Federal inspection record · CMS data as of October 1, 2026
Heritage Care Center
4401 North Hanley Road, Saint Louis, MO · (314) 521-7471
- Cited for abuse (CMS abuse icon)
- Special Focus Facility
- Certified beds
- 120
- Residents per day
- 103
- Ownership
- For-Profit
- Chain
- Reliant Care Management
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- June 21, 1993
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.
-
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
Heritage Care Center carries 429.75 inspection points. That is fewer than 2% 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
94 health citations on record since 2019. 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 (15)
-
J
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
J
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
G
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
-
J
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
G
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
-
G
Protect each resident from separation (from other residents, his/her room, or confinement to his/her room).
-
J
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
J
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
J
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
J
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
-
J
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
-
J
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
J
Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder.
-
J
Provide and implement an infection prevention and control program.
-
G
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Everything else, by area of care
Resident Rights21E
- D
Not prohibit or in any way discourage a resident from communicating with federal, state, or local officials.
- E
Honor the resident's right to choose his or her attending physician.
- 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
Reasonably accommodate the needs and preferences of each resident.
- D
Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.
- D
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
- E
Ensure residents have reasonable access to and privacy in their use of communication methods.
- D
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
- E
Ensure residents have reasonable access to and privacy in their use of communication methods.
- 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 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 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 manage his or her financial affairs.
- E
Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.
- E
Assure the security of all personal funds of residents deposited with the facility.
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- D
Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.
- D
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
- D
Let each resident or the resident's legal representative access or purchase copies of all the resident's records.
- 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.
Freedom from Abuse, Neglect, and Exploitation13D
- D
Respond appropriately to all alleged violations.
- 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
Respond appropriately to all alleged violations.
- D
Respond appropriately to all alleged violations.
- 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 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
Respond appropriately to all alleged violations.
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Respond appropriately to all alleged violations.
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Respond appropriately to all alleged violations.
Quality of Life and Care13D
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide safe, appropriate pain management for a resident who requires such services.
- D
Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents.
- D
Provide safe, appropriate pain management for a resident who requires such services.
- D
Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents.
- D
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
- D
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- D
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- D
Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services.
- D
Provide safe and appropriate respiratory care for a resident when needed.
- D
Provide safe, appropriate dialysis care/services for a resident who requires such services.
- D
Provide medically-related social services to help each resident achieve the highest possible quality of life.
Pharmacy Service9E
- E
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
- D
Ensure that residents are free from significant medication errors.
- 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.
- D
Ensure medication error rates are not 5 percent or greater.
- D
Ensure that residents are free from significant medication errors.
- E
Ensure medication error rates are not 5 percent or greater.
- 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
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 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.
Resident Assessment and Care Planning9E
- D
Ensure each resident receives an accurate assessment.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Ensure each resident receives an accurate assessment.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Infection Control6F
- F
Provide and implement an infection prevention and control program.
- F
Implement a program that monitors antibiotic use.
- F
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
- E
Develop and implement policies and procedures for flu and pneumonia vaccinations.
- E
Provide and implement an infection prevention and control program.
- F
Provide and implement an infection prevention and control program.
Administration2F
- F
Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
- F
Have a plan that describes the process for conducting QAPI and QAA activities.
Nursing and Physician Services2E
- E
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
- D
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Environmental2F
- E
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
- F
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Nutrition and Dietary2F
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Inspection history
2025-09-09
24 health deficiencies · 8 fire-safety deficiencies
Top issue: Resident Rights (6 deficiencies)
2023-09-29
41 health deficiencies · 3 fire-safety deficiencies
Top issue: Quality of Life and Care (13 deficiencies)
2019-07-26
29 health deficiencies · 13 fire-safety deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (8 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 1 h 35 min of nursing staff time a day, 5 min of it from a registered nurse.
This home
1 h 35 min
Missouri average
3 h 24 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 74% of nursing staff and 88% of registered nurses left in the past year, along with 1 administrator.
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
$369,383 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2026-02-17 | Fine | $52,930 |
| 2025-03-14 | Fine | $146,162 |
| 2025-03-14 | Payment Denial · 99 day denial | $0 |
| 2024-12-26 | Fine | $108,179 |
| 2024-06-14 | Fine | $16,801 |
| 2023-12-12 | Fine | $45,311 |
| 2023-12-12 | Payment Denial · 60 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. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.5 pts worse | 2.5 | 2.0 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.4 pts better | 1.8 | 2.2 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine22.9 pts worse | 61.1% | 84.0% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine4.7 pts better | 95.5% | 90.8% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury3.3 pts better | 0.7% | 4.0% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms53.3 pts worse | 73.3% | 20.0% | 13.5% |
| Percentage of long-stay residents who lose too much weight2 pts worse | 7.1% | 5.1% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication4.8 pts worse | 30.4% | 25.6% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication30.6 pts worse | 54.1% | 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 worsened4 pts better | 11.8% | 15.8% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased1.7 pts better | 15.7% | 17.4% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.7 pts better | 0.2% | 0.9% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection2.2 pts better | 0.0% | 2.2% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence6.1 pts better | 11.0% | 17.1% | 18.3% |
| Percentage of long-stay residents with pressure ulcers3.1 pts better | 1.3% | 4.4% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine39.3 pts worse | 26.4% | 65.7% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit11.4 pts better | 2.0% | 13.4% | 11.8% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission4.7 pts better | 21.0% | 25.7% | 23.4% |
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Who owns and runs it
4 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 |
|---|---|---|---|
| Atkins, Monica | W-2 Managing Employee · Individual | 0% | 1 facilities |
| Destefane, Richard | Corporate Director · Individual | 0% | 35 facilities |
| Destefane, Richard | Corporate Officer · Individual | 0% | 35 facilities |
| Reliant Care Management Company LLC | Operational/Managerial Control · Organization | 0% | 35 facilities |
·
Fire safety
24 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke7F
- E
Inspect, test, and maintain automatic sprinkler systems.
- E
Properly select, install, inspect, or maintain portable fire extinguishes.
- F
Provide properly protected cooking facilities.
- F
Have approved installation, maintenance and testing program for fire alarm systems.
- 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.
- E
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Gas, Vacuum, and Electrical Systems5F
- E
Have proper medical gas storage and administration areas.
- F
Ensure proper usage of power strips and extension cords.
- F
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- F
Meet requirements for the use of electrical equipment.
- E
Have proper medical gas storage and administration areas.
Emergency Preparedness4F
- F
List the names and contact information of those in the facility.
- F
Implement emergency and standby power systems.
- F
Establish staff and initial training requirements.
- F
Develop and maintain an Emergency Preparedness Program (EP).
Egress3F
- F
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- 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.
Services2E
- E
Have properly installed electrical wiring and gas equipment.
- E
Have properly installed electrical wiring and gas equipment.
Miscellaneous2E
- E
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.
Construction1E
- E
Use approved construction type or materials.
·
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- E
- Nursing / resident / day
- 2 h 38 min
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- $0
-
Oak Knoll Skilled Nursing & Rehabilitation Center
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- E
- Nursing / resident / day
- 2 h 58 min
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-
St Johns Place
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- F
- Nursing / resident / day
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