Steele, MO

River Oaks Care Center

1-star overall rating with 3-star inspections with $41,389 in total fines with 5 recent health deficiencies

1001 North Walnut, Steele, MO

(573) 695-2121

Compare this facility

Overall

1 / 5

CMS overall stars

Health inspections

3 / 5

Survey and complaint cycles

Staffing

1 / 5

RN + nurse staffing

Quality measures

1 / 5

Resident outcomes and process measures

Quick facts

Facility snapshot

Beds

90

Certified beds

Average residents

64

Average occupied residents

Ownership

For-Profit

Publicly displayed owner type

Chain

Circle B Enterprises

Operator or chain grouping

Approved since

1983-10-31

CMS approved date

Coverage

Medicare + Medicaid

Participation flags

Chain footprint

29 facilities

Chain averages 2 overall / 3 health / 2 staffing / 2 quality stars

Changed ownership

No

Within the last 12 months

Family council

Yes

Resident and family council reported

Sprinklers

Yes

Automatic sprinklers in all required areas

Staffing

Hours and turnover

RN hours / resident day

0.28

Registered nurse staffing · state 0.46 · national 0.68

LPN hours / resident day

0.70

Licensed practical nurse staffing · state 0.68 · national 0.87

Aide hours / resident day

2.54

Nurse aide staffing · state 2.33 · national 2.35

Total nurse hours

3.52

All reported nurse hours · state 3.47 · national 3.89

Licensed hours

0.98

RN + LPN hours · state 1.14 · national 1.54

Weekend hours

3.12

Weekend nurse staffing · state 3.04 · national 3.43

Weekend RN hours

0.19

Weekend registered nurse coverage · state 0.33 · national 0.47

Physical therapist

0.02

Reported PT staffing · state 0.05 · national 0.07

Adjusted RN hours

0.27

CMS adjusted RN staffing hours

Adjusted total hours

3.41

CMS adjusted total nurse staffing hours

Case-mix index

1.41

Higher values indicate more complex resident acuity

RN turnover

67%

Annual RN turnover · state 51% · national 45%

Total nurse turnover

67%

Annual nurse turnover · state 57% · national 46%

SNF VBP

Value-based purchasing

Program rank

13,682

Lower is better among SNFs in the FY 2026 VBP program.

Performance score

1.73

Composite VBP score used to determine payment impact.

Payment multiplier

0.9804

Above 1.000 increases Medicare payment; below 1.000 reduces it.

Program components

How the VBP score is built

Readmission

Not reported

This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.

Healthcare-associated infections

Not reported

This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.

Total nurse turnover

0.35

Baseline 78.38% · Performance 73.85% · Measure score 0.35 · Achievement 0 · Improvement 0.35

Adjusted total nurse staffing

0

Baseline 3.18 hours · Performance 3.05 hours · Measure score 0 · Achievement 0 · Improvement 0

SNF QRP

Medicare quality reporting measures

Measure	Facility	National	Note
Potentially preventable 30-day readmission	10.26%	10.72% 0.5 pts better	No Different than the National Rate · Eligible stays 29 · Observed rate 6.9% · Lower 95% interval 6.06%
Discharge to community	Not Available	50.57%	Not Available · Eligible stays 11 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly.
Medicare spending per beneficiary	1.29	1.02 0.3 pts worse
Drug regimen review with follow-up	100%	95.27% 4.7 pts better	Numerator 33 · Denominator 33
Falls with major injury	0%	0.77% 0.8 pts better	Numerator 0 · Denominator 33
Discharge self-care score	Not Available	53.69%	Numerator Not Available · Denominator 19 · Too few residents or stays to report publicly.
Discharge mobility score	Not Available	50.94%	Numerator Not Available · Denominator 19 · Too few residents or stays to report publicly.
Pressure ulcers or injuries, new or worsened	3.03%	2.29% 0.7 pts worse	Numerator 1 · Denominator 33 · Adjusted rate 2.38%
Healthcare-associated infections requiring hospitalization	Not Available	7.12%	Not Available · Eligible stays 14 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly.
Staff COVID-19 vaccination coverage	0%	8.2% 8.2 pts worse	Numerator 0 · Denominator 61
Staff flu vaccination coverage	0%	42% 42 pts worse	Numerator 0 · Denominator 62
Discharge function score	Not Available	56.45%	Numerator Not Available · Denominator 19 · Too few residents or stays to report publicly.
Transfer of health information to provider	Not Available	95.95%	Numerator Not Available · Denominator 14 · Too few residents or stays to report publicly.
Transfer of health information to patient	Not Available	96.28%	Numerator Not Available · Denominator 1 · Too few residents or stays to report publicly.
Resident COVID-19 vaccinations up to date	Not Available	25.2%	Numerator Not Available · Denominator 15 · Too few residents or stays to report publicly.

