Federal inspection record · CMS data as of October 1, 2026
Lincoln County Nursing & Rehab
1145 East Cherry Street, Troy, MO · (636) 528-5712
- Cited for abuse (CMS abuse icon)
- Special Focus Facility
- Certified beds
- 90
- Residents per day
- 81
- Ownership
- For-Profit
- Chain
- James & Judy Lincoln
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- June 26, 1990
3
What inspectors found
111 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.
Harm and immediate-jeopardy citations (9)
-
G
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
-
H
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
G
Provide safe, appropriate pain management for a resident who requires such services.
-
G
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.
-
G
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
-
G
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
-
G
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
-
J
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
-
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
Quality of Life and Care19F
- E
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide enough food/fluids to maintain a resident's health.
- D
Provide care or services that was trauma informed and/or culturally competent.
- D
Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
- E
Provide care and assistance to perform activities of daily living for any resident who is unable.
- F
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
- F
Ensure the activities program is directed by a qualified professional.
- E
Provide care and assistance to perform activities of daily living for any resident who is unable.
- E
Provide activities to meet all resident's needs.
- E
Provide appropriate foot care.
- E
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.
- E
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
- 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 safe and appropriate respiratory care for a resident when needed.
- D
Provide or get specialized rehabilitative services as required for a resident.
- E
Provide care and assistance to perform activities of daily living for any resident who is unable.
- E
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- D
Provide enough food/fluids to maintain a resident's health.
- D
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Resident Rights17F
- E
Ensure residents have reasonable access to and privacy in their use of communication methods.
- 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
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- F
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 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
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- D
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
- C
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
- C
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
- C
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.
- E
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her 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 a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
- C
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
- C
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.
Nursing and Physician Services15F
- F
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.
- E
Ensure 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.
- E
Observe each nurse aide's job performance and give regular training.
- E
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
- F
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
- F
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.
- F
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.
- F
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
- E
Ensure 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.
- E
Observe each nurse aide's job performance and give regular training.
- C
Post nurse staffing information every day.
- E
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
- F
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.
- E
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
- F
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.
Resident Assessment and Care Planning12E
- E
Ensure services provided by the nursing facility meet professional standards of quality.
- E
Assess the resident when there is a significant change in condition
- 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.
- E
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Ensure each resident receives an accurate assessment.
- D
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
- E
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
- E
Assure that each resident’s assessment is updated at least once every 3 months.
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Assess the resident when there is a significant change in condition
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Nutrition and Dietary9F
- 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.
- F
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
- 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.
- F
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
- 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.
- E
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Administration9F
- F
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
- F
Have a plan that describes the process for conducting QAPI and QAA activities.
- F
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
- F
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
- F
Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
- F
Provide behavior health training consistent with the requirements and as determined by a facility assessment.
- C
Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse.
- F
Have a plan that describes the process for conducting QAPI and QAA activities.
- F
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Pharmacy Service8E
- 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 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
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 each resident’s drug regimen must be free from unnecessary drugs.
- 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.
- E
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Infection Control8F
- E
Provide and implement an infection prevention and control program.
- F
Provide and implement an infection prevention and control program.
- F
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
- F
Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program.
- E
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
Provide and implement an infection prevention and control program.
- E
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Freedom from Abuse, Neglect, and Exploitation3E
- D
Respond appropriately to all alleged violations.
- D
Respond appropriately to all alleged violations.
- E
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Environmental2E
- E
Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame.
- E
Put firmly secured handrails on each side of hallways.
Inspection history
2026-04-16
16 health deficiencies · 12 fire-safety deficiencies
Top issue: Quality of Life and Care (4 deficiencies)
2024-05-23
58 health deficiencies · 21 fire-safety deficiencies
Top issue: Quality of Life and Care (13 deficiencies)
2022-10-27
37 health deficiencies · 16 fire-safety deficiencies
Top issue: Quality of Life and Care (9 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 2 h 27 min of nursing staff time a day, 11 min of it from a registered nurse.
This home
2 h 27 min
Missouri average
3 h 24 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 67% of nursing staff and 80% of registered nurses left in the past year.
