Federal inspection record · CMS data as of October 1, 2026
Grand River Health Care
118 Trenton Road, Chillicothe, MO · (660) 646-0353
- Cited for abuse (CMS abuse icon)
- Certified beds
- 60
- Residents per day
- 31
- Ownership
- For-Profit
- Chain
- James & Judy Lincoln
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- January 8, 1992
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.
-
Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Missouri.
-
Staffing
★★★★★no change (already 1)
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
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
-
Overall
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
This home carries CMS's abuse icon, which caps its inspection rating at 2 stars and so its overall rating at 4.
2
Where it sits among Missouri homes
Grand River Health Care carries 221.25 inspection points. That is fewer than 10% 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
60 health citations on record since 2021. 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.
Harm and immediate-jeopardy citations (4)
-
J
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
-
G
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
-
G
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
-
G
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Everything else, by area of care
Resident Rights14E
- E
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- E
Reasonably accommodate the needs and preferences of each resident.
- E
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
- E
Honor the resident's right to manage his or her financial affairs.
- 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.
- E
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- E
Ensure residents have reasonable access to and privacy in their use of communication methods.
- 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
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
- E
Honor the resident's right to organize and participate in resident/family groups in the facility.
- E
Honor 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.
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- D
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
- D
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.
Quality of Life and Care12E
- E
Provide enough food/fluids to maintain a resident's health.
- E
Provide safe and appropriate respiratory care for a resident when needed.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
- E
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- 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.
- E
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- E
Provide enough food/fluids to maintain a resident's health.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide safe and appropriate respiratory care for a resident when needed.
- D
Provide or get specialized rehabilitative services as required for a resident.
Pharmacy Service9E
- E
Ensure medication error rates are not 5 percent or greater.
- E
Ensure 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.
- E
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
- E
Ensure medication error rates are not 5 percent or greater.
- E
Ensure that residents are free from significant medication errors.
- E
Ensure 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.
- D
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.
- D
Ensure medication error rates are not 5 percent or greater.
- D
Ensure 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.
Freedom from Abuse, Neglect, and Exploitation7D
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- D
Protect each resident from the wrongful use of the resident's belongings or money.
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Nutrition and Dietary5F
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- D
Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.
- D
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- D
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
Infection Control4E
- E
Provide and implement an infection prevention and control program.
- E
Provide and implement an infection prevention and control program.
- E
Implement a program that monitors antibiotic use.
- E
Provide and implement an infection prevention and control program.
Resident Assessment and Care Planning3E
- E
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- E
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
Environmental2D
- D
Keep all essential equipment working safely.
- D
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Inspection history
2025-02-27
18 health deficiencies · 11 fire-safety deficiencies
Top issue: Resident Rights (5 deficiencies)
2023-04-24
20 health deficiencies · 12 fire-safety deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (6 deficiencies)
2021-02-10
22 health deficiencies · 13 fire-safety deficiencies
Top issue: Quality of Life and Care (6 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 3 min of nursing staff time a day, 24 min of it from a registered nurse.
This home
3 h 3 min
Missouri average
3 h 24 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 83% of nursing staff and 83% 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
Fines and payment denials
$68,226 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2026-01-09 | Fine | $41,615 |
| 2024-12-05 | Fine | $26,611 |
| 2024-12-05 | Payment Denial · 2 day denial | $0 |
6
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine73.2 pts worse | 10.8% | 84.0% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine7.5 pts worse | 83.3% | 90.8% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury0.4 pts better | 3.6% | 4.0% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms10.8 pts better | 9.2% | 20.0% | 13.5% |
| Percentage of long-stay residents who lose too much weight1 pts better | 4.1% | 5.1% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication17.8 pts worse | 43.4% | 25.6% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication52.4 pts worse | 75.9% | 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 worsened2.8 pts better | 13.0% | 15.8% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased1.1 pts better | 16.3% | 17.4% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.1 pts worse | 1.0% | 0.9% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection1.4 pts worse | 3.6% | 2.2% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence5.1 pts worse | 22.2% | 17.1% | 18.3% |
| Percentage of long-stay residents with pressure ulcers3.3 pts better | 1.1% | 4.4% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine49 pts worse | 16.7% | 65.7% | 82.3% |
·
Who owns and runs it
7 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 |
|---|---|---|---|
| Lincoln, James | 5% Or Greater Direct Ownership Interest · Individual | 50% | 53 facilities |
| Lincoln, Judy | 5% Or Greater Direct Ownership Interest · Individual | 50% | 52 facilities |
| Crane, Gary | Corporate Director · Individual | 0% | 3 facilities |
| Drake, Timothy | Corporate Officer · Individual | 0% | 18 facilities |
| Lauhoff, Kent | W-2 Managing Employee · Individual | 0% | 1 facilities |
| N & R Of Chillicothe, Inc. | Operational/Managerial Control · Organization | 0% | 1 facilities |
| Stutts, Charlotte | Corporate Officer · Individual | 0% | 15 facilities |
·
Fire safety
36 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke16F
- F
Provide properly protected cooking facilities.
- F
Have approved installation, maintenance and testing program for fire alarm systems.
- F
Inspect, test, and maintain automatic sprinkler systems.
- F
Properly select, install, inspect, or maintain portable fire extinguishes.
- E
Have an enclosure around a vertical opening shaft.
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- F
Inspect, test, and maintain automatic sprinkler systems.
- E
Have an enclosure around a vertical opening shaft.
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- E
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- D
Install smoke barrier doors that can resist smoke for at least 20 minutes.
- F
Properly select, install, inspect, or maintain portable fire extinguishes.
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- E
Install an approved automatic sprinkler system.
- E
Inspect, test, and maintain automatic sprinkler systems.
- E
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Egress6F
- F
Have exits that are accessible at all times.
- F
Install emergency lighting that can last at least 1 1/2 hours.
- F
Install emergency lighting that can last at least 1 1/2 hours.
- E
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- F
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
Install emergency lighting that can last at least 1 1/2 hours.
Emergency Preparedness5F
- F
List the names and contact information of those in the facility.
- F
Develop and maintain an Emergency Preparedness Program (EP).
- E
Establish policies and procedures including evacuation.
- F
Conduct testing and exercise requirements.
- E
Develop and maintain an Emergency Preparedness Program (EP).
Construction4E
- E
Use approved construction type or materials.
- D
Meet other general requirements.
- E
Meet other general requirements.
- E
Use approved construction type or materials.
Miscellaneous3F
- F
Have simulated fire drills held at unexpected times.
- F
Have simulated fire drills held at unexpected times.
- E
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Gas, Vacuum, and Electrical Systems2E
- E
Have proper medical gas storage and administration areas.
- E
Have proper medical gas storage and administration areas.
·
Other homes nearby
-
Morningside Center
Chillicothe, MO · Abuse icon
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 3 h 37 min
- Fines
- $0
-
Livingston Manor Care Center
Chillicothe, MO · Juckette Family Homes · Abuse icon
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 2 h 58 min
- Fines
- $149,377
-
Stonebridge Chillicothe
Chillicothe, MO · Stonebridge Senior Living
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 3 h 20 min
- Fines
- $0