Quality measures

Resident outcomes and process scores

Measure	Facility	State	National	Note
Number of hospitalizations per 1000 long-stay resident days	3.1	2.1 1 pts worse	1.9 1.2 pts worse	Long Stay · 20240701-20250630 · Adjusted 3.1 · Observed 3.7 · Expected 2.2 · Used in QM five-star
Number of outpatient emergency department visits per 1000 long-stay resident days	5.7	2.3 3.4 pts worse	1.8 3.9 pts worse	Long Stay · 20240701-20250630 · Adjusted 5.7 · Observed 6.7 · Expected 2.0 · Used in QM five-star
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine	100.0%	84.8% 15.2 pts better	93.4% 6.6 pts better	Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 100.0%
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine	95.9%	90.9% 5 pts better	95.5% 0.4 pts better	Long Stay · 2024Q3-2025Q2 · 4Q avg 95.9%
Percentage of long-stay residents experiencing one or more falls with major injury	3.0%	4.1% 1.1 pts better	3.3% 0.3 pts better	Long Stay · 2024Q4-2025Q3 · Q1 4.1% · Q2 3.0% · Q3 3.2% · Q4 1.6% · 4Q avg 3.0% · Used in QM five-star
Percentage of long-stay residents who have depressive symptoms	0.0%	14.7% 14.7 pts better	11.4% 11.4 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0%
Percentage of long-stay residents who lose too much weight	9.0%	5.5% 3.5 pts worse	5.4% 3.6 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 1.6% · Q2 11.5% · Q3 12.0% · Q4 13.0% · 4Q avg 9.0%
Percentage of long-stay residents who received an antianxiety or hypnotic medication	44.1%	25.3% 18.8 pts worse	19.6% 24.5 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 41.5% · Q2 50.0% · Q3 42.3% · Q4 42.6% · 4Q avg 44.1%
Percentage of long-stay residents who received an antipsychotic medication	35.3%	25.0% 10.3 pts worse	16.7% 18.6 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 38.6% · Q2 39.4% · Q3 32.3% · Q4 28.6% · 4Q avg 35.3% · Used in QM five-star
Percentage of long-stay residents who were physically restrained	0.0%	0.0% About the same	0.1% 0.1 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0%
Percentage of long-stay residents whose ability to walk independently worsened	29.2%	20.3% 8.9 pts worse	16.3% 12.9 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 28.0% · Q2 51.9% · Q3 22.2% · Q4 8.8% · 4Q avg 29.2% · Used in QM five-star
Percentage of long-stay residents whose need for help with daily activities has increased	21.5%	19.8% 1.7 pts worse	14.9% 6.6 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 26.6% · Q2 40.7% · Q3 6.0% · Q4 8.7% · 4Q avg 21.5% · Used in QM five-star
Percentage of long-stay residents with a catheter inserted and left in their bladder	2.6%	1.4% 1.2 pts worse	1.0% 1.6 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 1.6% · Q2 3.8% · Q3 2.8% · Q4 2.3% · 4Q avg 2.6% · Used in QM five-star
Percentage of long-stay residents with a urinary tract infection	2.8%	2.6% 0.2 pts worse	1.7% 1.1 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 7.1% · Q2 3.2% · Q3 0.0% · Q4 0.0% · 4Q avg 2.8% · Used in QM five-star
Percentage of long-stay residents with new or worsened bowel or bladder incontinence	8.3%	18.1% 9.8 pts better	19.8% 11.5 pts better	Long Stay · 2024Q4-2025Q3 · Q1 5.5% · Q2 9.6% · Q3 11.0% · Q4 7.9% · 4Q avg 8.3%
Percentage of long-stay residents with pressure ulcers	2.4%	5.0% 2.6 pts better	5.1% 2.7 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 1.5% · Q3 3.1% · Q4 5.2% · 4Q avg 2.4% · Used in QM five-star
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine	100.0%	66.4% 33.6 pts better	81.7% 18.3 pts better	Short Stay · 2024Q4-2025Q3 · Q2 100.0% · Q4 100.0% · 4Q avg 100.0%
Percentage of short-stay residents who had an outpatient emergency department visit	14.3%	13.4% 0.9 pts worse	12.0% 2.3 pts worse	Short Stay · 20240701-20250630 · Adjusted 14.3% · Observed 18.2% · Expected 14.2% · Used in QM five-star
Percentage of short-stay residents who newly received an antipsychotic medication	6.9%	2.2% 4.7 pts worse	1.6% 5.3 pts worse	Short Stay · 2024Q4-2025Q3 · 4Q avg 6.9% · Used in QM five-star
Percentage of short-stay residents who were rehospitalized after a nursing home admission	26.7%	25.3% 1.4 pts worse	23.9% 2.8 pts worse	Short Stay · 20240701-20250630 · Adjusted 26.7% · Observed 31.8% · Expected 28.4% · Used in QM five-star