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
$259,609 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2026-04-16 | Fine | $24,195 |
| 2026-04-16 | Payment Denial · 3 day denial | $0 |
| 2024-05-23 | Fine | $151,801 |
| 2024-05-23 | Payment Denial · 21 day denial | $0 |
| 2024-03-29 | Fine | $30,641 |
| 2023-10-17 | Fine | $52,972 |
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 vaccine3 pts worse | 81.0% | 84.0% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine9.2 pts better | 100.0% | 90.8% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury2.9 pts worse | 6.9% | 4.0% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms17.5 pts better | 2.5% | 20.0% | 13.5% |
| Percentage of long-stay residents who lose too much weight4 pts better | 1.1% | 5.1% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication2.6 pts worse | 28.2% | 25.6% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication5.4 pts better | 18.1% | 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 worsened8.8 pts better | 7.0% | 15.8% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased0.5 pts better | 16.9% | 17.4% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.2 pts worse | 1.1% | 0.9% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection0.2 pts worse | 2.4% | 2.2% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence6.3 pts better | 10.8% | 17.1% | 18.3% |
| Percentage of long-stay residents with pressure ulcers4.5 pts worse | 8.9% | 4.4% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine3.7 pts worse | 62.0% | 65.7% | 82.3% |
| Percentage of short-stay residents who newly received an antipsychotic medication0.7 pts worse | 2.8% | 2.1% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine8.4 pts better | 69.8% | 61.4% | 80.1% |
·
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 |
|---|---|---|---|
| Lincoln, James | 5% Or Greater Direct Ownership Interest · Individual | 50% | 53 facilities |
| Lincoln, Judy | 5% Or Greater Direct Ownership Interest · Individual | 50% | 52 facilities |
| Brick, Julie | W-2 Managing Employee · Individual | 0% | 1 facilities |
| N & R Of Lincoln County, Inc. | Operational/Managerial Control · Organization | 0% | 1 facilities |
·
Fire safety
49 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke17F
- F
Inspect, test, and maintain automatic sprinkler systems.
- E
Have an enclosure around a vertical opening shaft.
- E
Provide properly protected cooking facilities.
- E
Install corridor and hallway doors that block smoke.
- 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.
- F
Properly select, install, inspect, or maintain portable fire extinguishes.
- F
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- 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
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
Have approved installation, maintenance and testing program for fire alarm systems.
- E
Provide properly protected cooking facilities.
- E
Inspect, test, and maintain automatic sprinkler systems.
- E
Install corridor and hallway doors that block smoke.
Gas, Vacuum, and Electrical Systems11F
- F
Meet requirements for the use of electrical equipment.
- E
Ensure proper usage of power strips and extension cords.
- F
Have generator or other power source capable of supplying service within 10 seconds.
- F
Meet requirements for the use of electrical equipment.
- F
Ensure that testing and maintenance of electrical equipment is performed.
- E
Ensure proper usage of power strips and extension cords.
- E
Have proper medical gas storage and administration areas.
- E
Ensure that personnel concerned with handling of medical gases and cylinders are trained on the risk.
- F
Ensure that testing and maintenance of electrical equipment is performed.
- E
Ensure proper usage of power strips and extension cords.
- E
Have proper medical gas storage and administration areas.
Egress9F
- 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
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- E
Install proper backup exit lighting.
- E
Have properly located and lighted "Exit" signs.
- F
Install emergency lighting that can last at least 1 1/2 hours.
- 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 properly located and lighted "Exit" signs.
- 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
Install emergency lighting that can last at least 1 1/2 hours.
Emergency Preparedness6F
- F
Establish staff and initial training requirements.
- F
Conduct testing and exercise requirements.
- F
Establish policies and procedures including evacuation.
- F
Establish policies and procedures for volunteers.
- F
Provide a means of sharing information on occupancy/needs.
- F
Address patient/client population and determine types of services needed.
Miscellaneous4F
- 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.
- F
Have simulated fire drills held at unexpected times.
- F
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Construction2E
- E
Meet other general requirements.
- E
Meet other general requirements.
·
Other homes nearby
-
Troy Manor
Troy, MO · James & Judy Lincoln
★★★★★- Worst citation, 3 yrs
- K
- Nursing / resident / day
- 2 h 28 min
- Fines
- $104,685
-
Elsberry Missouri Health Care Center
Elsberry, MO
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 3 h 21 min
- Fines
- $28,704
-
Warrenton Manor
Wright City, MO · James & Judy Lincoln
★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
- 2 h 59 min
- Fines
- $0