Cycle 1
Health 2025-07-25 · Fire 2025-07-25
1 health deficiencies
Top issue: Resident Rights (1 deficiency)
2 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (2 deficiencies)
Bernie, MO
Winchester Nursing Center, Inc
4-star overall rating with 5-star inspections with 1 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle
400 Winchester Dr, Bernie, MO
(573) 293-6702
Overall
4 / 5
CMS overall stars
Health inspections
5 / 5
Survey and complaint cycles
Staffing
1 / 5
RN + nurse staffing
Quality measures
3 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
60
Certified beds
Average residents
52
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Paradigm Senior Management
Operator or chain grouping
Approved since
2019-01-09
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
6 facilities
Chain averages 3 overall / 5 health / 1 staffing / 2 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
Hours and turnover
RN hours / resident day
0.63
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
2.24
Nurse aide staffing · state 2.33 · national 2.35
Total nurse hours
3.41
All reported nurse hours · state 3.47 · national 3.89
Licensed hours
1.16
RN + LPN hours · state 1.14 · national 1.54
Weekend hours
2.76
Weekend nurse staffing · state 3.04 · national 3.43
Weekend RN hours
0.26
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
0.59
CMS adjusted RN staffing hours
Adjusted total hours
3.16
CMS adjusted total nurse staffing hours
Case-mix index
1.48
Higher values indicate more complex resident acuity
RN turnover
54%
Annual RN turnover · state 51% · national 45%
Total nurse turnover
61%
Annual nurse turnover · state 57% · national 46%
SNF VBP
Value-based purchasing
Program rank
13,689
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
1.7
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
0
Baseline 6.30% · Performance 7.71% · Measure score 0 · Achievement 0 · Improvement 0
Total nurse turnover
0
Baseline 55.26% · Performance 71.43% · Measure score 0 · Achievement 0 · Improvement 0
Adjusted total nurse staffing
0.51
Baseline 3.35 hours · Performance 3.22 hours · Measure score 0.51 · Achievement 0.51 · Improvement 0
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 10.71% |
10.72%
About the same
|
No Different than the National Rate · Eligible stays 42 · Observed rate 9.52% · Lower 95% interval 7.04% |
| Discharge to community | 61.17% |
50.57%
10.6 pts better
|
No Different than the National Rate · Eligible stays 32 · Observed rate 62.5% · Lower 95% interval 48.47% |
| Medicare spending per beneficiary | 1.23 |
1.02
0.2 pts worse
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 28 · Denominator 28 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 28 |
| Discharge self-care score | 86.36% |
53.69%
32.7 pts better
|
Numerator 19 · Denominator 22 |
| Discharge mobility score | 72.73% |
50.94%
21.8 pts better
|
Numerator 16 · Denominator 22 |
| Pressure ulcers or injuries, new or worsened | 0% |
2.29%
2.3 pts better
|
Numerator 0 · Denominator 28 · Adjusted rate 0% |
| Healthcare-associated infections requiring hospitalization | 7.71% |
7.12%
0.6 pts worse
|
No Different than the National Rate · Eligible stays 28 · Observed rate 10.71% · Lower 95% interval 3.86% |
| Staff COVID-19 vaccination coverage | 0% |
8.2%
8.2 pts worse
|
Numerator 0 · Denominator 44 |
| Staff flu vaccination coverage | 10.71% |
42%
31.3 pts worse
|
Numerator 6 · Denominator 56 |
| Discharge function score | 90.91% |
56.45%
34.5 pts better
|
Numerator 20 · Denominator 22 |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 7 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 11 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | Not Available |
25.2%
|
Numerator Not Available · Denominator 18 · 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 | 2.0 |
2.1
0.1 pts better
|
1.9
0.1 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.0 · Observed 1.9 · Expected 1.8 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 3.0 |
2.3
0.7 pts worse
|
1.8
1.2 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 3.0 · Observed 2.8 · Expected 1.6 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 22.4% |
84.8%
62.4 pts worse
|
93.4%
71 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 40.4% · Q2 22.2% · Q3 14.0% · Q4 12.5% · 4Q avg 22.4% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 49.1% |
90.9%
41.8 pts worse
|
95.5%
46.4 pts worse
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 49.1% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 12.6% |
4.1%
8.5 pts worse
|
3.3%
9.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 8.5% · Q2 8.9% · Q3 18.6% · Q4 14.6% · 4Q avg 12.6% · 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 | 11.8% |
5.5%
6.3 pts worse
|
5.4%
6.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 9.8% · Q2 5.3% · Q3 13.9% · Q4 18.4% · 4Q avg 11.8% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 13.8% |
25.3%
11.5 pts better
|
19.6%
5.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 19.5% · Q2 10.0% · Q3 12.8% · Q4 12.8% · 4Q avg 13.8% |
| Percentage of long-stay residents who received an antipsychotic medication | 25.0% |
25.0%
About the same
|
16.7%
8.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 32.3% · Q2 27.0% · Q3 24.2% · Q4 16.1% · 4Q avg 25.0% · 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 | 15.5% |
20.3%
4.8 pts better
|
16.3%
0.8 pts better
|
Long Stay · 2024Q4-2025Q3 · 4Q avg 15.5% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 12.7% |
