Federal inspection record · CMS data as of October 1, 2026
Shepherd Of The Hills Living Center
996 State Highway 248, Branson, MO · (417) 334-6431
- Certified beds
- 100
- Residents per day
- 79
- Ownership
- For-Profit
- Chain
- James & Judy Lincoln
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- August 24, 1989
1
How this home got 4 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.
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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
★★★★★+1 star
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
★★★★★4 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Missouri homes
Shepherd Of The Hills Living Center carries 73 inspection points. That is fewer than 54% 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
31 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 (1)
-
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
Pharmacy Service7F
- F
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
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 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.
Resident Rights7E
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- D
Allow residents to self-administer drugs if determined clinically appropriate.
- D
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.
- E
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
- E
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
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
- C
Post a list of names, addresses, and telephone numbers of all pertinent State agencies and advocacy groups and a statement that the resident may file a complaint with the State Survey Agency.
Quality of Life and Care6E
- D
Provide enough food/fluids to maintain a resident's health.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- E
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide safe, appropriate dialysis care/services for a resident who requires such services.
- 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.
Resident Assessment and Care Planning3D
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Infection Control2E
- E
Provide and implement an infection prevention and control program.
- E
Provide and implement an infection prevention and control program.
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.
Nursing and Physician Services1F
- 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.
Freedom from Abuse, Neglect, and Exploitation1E
- E
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Environmental1D
- D
Provide bedrooms that don't allow residents to see each other when privacy is needed.
Inspection history
2026-02-13
10 health deficiencies · 5 fire-safety deficiencies
Top issue: Pharmacy Service (2 deficiencies)
2024-03-21
9 health deficiencies · 9 fire-safety deficiencies
Top issue: Pharmacy Service (3 deficiencies)
2022-07-28
12 health deficiencies · 2 fire-safety deficiencies
Top issue: Resident Rights (4 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 15 min of nursing staff time a day, 22 min of it from a registered nurse.
This home
3 h 15 min
Missouri average
3 h 24 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 57% of nursing staff and 80% 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
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 days0.6 pts better | 1.4 | 2.0 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days2 pts better | 0.2 | 2.2 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine52.1 pts worse | 31.9% | 84.0% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine4.7 pts worse | 86.1% | 90.8% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury2.7 pts worse | 6.7% | 4.0% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms19 pts better | 1.0% | 20.0% | 13.5% |
| Percentage of long-stay residents who lose too much weight3.1 pts worse | 8.2% | 5.1% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication13.4 pts better | 12.2% | 25.6% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication17 pts better | 6.5% | 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 worsened12 pts worse | 27.8% | 15.8% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased12.8 pts worse | 30.2% | 17.4% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.3 pts better | 0.6% | 0.9% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection0.8 pts worse | 3.0% | 2.2% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence4.1 pts worse | 21.2% | 17.1% | 18.3% |
| Percentage of long-stay residents with pressure ulcers1.5 pts better | 2.9% | 4.4% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine21.5 pts worse | 44.2% | 65.7% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit2.6 pts better | 10.8% | 13.4% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication1.8 pts better | 0.3% | 2.1% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine7.7 pts worse | 53.7% | 61.4% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission12.6 pts better | 13.1% | 25.7% | 23.4% |
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Who owns and runs it
3 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 |
| Ltc Management Services LLC | Operational/Managerial Control · Organization | 0% | 37 facilities |
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Fire safety
16 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke7F
- E
Inspect, test, and maintain automatic sprinkler systems.
- F
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- F
Provide properly protected cooking facilities.
- F
Inspect, test, and maintain automatic sprinkler systems.
- E
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- E
Inspect, test, and maintain automatic sprinkler systems.
- E
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Miscellaneous3F
- 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.
Gas, Vacuum, and Electrical Systems3F
- F
Have generator or other power source capable of supplying service within 10 seconds.
- F
Have generator or other power source capable of supplying service within 10 seconds.
- E
Have proper medical gas storage and administration areas.
Construction2E
- E
Use approved construction type or materials.
- E
Use approved construction type or materials.
Egress1F
- 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.
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Other homes nearby
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Point Lookout Nursing & Rehab
Hollister, MO · James & Judy Lincoln
★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
- 2 h 24 min
- Fines
- $0
-
Forsyth Rehabilitation & Health Care Center
Forsyth, MO · James & Judy Lincoln
★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
- 2 h 52 min
- Fines
- $0
-
Ozark Riverview Manor
Ozark, MO
★★★★★- Worst citation, 3 yrs
- E
- Nursing / resident / day
- 3 h 15 min
- Fines
- $0