Map showing the location of LEWIS COUNTY NURSING HOME DISTRICT in CANTON, Missouri
17528 STATE HIGHWAY 81, CANTON, MO, 63435

Overall Score

CMS Five-Star Quality Rating
2/5Below averageCMS Five-Star overall rating
  1. Much below average
  2. Below average
  3. Average
  4. Above average
  5. Much above average

Where it ranks

  • MissouriAbove only 33% of peers479 rated homes · average 2.5★
  • United StatesAbove only 20% of peers14,574 rated homes · average 3.0★

How the rating is built

  • Health inspectionsStarting point2★−0.8 vs MO avg
  • StaffingCan add or remove a star4★+1.9 vs MO avg
  • Quality measuresCan add or remove a star3★+0.3 vs MO avg

CMS starts from the health inspection stars, then adds or subtracts a star for staffing and for quality measures. Stars are assigned relative to other facilities in the same state.

  • Standard inspection overdueThe most recent standard health inspection is older than CMS expects, so the health inspection rating may not reflect current conditions.

Ratings & measures

Tap a row to see what it means
Health inspection ratingCMS stars from the last three on-site inspection cycles2★Above only 19% of peersMO avg2.8★U.S. avg2.8★
What is health inspection rating?

Stars assigned from the last three standard surveys and every complaint investigation in that window, weighted toward the most recent and the most serious findings. CMS assigns these stars relative to other facilities in the same state.

Why it matters

It carries the most weight in the overall rating and is the only domain based on what trained inspectors saw on site rather than what the facility reported.

Staffing ratingCMS stars from payroll-reported hours and turnover4★Above 83% of peersMO avg2.1★U.S. avg2.9★
What is staffing rating?

Nurse and aide hours per resident day from payroll records CMS collects every quarter, adjusted for how much care residents need, plus staff turnover and weekend coverage.

Why it matters

More hours and lower turnover are the strongest predictors of fewer falls, pressure sores, and avoidable hospital stays.

Quality measures ratingCMS stars from clinical outcomes and resident assessments3★Above only 49% of peersMO avg2.7★U.S. avg3.6★
What is quality measures rating?

Clinical outcomes from resident assessments and Medicare claims: falls with injury, pressure ulcers, hospitalizations, antipsychotic use, and more, for both short-stay and long-stay residents.

Why it matters

It shows whether care is working, but part of it comes from the facility’s own assessments, so read it alongside the inspection results.

Total nurse hoursPer resident per day, all nursing staff3.51hrsAbove 59% of peersMO avg3.47Benchmark4.10
What is total nurse hours?

All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.

Why it matters

Federal research links 4.1 hours a day to fewer avoidable harms. Below about 3 hours, residents wait longer for help with basics like toileting and repositioning.

RN hoursPer resident per day, registered nurses only0.47hrsAbove 64% of peersMO avg0.46Benchmark0.75
What is rn hours?

Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.

Why it matters

RN coverage is the staffing measure most tied to fewer hospital transfers and infections, and it is where thinly staffed facilities cut first.

Nursing staff turnoverShare of nursing staff who left within a year · lower is better52%Above 63% of peersMO avg57%RN turnover
What is nursing staff turnover?

The share of nursing staff who left within the past year, from the same payroll data.

Why it matters

High turnover means residents are cared for by people who do not know them, and it is one of the strongest predictors of inspection problems.

Fines in the last three yearsCivil money penalties imposed by CMS · lower is better$19,991Above only 33% of peersMO avg$37,310Fines · denials2 · 0
What is fines in the last three years?

Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.

Why it matters

Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.

Inspection history

Last three inspection cycles
30citations
6inspection dates
1actual harm (G–I)
0immediate jeopardy (J–L)
Jan 5, 2024most recent

Citations by monthApr 2019 – Jan 2024

  • No actual harm (D–F)
  • Actual harm (G–I)
  • Immediate jeopardy (J–L)
  • $Fine or payment denial

Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.