19.8%
7.1 pts better
|
14.9%
2.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 12.2% · Q2 7.5% · Q3 21.1% · Q4 10.3% · 4Q avg 12.7% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 1.3% |
1.4%
0.1 pts better
|
1.0%
0.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 1.6% · Q2 0.0% · Q3 2.1% · Q4 1.5% · 4Q avg 1.3% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 4.0% |
2.6%
1.4 pts worse
|
1.7%
2.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 2.1% · Q2 0.0% · Q3 5.0% · Q4 8.5% · 4Q avg 4.0% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 4.8% |
18.1%
13.3 pts better
|
19.8%
15 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 4.4% · Q2 12.6% · Q3 0.0% · Q4 2.0% · 4Q avg 4.8% |
| Percentage of long-stay residents with pressure ulcers | 9.9% |
5.0%
4.9 pts worse
|
5.1%
4.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 16.2% · Q2 11.3% · Q3 8.4% · Q4 3.4% · 4Q avg 9.9% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 2.4% |
66.4%
64 pts worse
|
81.7%
79.3 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 7.7% · Q3 2.1% · Q4 0.0% · 4Q avg 2.4% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 8.6% |
13.4%
4.8 pts better
|
12.0%
3.4 pts better
|
Short Stay · 20240701-20250630 · Adjusted 8.6% · Observed 8.3% · Expected 10.8% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 4.0% |
2.2%
1.8 pts worse
|
1.6%
2.4 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 0.0% · Q3 7.1% · Q4 0.0% · 4Q avg 4.0% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 10.0% |
63.5%
53.5 pts worse
|
79.7%
69.7 pts worse
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 10.0% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 35.1% |
25.3%
9.8 pts worse
|
23.9%
11.2 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 35.1% · Observed 33.3% · Expected 22.6% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-05-09 · Fire 2024-05-09
6 health deficiencies
Top issue: Quality of Life and Care (2 deficiencies)
1 fire-safety deficiencies
Top issue: Smoke (1 deficiency)
Cycle 3
Health 2023-02-23 · Fire 2023-02-23
0 health deficiencies
No concentrated health issue counts in this cycle.
1 fire-safety deficiencies
Top issue: Smoke (1 deficiency)
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2025-07-25
K920 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure proper usage of power strips and extension cords.
Corrected 2025-09-12
F · Potential for more than minimal harm
2025-07-25
K923 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have proper medical gas storage and administration areas.
Corrected 2025-09-12
F · Potential for more than minimal harm
2024-05-09
K324 · Smoke Deficiencies
Fire Safety
Provide properly protected cooking facilities.
Corrected 2024-06-26
F · Potential for more than minimal harm
2023-02-23
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2023-04-08
Inspection history
Recent health citations
D · Potential for more than minimal harm
2025-07-25
F628 · Resident Rights Deficiencies
Health
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Corrected 2025-09-12
D · Potential for more than minimal harm
2024-05-09
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 2024-06-26
D · Potential for more than minimal harm
2024-05-09
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2024-06-26
D · Potential for more than minimal harm
2024-05-09
F690 · Quality of Life and Care Deficiencies
Health
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Corrected 2024-06-26
D · Potential for more than minimal harm
2024-05-09
F698 · Quality of Life and Care Deficiencies
Health
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Corrected 2024-06-26
D · Potential for more than minimal harm
2024-05-09
F759 · Pharmacy Service Deficiencies
Health
Ensure medication error rates are not 5 percent or greater.
Corrected 2024-06-26
D · Potential for more than minimal harm
2024-05-09
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2024-06-26
Penalties and ownership
What sits behind the stars
Ownership
Jones, Angela
5% Or Greater Direct Ownership Interest · Individual
Sells, Benjamin
5% Or Greater Direct Ownership Interest · Individual
Aters, Kelli
Operational/Managerial Control · Individual
Caldwell, Fred
Operational/Managerial Control · Individual
Diebold, Colby
Operational/Managerial Control · Individual
First Midwest Bank Of Dexter
5% Or Greater Mortgage Interest · Organization
Forvis Mazars Llp
Operational/Managerial Control · Organization
Hutchinson, Dalen
Operational/Managerial Control · Individual
Jones, Angela
Corporate Officer · Individual
Paradigm Rehab Services LLC
Operational/Managerial Control · Organization
Paradigm Senior Management LLC
Operational/Managerial Control · Organization
Sells, Benjamin
Operational/Managerial Control · Individual
Sells, Benjamin
Corporate Officer · Individual
Nearby options
Other facilities in reach
#1
Aspire Senior Living Malden
Malden, MO
4-star overall rating with 4-star inspections with 10 recent health deficiencies with 4 fire-safety deficiencies in the latest cycle
#2
Memory Lane Of Dexter
Dexter, MO
2-star overall rating with 4-star inspections with 4 recent health deficiencies with 4 fire-safety deficiencies in the latest cycle
#3
Cypress Point-Skilled Nursing By Americare
Dexter, MO
4-star overall rating with 3-star inspections with $73,743 in total fines with 7 recent health deficiencies with 1 fire-safety deficiencies in the latest cycle
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