Federal inspection record · CMS data as of October 1, 2026
Nathan Richard Health Care Center
700 East Highland Avenue, Nevada, MO · (417) 667-8889
- Certified beds
- 68
- Residents per day
- 62
- Ownership
- For-Profit
- Chain
- Reliant Care Management
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- October 12, 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
★★★★★−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
★★★★★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.
2
Where it sits among Missouri homes
Nathan Richard Health Care Center carries 159 inspection points. That is fewer than 19% 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
38 health citations on record since 2020. 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 (3)
-
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.
-
K
Provide and implement an infection prevention and control program.
Everything else, by area of care
Pharmacy Service8E
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
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 medication error rates are not 5 percent or greater.
- D
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 medication error rates are not 5 percent or greater.
- 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.
Resident Rights5D
- 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
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.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- 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 Care4E
- D
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
- 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.
- 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.
Nutrition and Dietary4F
- 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.
- E
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Infection Control4E
- E
Provide and implement an infection prevention and control program.
- E
Implement a program that monitors antibiotic use.
- D
Develop and implement policies and procedures for flu and pneumonia vaccinations.
- E
Provide and implement an infection prevention and control program.
Resident Assessment and Care Planning4D
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Freedom from Abuse, Neglect, and Exploitation2E
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- E
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Nursing and Physician Services2F
- 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
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
Administration2F
- F
Have an agreement with at least one or more hospitals certified by Medicare or Medicaid to make sure residents can be moved quickly to the hospital when they need medical care.
- C
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.
Inspection history
2025-02-28
17 health deficiencies · 7 fire-safety deficiencies
Top issue: Infection Control (3 deficiencies)
2023-06-16
12 health deficiencies · 8 fire-safety deficiencies
Top issue: Nutrition and Dietary (2 deficiencies)
2020-11-06
9 health deficiencies · 4 fire-safety deficiencies
Top issue: Pharmacy Service (3 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 1 h 42 min of nursing staff time a day, 14 min of it from a registered nurse.
This home
1 h 42 min
Missouri average
3 h 24 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 81% of nursing staff and 83% 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
$69,178 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2025-02-28 | Fine | $69,178 |
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 days0.8 pts worse | 2.8 | 2.0 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.7 pts better | 1.5 | 2.2 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine16.8 pts worse | 67.2% | 84.0% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine58.5 pts worse | 32.3% | 90.8% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury4 pts better | 0.0% | 4.0% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms52 pts worse | 72.0% | 20.0% | 13.5% |
| Percentage of long-stay residents who lose too much weight5.1 pts better | 0.0% | 5.1% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication35.1 pts worse | 60.7% | 25.6% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication38.1 pts worse | 61.6% | 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 worsened6.4 pts worse | 22.2% | 15.8% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased8.1 pts worse | 25.5% | 17.4% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.6 pts better | 0.3% | 0.9% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection1.3 pts better | 0.9% | 2.2% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence1.7 pts worse | 18.8% | 17.1% | 18.3% |
| Percentage of long-stay residents with pressure ulcers2 pts better | 2.4% | 4.4% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine19.2 pts worse | 46.5% | 65.7% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit9.7 pts better | 3.7% | 13.4% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication12.9 pts worse | 15.0% | 2.1% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine56.4 pts worse | 5.0% | 61.4% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission17 pts better | 8.7% | 25.7% | 23.4% |
·
Who owns and runs it
16 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 |
|---|---|---|---|
| Arshad, Abdullah | Operational/Managerial Control · Individual | 0% | 27 facilities |
| Arshad, Abdullah | Adp Of The SNF · Individual | 0% | 27 facilities |
| Destefane, Richard | Indirect Ownership Interest · Individual | 0% | 35 facilities |
| Destefane, Richard | Corporate Officer · Individual | 0% | 35 facilities |
| Destefane, Richard | Operational/Managerial Control · Individual | 0% | 35 facilities |
| Destefane, Richard | Adp Of The SNF · Individual | 0% | 35 facilities |
| Nevada Associates, L.l.c. | Adp Of The SNF · Organization | 0% | 1 facilities |
| Rcg Inc | Indirect Ownership Interest · Organization | 0% | 23 facilities |
| Reliant Care Group LLC | Direct Ownership Interest · Organization | 0% | 21 facilities |
| Reliant Care Management Company LLC | Operational/Managerial Control · Organization | 0% | 35 facilities |
| Reliant Care Management Company LLC | Adp Of The SNF · Organization | 0% | 35 facilities |
| Richard J Destefane Revocable Living Trust | Indirect Ownership Interest · Organization | 0% | 3 facilities |
| Richard J Destefane Revocable Living Trust | Adp Of The SNF · Organization | 0% | 3 facilities |
| Tlg Ii Llp | Adp Of The SNF · Organization | 0% | 18 facilities |
| Willis, Lawrence | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Willis, Lawrence | Adp Of The SNF · Individual | 0% | 1 facilities |
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Fire safety
19 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke5F
- F
Install corridor and hallway doors that block smoke.
- E
Install a fire alarm system that can be heard throughout the facility.
- F
Have approved installation, maintenance and testing program for fire alarm systems.
- F
Inspect, test, and maintain automatic sprinkler systems.
- E
Install corridor and hallway doors that block smoke.
Miscellaneous4F
- F
Have simulated fire drills held at unexpected times.
- E
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- F
Have simulated fire drills held at unexpected times.
- F
Have simulated fire drills held at unexpected times.
Gas, Vacuum, and Electrical Systems4F
- F
Ensure proper usage of power strips and extension cords.
- F
Have generator or other power source capable of supplying service within 10 seconds.
- E
Ensure proper usage of power strips and extension cords.
- E
Have proper medical gas storage and administration areas.
Egress4F
- 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.
- 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
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
Construction2F
- F
Use approved construction type or materials.
- F
Use approved construction type or materials.
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Other homes nearby
-
Medicalodges Nevada
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★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
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- Fines
- $0
-
Moore Few Care Center
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- Nursing / resident / day
- 3 h 24 min
- Fines
- $0
-
Community Springs Healthcare Facility
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★★★★★- Worst citation, 3 yrs
- E
- Nursing / resident / day
- 3 h 22 min
- Fines
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