Federal inspection record · CMS data as of October 1, 2026
Butler Rehab And Healthcare Center
416 S High Street, Butler, MO · (660) 679-6158
- Certified beds
- 98
- Residents per day
- 59
- Ownership
- For-Profit
- Chain
- Ama Holdings
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- March 11, 1985
1
How this home got 1 star
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Missouri.
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Staffing
★★★★★−1 star
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
-
Quality measures
★★★★★−1 star
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
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Overall
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Missouri homes
Butler Rehab And Healthcare Center carries 74 inspection points. That is fewer than 53% of Missouri's 479 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Missouri: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–20 pts
- 4★ 20–54 pts
- 3★ 54–93.75 pts
- 2★ 93.75–159 pts
- 1★ over 159 pts
Bars show every rated home in Missouri by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
35 health citations on record since 2022. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
No citation on record at the harm or immediate-jeopardy level.
Everything else, by area of care
Resident Rights10E
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- E
Honor 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.
- D
Allow residents to self-administer drugs if determined clinically appropriate.
- D
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
- D
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
- E
Ensure that residents are fully informed and understand their health status, care and treatments.
- D
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
- D
Honor 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.
- D
Honor 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.
- D
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Quality of Life and Care8D
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services.
- D
Ensure 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.
- D
Provide safe and appropriate respiratory care for a resident when needed.
- D
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
- D
Provide or obtain dental services for each resident.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
Resident Assessment and Care Planning4E
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- E
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Nutrition and Dietary3F
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- D
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- D
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Infection Control3E
- E
Provide and implement an infection prevention and control program.
- E
Provide and implement an infection prevention and control program.
- E
Provide and implement an infection prevention and control program.
Freedom from Abuse, Neglect, and Exploitation3E
- D
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
- D
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
- E
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Pharmacy Service2E
- D
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
- E
Implement 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.
Nursing and Physician Services1E
- E
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
Environmental1F
- F
Provide enough power supply for lighting all entrances and exits; equipment for fire detection and alarm systems, and extinguishers.
Inspection history
2026-02-27
15 health deficiencies · 14 fire-safety deficiencies
Top issue: Resident Rights (5 deficiencies)
2024-04-05
10 health deficiencies · 2 fire-safety deficiencies
Top issue: Resident Rights (3 deficiencies)
2022-08-05
10 health deficiencies · 5 fire-safety deficiencies
Top issue: Quality of Life and Care (2 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 32 min of nursing staff time a day, 21 min of it from a registered nurse.
This home
3 h 32 min
Missouri average
3 h 24 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 72% of nursing staff and 67% of registered nurses left in the past year, along with 2 administrators.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days1.4 pts worse | 3.4 | 2.0 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days1.6 pts worse | 3.8 | 2.2 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine0.9 pts worse | 83.1% | 84.0% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine14.9 pts worse | 75.9% | 90.8% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury0.1 pts better | 3.9% | 4.0% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms64.2 pts worse | 84.2% | 20.0% | 13.5% |
| Percentage of long-stay residents who lose too much weight3.3 pts better | 1.8% | 5.1% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication9.4 pts worse | 35.0% | 25.6% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication7 pts better | 16.5% | 23.5% | 15.4% |
| Percentage of long-stay residents who were physically restrainedAbout the same | 0.0% | 0.0% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened8.2 pts better | 7.6% | 15.8% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased12 pts better | 5.4% | 17.4% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.9 pts better | 0.0% | 0.9% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection1.7 pts better | 0.5% | 2.2% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence5.1 pts better | 12.0% | 17.1% | 18.3% |
| Percentage of long-stay residents with pressure ulcers1.7 pts worse | 6.1% | 4.4% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine37.4 pts worse | 28.3% | 65.7% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visitAbout the same | 13.4% | 13.4% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication0.1 pts worse | 2.2% | 2.1% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine55.8 pts worse | 5.6% | 61.4% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission13.4 pts worse | 39.1% | 25.7% | 23.4% |
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Who owns and runs it
15 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Butler Holdco LLC | 5% Or Greater Direct Ownership Interest · Organization | 100% | 1 facilities |
| Ama Holdings LLC | 5% Or Greater Indirect Ownership Interest · Organization | 0% | 13 facilities |
| Butler Manager LLC | 5% Or Greater Indirect Ownership Interest · Organization | 0% | 1 facilities |
| Butler Partners LLC | 5% Or Greater Indirect Ownership Interest · Organization | 0% | 1 facilities |
| Def Holdings LLC | 5% Or Greater Indirect Ownership Interest · Organization | 0% | 13 facilities |
| Excel Ntad LLC | 5% Or Greater Indirect Ownership Interest · Organization | 0% | 1 facilities |
| Leffert, Joyce | W-2 Managing Employee · Individual | 0% | 1 facilities |
| Marx, Asher | 5% Or Greater Indirect Ownership Interest · Individual | 0% | 13 facilities |
| Marx, Asher | Corporate Director · Individual | 0% | 13 facilities |
| Marx, Asher | Operational/Managerial Control · Individual | 0% | 13 facilities |
| Mo Butler LLC | 5% Or Greater Indirect Ownership Interest · Organization | 0% | 1 facilities |
| Treitel, Nassan | 5% Or Greater Indirect Ownership Interest · Individual | 0% | 2 facilities |
| Wolf, Jacques | 5% Or Greater Indirect Ownership Interest · Individual | 0% | 13 facilities |
| Wolf, Jacques | Corporate Director · Individual | 0% | 13 facilities |
| Wolf, Jacques | Operational/Managerial Control · Individual | 0% | 13 facilities |
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Fire safety
21 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Emergency Preparedness5F
- F
Address subsistence needs for staff and patients.
- F
Establish policies and procedures including evacuation.
- F
Develop and maintain an Emergency Preparedness Program (EP).
- E
Address patient/client population and determine types of services needed.
- F
Address subsistence needs for staff and patients.
Smoke5F
- E
Inspect, test, and maintain automatic sprinkler systems.
- E
Install corridor and hallway doors that block smoke.
- E
Install smoke barrier doors that can resist smoke for at least 20 minutes.
- F
Inspect, test, and maintain automatic sprinkler systems.
- F
Install corridor and hallway doors that block smoke.
Egress4E
- E
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- E
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
- E
Have exits that are accessible at all times.
- E
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Gas, Vacuum, and Electrical Systems3F
- F
Meet requirements for the installation and maintenance of electrical systems.
- E
Meet requirements for the use of electrical equipment.
- F
Have generator or other power source capable of supplying service within 10 seconds.
Miscellaneous3F
- D
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
- E
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
- F
Have simulated fire drills held at unexpected times.
Construction1E
- E
Use approved construction type or materials.
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Other homes nearby
-
Ml Op Butler LLC
Butler, MO · Medicalodges, Inc.
★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
- 3 h 40 min
- Fines
- $0
-
Baptist Homes Of Adrian
Adrian, MO
★★★★★- Worst citation, 3 yrs
- E
- Nursing / resident / day
- 3 h 14 min
- Fines
- $0
-
Appleton City Manor
Appleton City, MO
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 3 h 11 min
- Fines
- $82,680