only necessary for wound or catheter care. In another instance, a CMT failed to wear gloves while obtaining a blood sugar sample from a resident, contrary to facility policy. The CMT also did not wash hands before the procedure. The resident did not have a physician's order for blood sugar monitoring, but the focus of the deficiency was on the lack of glove use and hand hygiene during the procedure. The DON confirmed that gloves should be worn when obtaining blood sugars, but the CMT reported not being taught this requirement. Additionally, staff did not follow proper protocol for insulin pen use for three residents. CMTs were observed attaching needles to insulin pens without first cleaning the rubber port with an alcohol wipe, as required by facility policy. This occurred during insulin administration for residents with diabetes. Interviews with staff confirmed awareness of the correct procedure, but it was not followed during the observed events. The DON also stated that insulin ports should be cleaned with an alcohol wipe before needle attachment.
Facility Fails to Maintain Safe and Clean Environment
Penalty
Summary
The facility failed to maintain a safe, clean, and comfortable environment for its residents. Observations revealed multiple areas with chipped paint, exposed wood, and damaged sheetrock in various rooms and hallways. Specific issues included scuff marks on doors, bent metal frames on fan heaters causing sharp protrusions, and exposed screws on sliding bathroom doors. Additionally, a mattress in one room had its protective coating peeling off, exposing the foam underneath. The Maintenance Supervisor acknowledged the need for repairs and mentioned working on a schedule of repairs and audits. The Administrator was also aware of the issues and had a list of needed repairs by room, along with a performance improvement plan for building repairs. The facility also failed to maintain the only drinking fountain, which was non-functional. The Administrator and Director of Nursing were unaware that the water fountain needed to be maintained and in good repair, as they believed a hydration station set up near the activity room was sufficient. They did not realize that a State tag required the water fountain to be operational and had not received or submitted approval for an exception to the regulation.
Failure to Maintain Accurate and Individualized Care Plans
Penalty
Summary
The facility failed to ensure residents had a complete, accurate, and individualized care plan to address specific needs for three of the 12 sampled residents. Resident #22, who was not cognitively intact and had a history of behaviors and wandering, experienced multiple falls. Despite these incidents, there were no updates to the care plan related to medication usage, urinary tract infection, or the implementation of personal alarms. The resident's care plan did not reflect the necessary interventions to prevent further falls, such as moving the resident closer to the nurse's station or using positioning devices and alarms, even after multiple falls were documented in the progress notes. Resident #1, who was alert and oriented with no cognitive loss, had physician orders to self-administer nasal sprays for seasonal allergic rhinitis. However, the resident's care plan did not include any information about keeping medications at the bedside. This oversight was observed when the resident was seen with the nasal sprays on the over-the-bed table, and the resident confirmed self-administration as needed. Resident #13, who had some cognitive loss and required substantial assistance with activities of daily living, had a physician order for a no-added-salt diet and a fluid restriction. The care plan did not include these dietary restrictions, leading to the resident being given a salt shaker by a CNA and liberally salting their food. Additionally, staff interviews revealed a lack of awareness about the resident's dietary restrictions and fluid limitations, indicating a communication breakdown regarding care plan updates and resident needs.
Failure to Implement Fall Prevention Interventions
Penalty
Summary
The facility failed to ensure systems and interventions were put in place for a resident with a history of falls, severely impaired cognition, and medication use for anxiety and pain. The resident sustained three falls within a week, resulting in a hematoma to the back of the head, without additional interventions being implemented. The resident's care plan did not include measures to address the increased fall risk due to a urinary tract infection, nor were there any orders for personal alarms or positioning devices to prevent further falls. Observations revealed that the resident was often found sitting alone, appearing sleepy, and with uneaten meals. The resident's room was located far from the nurses' station, and the resident was unable to use the call light due to severe cognitive impairment. Despite multiple falls, the resident's care plan was not updated to include new interventions, and the resident continued to be at risk for further falls. Interviews with staff and the resident's family indicated that there was a noticeable decline in the resident's condition, with increased sleepiness and a lack of participation in meals. The family was aware of the increased fall risk due to the resident's medications and recent infection. The Director of Nursing and the Administrator acknowledged that changes in the resident's condition should have been care planned, and they were working on other interventions, including moving the resident closer to the nurses' station.
What surveyors are citing around you — mapped
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Illustrative
What surveyors actually found near you
We read the 24 citations issued within 25 miles in the last 12 months — and tell you exactly what happened, in plain English, matched to your record.
Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
Illustrative
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Illustrative
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Nursing homes near Maryville
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Maryville Living Center | 0.6 mi | ★★★★★ | 5 | 0 |
| Parkdale Manor Health & Rehabilitation | 1.1 mi | ★★★★★ | 1 | 0 |
| Nodaway Healthcare | 5.1 mi | ★★★★★ | 2 | 0 |
| Pine View Manor Inc | 19.7 mi | ★★★★★ | 1 | 0 |
| Tiffany Heights | 23.7 mi | ★★★★★ | 15 | 0 |
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