Federal inspection record · CMS data as of October 1, 2026
Twin Pines Adult Care Center
1900 S Jamison, Kirksville, MO · (660) 665-2887
- Certified beds
- 120
- Residents per day
- 68
- Ownership
- Non-Profit
- Chain
- No chain reported
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- September 1, 1983
1
How this home got 2 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.
-
Overall
★★★★★2 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Missouri homes
Twin Pines Adult Care Center carries 151 inspection points. That is fewer than 20% 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
35 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.
No citation on record at the harm or immediate-jeopardy level.
Everything else, by area of care
Resident Rights7F
- E
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- F
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
Allow residents to self-administer drugs if determined clinically appropriate.
- 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.
Quality of Life and Care7E
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- 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.
- D
Provide safe, appropriate pain management 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 activities to meet all resident's needs.
- E
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Nutrition and Dietary5F
- 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.
- 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.
Resident Assessment and Care Planning5E
- E
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
- E
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- E
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
Infection Control4F
- E
Provide and implement an infection prevention and control program.
- D
Develop and implement policies and procedures for flu and pneumonia vaccinations.
- F
Provide and implement an infection prevention and control program.
- E
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Nursing and Physician Services3E
- E
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
- D
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.
- B
Post nurse staffing information every day.
Administration1F
- F
Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
Freedom from Abuse, Neglect, and Exploitation1E
- E
Not hire anyone with a finding of abuse, neglect, exploitation, or theft.
Environmental1D
- D
Make sure that a working call system is available in each resident's bathroom and bathing area.
Pharmacy Service1E
- 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.
Inspection history
2024-10-11
14 health deficiencies · 2 fire-safety deficiencies
Top issue: Resident Rights (6 deficiencies)
2023-01-30
10 health deficiencies · 18 fire-safety deficiencies
Top issue: Infection Control (2 deficiencies)
2019-06-07
11 health deficiencies · 8 fire-safety deficiencies
Top issue: Quality of Life and Care (4 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 38 min of nursing staff time a day, 21 min of it from a registered nurse.
This home
3 h 38 min
Missouri average
3 h 24 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 45% of nursing staff and 0% 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 days0.5 pts better | 1.5 | 2.0 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.9 pts worse | 3.1 | 2.2 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine7.1 pts better | 91.1% | 84.0% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine2.1 pts better | 92.9% | 90.8% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury1.3 pts better | 2.7% | 4.0% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms16.7 pts better | 3.3% | 20.0% | 13.5% |
| Percentage of long-stay residents who lose too much weight4.3 pts better | 0.8% | 5.1% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication2.7 pts better | 22.9% | 25.6% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication8.2 pts better | 15.3% | 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 worsened4.2 pts better | 11.6% | 15.8% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased1.7 pts better | 15.7% | 17.4% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder1.6 pts worse | 2.5% | 0.9% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection0.2 pts better | 2.0% | 2.2% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence4.9 pts better | 12.2% | 17.1% | 18.3% |
| Percentage of long-stay residents with pressure ulcers6.7 pts worse | 11.1% | 4.4% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine6.3 pts better | 72.0% | 65.7% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit11.1 pts worse | 24.5% | 13.4% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication1.9 pts worse | 4.0% | 2.1% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine17.5 pts worse | 43.9% | 61.4% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission4.1 pts better | 21.6% | 25.7% | 23.4% |
·
Who owns and runs it
9 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 |
|---|---|---|---|
| Adair County Nursing Home District | Operational/Managerial Control · Organization | 0% | 1 facilities |
| Adair County Nursing Home District | Adp Of The SNF · Organization | 0% | 1 facilities |
| Bell, Aurora | Operational/Managerial Control · Individual | 0% | 2 facilities |
| Bell, Aurora | Adp Of The SNF · Individual | 0% | 2 facilities |
| Besler, Wendy | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Besler, Wendy | Adp Of The SNF · Individual | 0% | 1 facilities |
| Richardson, James | Corporate Director · Individual | 0% | 2 facilities |
| Richardson, James | Operational/Managerial Control · Individual | 0% | 2 facilities |
| Richardson, James | Adp Of The SNF · Individual | 0% | 2 facilities |
·
Fire safety
28 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke11F
- F
Inspect, test, and maintain automatic sprinkler systems.
- E
Install an approved automatic sprinkler system.
- E
Have an enclosure around a vertical opening shaft.
- E
Provide properly protected cooking facilities.
- E
Install smoke barrier doors that can resist smoke for at least 20 minutes.
- F
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- E
Provide properly protected cooking facilities.
- E
Install corridor and hallway doors that block smoke.
- E
Install smoke barrier doors that can resist smoke for at least 20 minutes.
- D
Inspect, test, and maintain automatic sprinkler systems.
Emergency Preparedness8E
- E
Address subsistence needs for staff and patients.
- E
Establish procedures for tracking staff and patients during an emergency.
- E
Establish policies and procedures including evacuation.
- E
Establish policies and procedures for volunteers.
- E
Establish roles under a Waiver declared by secretary.
- E
Establish emergency prep training and testing.
- E
Establish staff and initial training requirements.
- E
Conduct testing and exercise requirements.
Egress3F
- F
Install emergency lighting that can last at least 1 1/2 hours.
- 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
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.
Gas, Vacuum, and Electrical Systems3F
- F
Have generator or other power source capable of supplying service within 10 seconds.
- F
Ensure that testing and maintenance of electrical equipment is performed.
- D
Have proper medical gas storage and administration areas.
Miscellaneous2F
- 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.
Construction1E
- E
Meet other general requirements.
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Other homes nearby
-
Kirksville Manor Care Center
Kirksville, MO · Juckette Family Homes
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 3 h 42 min
- Fines
- $250,823
-
La Plata Nursing Home
La Plata, MO
★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
- 3 h 36 min
- Fines
- $0
-
Schuyler County Nursing Home District
Queen City, MO
★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
- 4 h 16 min
- Fines
- $0