Map showing the location of GRAND RIVER HEALTH CARE in CHILLICOTHE, Missouri
118 TRENTON ROAD, CHILLICOTHE, MO, 64601

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 star4★+1.3 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.

  • Abuse citation flagCMS shows an abuse icon: inspectors cited the facility for abuse that led to harm within the past year, or for abuse that could have led to harm in each of the last two years.

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 assessments4★Above 71% 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 staff2.96hrsAbove only 22% 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 only0.77hrsTop 7%MO 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 better85%Above only 3% of peersMO avg57%RN turnover57%
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$63,001Above only 19% of peersMO avg$37,310Fines · denials2 · 2
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
58citations
8inspection dates
3actual harm (G–I)
0immediate jeopardy (J–L)
Nov 21, 2025most recent

Citations by monthFeb 2021 – Jan 2026

  • 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.

Nov 21, 20251 citationCycle 1worst D · no actual harm
  1. F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Nov 30, 2025
Mar 25, 20253 citationsCycle 1worst G · actual harm
  1. F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.Freedom from Abuse, Neglect, and ExploitationG · isolatedCorrected Apr 22, 2025
  2. F602Protect each resident from the wrongful use of the resident's belongings or money.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Apr 22, 2025
  3. F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Apr 22, 2025
Feb 27, 202515 citationsCycle 1worst F · no actual harm
  1. F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Apr 7, 2025
  2. F692Provide enough food/fluids to maintain a resident's health.Quality of Life and CareE · patternCorrected Apr 7, 2025
  3. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareD · isolatedCorrected Apr 7, 2025
  4. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryF · widespreadCorrected Apr 7, 2025
  5. F558Reasonably accommodate the needs and preferences of each resident.Resident RightsE · patternCorrected Apr 7, 2025
  6. F561Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.Resident RightsE · patternCorrected Apr 7, 2025
  7. F567Honor the resident's right to manage his or her financial affairs.Resident RightsE · patternCorrected Apr 7, 2025
  8. F584Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.Resident RightsE · patternCorrected Apr 7, 2025
  9. F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.Resident Assessment and Care PlanningE · patternCorrected Apr 7, 2025
  10. F658Ensure services provided by the nursing facility meet professional standards of quality.Resident Assessment and Care PlanningE · patternCorrected Apr 7, 2025
  11. F695Provide safe and appropriate respiratory care for a resident when needed.Quality of Life and CareE · patternCorrected Apr 7, 2025
  12. F759Ensure medication error rates are not 5 percent or greater.Pharmacy ServiceE · patternCorrected Apr 7, 2025
  13. F761Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.Pharmacy ServiceE · patternCorrected Apr 7, 2025
  14. F880Provide and implement an infection prevention and control program.Infection ControlE · patternCorrected Apr 7, 2025
  15. F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Resident RightsE · patternCorrected Apr 7, 2025
Dec 16, 20241 citationCycle 2worst G · actual harm$26,611, payment denial
  1. F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.Freedom from Abuse, Neglect, and ExploitationG · isolatedCorrected Jan 10, 2025
Dec 5, 20242 citationsCycle 2worst G · actual harm$26,611, payment denial
  1. F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Dec 27, 2024
  2. F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.Freedom from Abuse, Neglect, and ExploitationG · isolatedCorrected Dec 27, 2024
Sep 11, 20242 citationsCycle 2worst D · no actual harm
  1. F604Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Oct 11, 2024
  2. F740Ensure each resident must receive and the facility must provide necessary behavioral health care and services.Quality of Life and CareD · isolatedCorrected Oct 11, 2024
Apr 24, 202314 citationsCycle 2worst F · no actual harmpayment denial
  1. F761Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.Pharmacy ServiceE · patternCorrected Jun 6, 2023
  2. F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Resident RightsE · patternCorrected Jun 6, 2023
  3. F576Ensure residents have reasonable access to and privacy in their use of communication methods.Resident RightsE · patternCorrected Jun 6, 2023
  4. F578Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.Resident RightsD · isolatedCorrected Jun 6, 2023
  5. F623Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.Resident RightsD · isolatedCorrected Jun 6, 2023
  6. F677Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and CareE · patternCorrected Jun 6, 2023
  7. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareD · isolatedCorrected Jun 6, 2023
  8. F693Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.Quality of Life and CareD · isolatedCorrected Jul 27, 2023
  9. F756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.Pharmacy ServiceE · patternCorrected Jun 6, 2023
  10. F759Ensure medication error rates are not 5 percent or greater.Pharmacy ServiceE · patternCorrected Jun 6, 2023
  11. F760Ensure that residents are free from significant medication errors.Pharmacy ServiceE · patternCorrected Jun 6, 2023
  12. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryF · widespreadCorrected Jun 6, 2023
  13. F880Provide and implement an infection prevention and control program.Infection ControlE · patternCorrected Jul 27, 2023
  14. F881Implement a program that monitors antibiotic use.Infection ControlE · patternCorrected Jun 6, 2023
Feb 10, 202120 citationsCycle 3worst E · no actual harm
  1. F908Keep all essential equipment working safely.EnvironmentalD · isolatedCorrected Mar 6, 2021
  2. F921Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.EnvironmentalD · isolatedCorrected Mar 6, 2021
  3. F565Honor the resident's right to organize and participate in resident/family groups in the facility.Resident RightsE · patternCorrected May 18, 2021
  4. F580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.Resident RightsD · isolatedCorrected Mar 6, 2021
  5. F585Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.Resident RightsE · patternCorrected May 18, 2021
  6. F623Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.Resident RightsD · isolatedCorrected May 18, 2021
  7. F658Ensure services provided by the nursing facility meet professional standards of quality.Resident Assessment and Care PlanningD · isolatedCorrected Mar 6, 2021
  8. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareE · patternCorrected Mar 6, 2021
  9. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareD · isolatedCorrected Mar 6, 2021
  10. F692Provide enough food/fluids to maintain a resident's health.Quality of Life and CareE · patternCorrected May 18, 2021
  11. F695Provide safe and appropriate respiratory care for a resident when needed.Quality of Life and CareD · isolatedCorrected Mar 6, 2021
  12. 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 Mar 6, 2021
  13. F759Ensure medication error rates are not 5 percent or greater.Pharmacy ServiceD · isolatedCorrected Mar 6, 2021
  14. F761Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.Pharmacy ServiceD · isolatedCorrected Mar 6, 2021
  15. F800Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.Nutrition and DietaryD · isolatedCorrected Mar 6, 2021
  16. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryD · isolatedCorrected Mar 6, 2021
  17. F813Have a policy regarding use and storage of foods brought to residents by family and other visitors.Nutrition and DietaryD · isolatedCorrected Mar 6, 2021
  18. F825Provide or get specialized rehabilitative services as required for a resident.Quality of Life and CareD · isolatedCorrected Mar 6, 2021
  19. 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 RightsD · isolatedCorrected May 18, 2021
  20. F880Provide and implement an infection prevention and control program.Infection ControlE · patternCorrected Mar 6, 2021

