18 health deficiencies
Top issue: Infection Control (3 deficiencies)
12 fire-safety deficiencies
Top issue: Smoke (7 deficiencies)
Columbia, MO
1-star overall rating with 1-star inspections with $12,735 in total fines with 18 recent health deficiencies with 12 fire-safety deficiencies in the latest cycle
4700 Brandon Woods, Columbia, MO
(573) 874-3674
Overall
1 / 5
CMS overall stars
Health inspections
1 / 5
Survey and complaint cycles
Staffing
1 / 5
RN + nurse staffing
Quality measures
1 / 5
Resident outcomes and process measures
Quick facts
Beds
100
Certified beds
Average residents
61
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
James & Judy Lincoln
Operator or chain grouping
Approved since
1995-07-14
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
58 facilities
Chain averages 3 overall / 3 health / 2 staffing / 3 quality stars
Changed ownership
No
Within the last 12 months
Family council
No
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
RN hours / resident day
0.57
Registered nurse staffing · state 0.46 · national 0.68
LPN hours / resident day
0.53
Licensed practical nurse staffing · state 0.68 · national 0.87
Aide hours / resident day
2.00
Nurse aide staffing · state 2.33 · national 2.35
Total nurse hours
3.10
All reported nurse hours · state 3.47 · national 3.89
Licensed hours
1.10
RN + LPN hours · state 1.14 · national 1.54
Weekend hours
2.71
Weekend nurse staffing · state 3.04 · national 3.43
Weekend RN hours
0.45
Weekend registered nurse coverage · state 0.33 · national 0.47
Physical therapist
0.10
Reported PT staffing · state 0.05 · national 0.07
Adjusted RN hours
0.55
CMS adjusted RN staffing hours
Adjusted total hours
3.00
CMS adjusted total nurse staffing hours
Case-mix index
1.41
Higher values indicate more complex resident acuity
RN turnover
0%
Annual RN turnover
Total nurse turnover
0%
Annual nurse turnover
SNF VBP
Program rank
12,091
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
13.93
Composite VBP score used to determine payment impact.
Payment multiplier
0.9813
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
Readmission
0
Baseline 20.94% · Performance 21.89% · Measure score 0 · Achievement 0 · Improvement 0
Healthcare-associated infections
3.66
Baseline 8.30% · Performance 6.92% · Measure score 3.66 · Achievement 3.05 · Improvement 3.66
Total nurse turnover
Not reported
This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.
Adjusted total nurse staffing
0.52
Baseline 3.51 hours · Performance 3.23 hours · Measure score 0.52 · Achievement 0.52 · Improvement 0
SNF QRP
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 12.07% |
10.72%
1.3 pts worse
|
No Different than the National Rate · Eligible stays 46 · Observed rate 21.74% · Lower 95% interval 7.26% |
| Discharge to community | 42.81% |
50.57%
7.8 pts worse
|
No Different than the National Rate · Eligible stays 43 · Observed rate 27.91% · Lower 95% interval 28.61% |
| Medicare spending per beneficiary | 1.05 |
1.02
About the same
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 46 · Denominator 46 |
| Falls with major injury | 2.17% |
0.77%
1.4 pts worse
|
Numerator 1 · Denominator 46 |
| Discharge self-care score | 45.83% |
53.69%
7.9 pts worse
|
Numerator 11 · Denominator 24 |
| Discharge mobility score | 33.33% |
50.94%
17.6 pts worse
|
Numerator 8 · Denominator 24 |
| Pressure ulcers or injuries, new or worsened | 4.35% |
2.29%
2.1 pts worse
|
Numerator 2 · Denominator 46 · Adjusted rate 5.51% |
| Healthcare-associated infections requiring hospitalization | 6.92% |
7.12%
0.2 pts better
|
No Different than the National Rate · Eligible stays 30 · Observed rate 10% · Lower 95% interval 3.64% |
| Staff COVID-19 vaccination coverage | 0% |
8.2%
8.2 pts worse
|
Numerator 0 · Denominator 76 |
| Staff flu vaccination coverage | 11.11% |
42%
30.9 pts worse
|
Numerator 12 · Denominator 108 |
| Discharge function score | 33.33% |
56.45%
23.1 pts worse
|
Numerator 8 · Denominator 24 |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 13 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | 100% |
96.28%
3.7 pts better
|
Numerator 24 · Denominator 24 |
| Resident COVID-19 vaccinations up to date | 16.67% |
25.2%
8.5 pts worse
|
Numerator 4 · Denominator 24 |
Quality measures
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 95.1% |
84.8%
10.3 pts better
|
93.4%
1.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 83.3% · Q4 95.6% · 4Q avg 95.1% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 96.5% |
90.9%
5.6 pts better
|
95.5%
1 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 96.5% |
| 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 1.8% · Q2 1.9% · Q3 2.1% · Q4 6.7% · 4Q avg 3.0% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 5.2% |
14.7%
9.5 pts better
|
11.4%
6.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 23.1% · 4Q avg 5.2% |
| Percentage of long-stay residents who lose too much weight | 3.3% |
5.5%
2.2 pts better
|
5.4%
2.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 4.3% · Q2 6.1% · Q3 2.2% · Q4 0.0% · 4Q avg 3.3% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 23.1% |
25.3%
2.2 pts better
|
19.6%
3.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 20.8% · Q2 22.4% · Q3 26.7% · Q4 22.5% · 4Q avg 23.1% |
| Percentage of long-stay residents who received an antipsychotic medication | 28.0% |
25.0%
3 pts worse
|
16.7%
11.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 30.8% · Q2 26.3% · Q3 25.0% · Q4 30.0% · 4Q avg 28.0% · 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 | 33.4% |
20.3%
13.1 pts worse
|
16.3%
17.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q2 51.4% · Q3 24.7% · 4Q avg 33.4% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 32.2% |
19.8%
12.4 pts worse
|
14.9%
17.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 43.5% · Q2 28.3% · Q3 35.7% · Q4 18.9% · 4Q avg 32.2% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.9% |
1.4%
0.5 pts better
|
1.0%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.1% · Q2 0.0% · Q3 0.0% · Q4 1.6% · 4Q avg 0.9% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 1.5% |
2.6%
1.1 pts better
|
1.7%
0.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 3.6% · Q2 0.0% · Q3 2.1% · Q4 0.0% · 4Q avg 1.5% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 22.8% |
18.1%
4.7 pts worse
|
19.8%
3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 7.5% · Q2 39.6% · Q3 15.5% · Q4 29.6% · 4Q avg 22.8% |
| Percentage of long-stay residents with pressure ulcers | 3.0% |
5.0%
2 pts better
|
5.1%
2.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 4.5% · Q2 4.5% · Q3 0.0% · Q4 2.6% · 4Q avg 3.0% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 85.4% |
