Federal inspection record · CMS data as of October 1, 2026
Pioneer Skilled Nursing Center
1500 South Kansas Avenue, Marceline, MO · (660) 376-2001
- Certified beds
- 96
- Residents per day
- 59
- Ownership
- For-Profit
- Chain
- Americare Senior Living
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- June 30, 1982
1
How this home got 3 stars
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
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.
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Overall
★★★★★3 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Missouri homes
Pioneer Skilled Nursing Center carries 75.75 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
20 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 (1)
-
J
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Everything else, by area of care
Quality of Life and Care6E
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- 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.
- E
Provide care and assistance to perform activities of daily living for any resident who is unable.
- E
Provide safe and appropriate respiratory care for a resident when needed.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Nutrition and Dietary3F
- 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.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Resident Rights3E
- E
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
- 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 safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Infection Control2F
- F
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 Exploitation2D
- 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.
Pharmacy Service2D
- 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.
Resident Assessment and Care Planning1D
- D
Ensure services provided by the nursing facility meet professional standards of quality.
Inspection history
2025-03-20
7 health deficiencies · 4 fire-safety deficiencies
Top issue: Quality of Life and Care (3 deficiencies)
2023-06-13
7 health deficiencies · 20 fire-safety deficiencies
Top issue: Quality of Life and Care (3 deficiencies)
2019-10-03
6 health deficiencies · 6 fire-safety deficiencies
Top issue: Pharmacy Service (2 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 30 min of nursing staff time a day, 28 min of it from a registered nurse.
This home
3 h 30 min
Missouri average
3 h 24 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 58% of nursing staff and 88% 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
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 better | 1.2 | 2.0 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.2 pts worse | 2.4 | 2.2 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine13 pts better | 97.0% | 84.0% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine0.2 pts worse | 90.6% | 90.8% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury1.5 pts worse | 5.5% | 4.0% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms20 pts better | 0.0% | 20.0% | 13.5% |
| Percentage of long-stay residents who lose too much weight19.3 pts worse | 24.4% | 5.1% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication0.2 pts worse | 25.8% | 25.6% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication5.8 pts better | 17.7% | 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 worsened0.9 pts better | 14.9% | 15.8% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased3.2 pts worse | 20.6% | 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 infection1.5 pts worse | 3.7% | 2.2% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence0.3 pts worse | 17.4% | 17.1% | 18.3% |
| Percentage of long-stay residents with pressure ulcers0.4 pts better | 4.0% | 4.4% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine23.6 pts better | 89.3% | 65.7% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit4.1 pts worse | 17.5% | 13.4% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication2.1 pts better | 0.0% | 2.1% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine19.7 pts better | 81.1% | 61.4% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission16.8 pts better | 8.9% | 25.7% | 23.4% |
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Who owns and runs it
12 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 |
|---|---|---|---|
| Montgomery, Anna | 5% Or Greater Indirect Ownership Interest · Individual | 50% | 16 facilities |
| Montgomery, Richard | 5% Or Greater Indirect Ownership Interest · Individual | 50% | 16 facilities |
| Americare Systems, Inc. | Operational/Managerial Control · Organization | 0% | 23 facilities |
| Crosson, Clay | Operational/Managerial Control · Individual | 0% | 14 facilities |
| Hatlestad, Steven | Operational/Managerial Control · Individual | 0% | 7 facilities |
| Pioneer Nursing, LLC | 5% Or Greater Direct Ownership Interest · Organization | 0% | 1 facilities |
| R H Montgomery Properties, Inc | 5% Or Greater Direct Ownership Interest · Organization | 0% | 15 facilities |
| Reiker, James | Corporate Officer · Individual | 0% | 13 facilities |
| Reiker, James | Operational/Managerial Control · Individual | 0% | 13 facilities |
| Schade, Kyle | Contracted Managing Employee · Individual | 0% | 23 facilities |
| Schade, Kyle | Corporate Officer · Individual | 0% | 23 facilities |
| Woods, Matthew J | W-2 Managing Employee · Individual | 0% | 2 facilities |
·
Fire safety
30 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke12F
- 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
Have an enclosure around a vertical opening shaft.
- 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.
- F
Install corridor and hallway doors that block smoke.
- F
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- E
Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.
- F
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- D
Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.
Gas, Vacuum, and Electrical Systems6F
- F
Have proper power supply for life support equipment.
- F
Have generator or other power source capable of supplying service within 10 seconds.
- F
Ensure proper usage of power strips and extension cords.
- F
Ensure that testing and maintenance of electrical equipment is performed.
- E
Have power receptacles that are properly grounded.
- F
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Egress5F
- 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.
- F
Install emergency lighting that can last at least 1 1/2 hours.
- E
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
- E
Have exits that are accessible at all times.
- D
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.
Miscellaneous4F
- F
Provide a written emergency evacuation plan.
- 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
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Construction2F
- F
Use approved construction type or materials.
- D
Use approved construction type or materials.
Services1F
- F
Have properly installed electrical wiring and gas equipment.
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Other homes nearby
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Life Care Center Of Brookfield
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★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 3 h 28 min
- Fines
- $45,159
-
Brookfield Health Care Center
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- G
- Nursing / resident / day
- 2 h 1 min
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-
Brunswick Health Care Center
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★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 2 h 34 min
- Fines
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