Survey summary

Recent inspection cycles

Cycle 1 Health 2025-08-08 · Fire 2025-08-08

5 health deficiencies

Top issue: Infection Control (1 deficiency)

0 fire-safety deficiencies

No concentrated fire-safety issue counts in this cycle.

Cycle 2 Health 2024-08-16 · Fire 2024-08-16

7 health deficiencies

Top issue: Freedom from Abuse and Neglect and Exploitation (2 deficiencies)

1 fire-safety deficiencies

Top issue: Smoke (1 deficiency)

Cycle 3 Health 2023-05-04 · Fire 2023-05-04

3 health deficiencies

Top issue: Pharmacy Service (1 deficiency)

3 fire-safety deficiencies

Top issue: Egress (1 deficiency)

Fire safety

Fire-safety citations

F · Potential for more than minimal harm 2024-08-16

K355 · Smoke Deficiencies

Fire Safety

Properly select, install, inspect, or maintain portable fire extinguishes.

Corrected 2024-10-15

F · Potential for more than minimal harm 2023-05-04

K281 · Egress Deficiencies

Fire Safety

Install proper backup exit lighting.

Corrected 2023-06-15

F · Potential for more than minimal harm 2023-05-04

K324 · Smoke Deficiencies

Fire Safety

Provide properly protected cooking facilities.

Corrected 2023-06-15

F · Potential for more than minimal harm 2023-05-04

K920 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Ensure proper usage of power strips and extension cords.

Corrected 2023-06-15

Inspection history

Recent health citations

E · Potential for more than minimal harm 2025-08-08

F584 · Resident Rights Deficiencies

Health

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.

Corrected 2025-09-22

D · Potential for more than minimal harm 2025-08-08

F655 · Resident Assessment and Care Planning Deficiencies

Health

Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted

Corrected 2025-09-22

D · Potential for more than minimal harm 2025-08-08

F699 · Quality of Life and Care Deficiencies

Health

Provide care or services that was trauma informed and/or culturally competent.

Corrected 2025-09-22

D · Potential for more than minimal harm 2025-08-08

F759 · Pharmacy Service Deficiencies

Health

Ensure medication error rates are not 5 percent or greater.

Corrected 2025-09-22

D · Potential for more than minimal harm 2025-08-08

F883 · Infection Control Deficiencies

Health

Develop and implement policies and procedures for flu and pneumonia vaccinations.

Corrected 2025-09-22

J · Immediate jeopardy 2024-11-20

F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Corrected 2024-12-16

J · Immediate jeopardy 2024-11-20