66.4%
19 pts better
|
81.7%
3.7 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 91.8% · Q3 74.7% · Q4 81.0% · 4Q avg 85.4% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 14.8% |
13.4%
1.4 pts worse
|
12.0%
2.8 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 14.8% · Observed 16.7% · Expected 12.6% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.5% |
2.2%
1.7 pts better
|
1.6%
1.1 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 2.1% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.5% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 87.5% |
63.5%
24 pts better
|
79.7%
7.8 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 87.5% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 37.3% |
25.3%
12 pts worse
|
23.9%
13.4 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 37.3% · Observed 40.5% · Expected 25.9% · Used in QM five-star |
Survey summary
Top issue: Infection Control (3 deficiencies)
12 fire-safety deficiencies
Top issue: Smoke (7 deficiencies)
Top issue: Quality of Life and Care (2 deficiencies)
5 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (2 deficiencies)
Top issue: Resident Assessment and Care Planning (3 deficiencies)
8 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (2 deficiencies)
Fire safety
Fire Safety
Establish an Emergency Preparedness Program (EP).
Corrected 2025-06-26
Fire Safety
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.
Corrected 2025-05-21
Fire Safety
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Corrected 2025-05-21
Fire Safety
Provide properly protected cooking facilities.
Corrected 2025-05-21
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2025-05-21
Fire Safety
Follow proper procedures when the fire alarm was out of service for more than 4 hours.
Corrected 2025-05-29
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2025-05-21
Fire Safety
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
Corrected 2025-05-29
Fire Safety
Install corridor and hallway doors that block smoke.
Corrected 2025-05-21
Fire Safety
Have properly installed electrical wiring and gas equipment.
Corrected 2025-05-21
Fire Safety
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Corrected 2025-05-21
Fire Safety
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Corrected 2025-05-27
Fire Safety
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Corrected 2024-04-08
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2024-04-08
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2024-04-08
Fire Safety
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Corrected 2024-04-08
Fire Safety
Ensure proper usage of power strips and extension cords.
Corrected 2024-04-08
Fire Safety
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.
Corrected 2023-03-29
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2023-03-29
Fire Safety
Meet other general requirements that are deficient.
Corrected 2023-03-29
Fire Safety
Have properly installed electrical wiring and gas equipment.
Corrected 2023-03-29
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2023-03-29
Fire Safety
Meet requirements for the installation and maintenance of electrical systems.
Corrected 2023-03-29
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2023-03-29
Fire Safety
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Corrected 2023-03-29
Inspection history
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2025-09-21
Health
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.
Corrected 2025-12-29
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2025-05-30
Health
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Corrected 2025-06-27
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2025-06-27
Health
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
Corrected 2025-05-21
Health
Provide and implement an infection prevention and control program.
Corrected 2025-07-09
Health
Honor the resident's right to manage his or her financial affairs.
Corrected 2025-05-21
Health
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.
Corrected 2025-05-21
Health
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.
Corrected 2025-05-21
Health
Implement a program that monitors antibiotic use.
Corrected 2025-05-21
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2025-06-26
Health
Observe each nurse aide's job performance and give regular training.
Corrected 2025-05-21
Health
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
Corrected 2025-05-21
Health
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.
Corrected 2025-05-21
Health
Ensure the activities program is directed by a qualified professional.
Corrected 2025-05-21
Health
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.
Corrected 2025-05-21
Health
Give residents a notice of rights, rules, services and charges.
Corrected 2025-05-21
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2024-04-08
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 2024-04-08
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2024-04-08
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2024-04-08
Health
Observe each nurse aide's job performance and give regular training.
Corrected 2024-04-08
Health
Provide or get specialized rehabilitative services as required for a resident.
Corrected 2024-04-08
Health
Provide and implement an infection prevention and control program.
Corrected 2024-04-08
Health
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected 2023-03-29
Health
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.
Corrected 2023-03-29
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2023-03-29
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2023-03-29
Health
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.
Corrected 2023-03-29
Health
Provide and implement an infection prevention and control program.
Corrected 2023-03-19
Health
Assure that each resident’s assessment is updated at least once every 3 months.
Corrected 2023-03-29
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2023-03-29
Penalties and ownership
Fine · fine $12,735
Fine
Payment Denial · denial start 2025-07-02 · 7 days
7 day denial
5% Or Greater Direct Ownership Interest · Individual
5% Or Greater Direct Ownership Interest · Individual
W-2 Managing Employee · Individual
Operational/Managerial Control · Organization
Nearby options
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Columbia, MO
2-star overall rating with 2-star inspections with $68,105 in total fines with 10 recent health deficiencies with 10 fire-safety deficiencies in the latest cycle
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