Staffing

From quarterly payroll reports

Hours per resident per day

  • All nursing staffRNs, LPNs and aides combined2.96hrsAbove only 22% of peers−0.51 vs MO avg
  • Registered nursesRN hours only0.77hrsTop 7%+0.31 vs MO avg
  • Licensed practical nursesLPN hours0.38hrs
  • Nurse aidesCNA hours1.81hrs
  • Weekend nursingAll staff on Saturdays and Sundays2.74hrs
  • Missouri average
  • Research benchmark (4.10 total, 0.75 RN)

Turnover & capacity

  • Nursing staff turnoverShare who left within a year · lower is better85%Above only 3% of peersMO avg 57%
  • RN turnoverRegistered nurses only57%Not ranked by CMS
  • Administrators who leftIn the past year1Leadership changed
  • Occupancy60 certified beds · ~28 residents a day47%Above only 9% of peersMO avg 72%

Fines & penalties

Roughly the past three years

Enforcement summary

  • $63,001In fines
  • 2Fines
  • 2Payment denials
  • $37,310MO avg in fines
Above only 19% of peersFewer fines than 19% of rated homes in Missouri

Actions on record

  1. Jan 9, 2026Civil money penalty$36,390
  2. Dec 5, 2024Civil money penalty$26,611
  3. Dec 5, 2024Denial of payment for new admissionsfrom Jan 8, 2025
  4. Apr 24, 2023Denial of payment for new admissionsfrom Jul 24, 2023

Ownership

As filed with CMS

Structure

Ownership type
For profit - Corporation
Chain
James & Judy Lincoln58 facilities in the chain2.6★ chain average
Certification
Medicare and Medicaid
Location type
Rural
Ownership change
None in the last 12 months

People and entities on file

Direct owners (5%+)
  • James Lincoln
  • Judy Lincoln
Operational or managerial control
  • N & R of Chillicothe, INC.
Corporate directors
  • Gary Crane
Corporate officers
  • Timothy Drake
  • Charlotte Stutts
Managing employees
  • Kent Lauhoff

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 265480 · 118 TRENTON ROAD, CHILLICOTHE, MO, 64601.
  • Percentiles compare this facility with every rated nursing home in Missouri and Livingston 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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