Jan 5, 20246 citationsCycle 3worst D · no actual harm
  1. F677Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and CareD · isolatedCorrected Feb 8, 2024
  2. F728Ensure that nurse aides who have worked more than 4 months, are trained and competent; and nurse aides who have worked less than 4 months are enrolled in appropriate training.Nursing and Physician ServicesD · isolatedCorrected Feb 8, 2024
  3. F880Provide and implement an infection prevention and control program.Infection ControlD · isolatedCorrected Feb 8, 2024
  4. F557Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.Resident RightsD · isolatedCorrected Feb 8, 2024
  5. F602Protect each resident from the wrongful use of the resident's belongings or money.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Feb 8, 2024
  6. F658Ensure services provided by the nursing facility meet professional standards of quality.Resident Assessment and Care PlanningD · isolatedCorrected Feb 8, 2024
Nov 17, 202316 citationsCycle 1worst F · no actual harm
  1. F637Assess the resident when there is a significant change in conditionResident Assessment and Care PlanningD · isolatedCorrected Jan 1, 2024
  2. F658Ensure services provided by the nursing facility meet professional standards of quality.Resident Assessment and Care PlanningD · isolatedCorrected Feb 8, 2024
  3. F677Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and CareD · isolatedCorrected Feb 8, 2024
  4. F686Provide appropriate pressure ulcer care and prevent new ulcers from developing.Quality of Life and CareD · isolatedCorrected Jan 1, 2024
  5. F692Provide enough food/fluids to maintain a resident's health.Quality of Life and CareD · isolatedCorrected Jan 1, 2024
  6. F728Ensure that nurse aides who have worked more than 4 months, are trained and competent; and nurse aides who have worked less than 4 months are enrolled in appropriate training.Nursing and Physician ServicesD · isolatedCorrected Feb 8, 2024
  7. F756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.Pharmacy ServiceD · isolatedCorrected Jan 1, 2024
  8. F758Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.Pharmacy ServiceD · isolatedCorrected Jan 1, 2024
  9. F865Have a plan that describes the process for conducting QAPI and QAA activities.AdministrationF · widespreadCorrected Jan 1, 2024
  10. F880Provide and implement an infection prevention and control program.Infection ControlF · widespreadCorrected Feb 8, 2024
  11. F881Implement a program that monitors antibiotic use.Infection ControlF · widespreadCorrected Jan 1, 2024
  12. F883Develop and implement policies and procedures for flu and pneumonia vaccinations.Infection ControlE · patternCorrected Jan 1, 2024
  13. F557Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.Resident RightsD · isolatedCorrected Feb 8, 2024
  14. F602Protect each resident from the wrongful use of the resident's belongings or money.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Nov 17, 2023
  15. F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Jan 1, 2024
  16. F641Ensure each resident receives an accurate assessment.Resident Assessment and Care PlanningE · patternCorrected Jan 1, 2024
Jun 13, 20231 citationCycle 3worst G · actual harm$12,649
  1. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareG · isolatedCorrected Jul 14, 2023
Feb 9, 20231 citationCycle 3worst D · no actual harm
  1. F686Provide appropriate pressure ulcer care and prevent new ulcers from developing.Quality of Life and CareD · isolatedCorrected Mar 10, 2023
May 21, 20215 citationsCycle 2worst E · no actual harm
  1. Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.Resident RightsE · patternCorrected Jun 23, 2021
  2. Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.Nutrition and DietaryE · patternCorrected Jun 23, 2021
  3. F623Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.Resident RightsE · patternCorrected Jun 23, 2021
  4. F679Provide activities to meet all resident's needs.Quality of Life and CareE · patternCorrected Jun 23, 2021
  5. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareE · patternCorrected Jun 23, 2021
Apr 11, 20191 citationCycle 3worst E · no actual harm
  1. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareE · patternCorrected May 25, 2019

Staffing

From quarterly payroll reports

Hours per resident per day

  • All nursing staffRNs, LPNs and aides combined3.51hrsAbove 59% of peers+0.04 vs MO avg
  • Registered nursesRN hours only0.47hrsAbove 64% of peers+0.01 vs MO avg
  • Licensed practical nursesLPN hours0.81hrs
  • Nurse aidesCNA hours2.23hrs
  • Weekend nursingAll staff on Saturdays and Sundays3.06hrs
  • Missouri average
  • Research benchmark (4.10 total, 0.75 RN)

Turnover & capacity

  • Nursing staff turnoverShare who left within a year · lower is better52%Above 63% of peersMO avg 57%
  • RN turnoverRegistered nurses onlyNot ranked by CMS
  • Administrators who leftIn the past year0Stable leadership
  • Occupancy118 certified beds · ~44 residents a day38%Above only 2% of peersMO avg 72%

Fines & penalties

Roughly the past three years

Enforcement summary

  • $19,991In fines
  • 2Fines
  • 0Payment denials
  • $37,310MO avg in fines
Above only 33% of peersFewer fines than 33% of rated homes in Missouri

Actions on record

  1. Jul 17, 2023Civil money penalty$7,342
  2. Jun 13, 2023Civil money penalty$12,649

Ownership

As filed with CMS

Structure

Ownership type
Government - County
Chain
Independent
Certification
Medicare and Medicaid
Location type
Rural
Ownership change
None in the last 12 months

People and entities on file

Operational or managerial control
  • Lewis County Nursing Home District
  • Michelle Nichols
Corporate directors
  • Gregory Collier
  • Karen Lasswell
  • Frances Spratt
  • Vicki Stiffey
Corporate officers
  • Naydene Berhorst
  • Susan Long

Person Organization

Sources & notes

Public data, updated quarterly

Data sources

  • CMS Care Compare · Provider InformationStar ratings, staffing hours, turnover, penalties and flags · processed February 2026.
  • CMS Health CitationsEvery deficiency from the last three inspection cycles, with scope, severity and inspection cycle.
  • CMS Penalties and Ownership filesCivil money penalties, payment denials, and the owners and managers on file.

Notes

  • CMS Certification Number 265360 · 17528 STATE HIGHWAY 81, CANTON, MO, 63435.
  • Percentiles compare this facility with every rated nursing home in Missouri and Lewis County. Turnover and fines are inverted so a high percentile is always good.
  • This is an informational summary of public data, not medical, legal, or placement advice. Facilities cannot pay to change it; a facility that believes a record is wrong can dispute it with CMS.

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