Based on observation, interview, and record review, the facility failed to ensure a safe environment for all residents. On 8/22/25, the facility received information from a structural engineer the middle common area framing, in its current condition, was not structurally sound. The structural engineer advised that the area below this needed to be unoccupied until all the framing deficiencies were addressed. The facility continued to utilize the middle common area, which included the resident sitting area toward the front entrance, the central nurses station, and the access to six hallways and the dining room and did not prohibit access until repairs were made. The facility census was 70. The facility was notified of the Immediate Jeopardy (IJ) on 09/04/25 at 5:08 P.M. …
F584 citations in Missouri
Safe, clean, homelike environment · Resident Rights Deficiencies
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.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Missouri cites F584 more often than its own record predicts
1.15 times the share F584 takes of citations nationally.
Of every deficiency written in Missouri in 2025, this is the portion that was F584.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Missouri surveyors wrote
F584 findings written in Missouri, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
Based on observation, interview and record review the facility failed to provide a clean and homelike environment for two residents (Residents #82 and #15) whose bathrooms were not kept in good repair. The facility also failed to maintain a common-use shower room in good repair when several areas of wall tile were missing. The sample size was 23. The census was 106. Review of the facility's Resident Rooms and Environment policy, dated 08/20, showed:-Purpose: To provide residents with a safe, clean, comfortable and homelike environment;-Policy: The Facility provides residents with a safe, clean, comfortable, and homelike environment. …
Based on observation, interview and record review, the facility staff failed to provide a clean, comfortable and homelike environment for residents, when staff failed to maintain one of one shower rooms free of an excessive buildup of foreign material. This failure has the potential to affect all residents. The facility census was 27.F1. Review of the facility's policy titled Safe and Homelike Environment, dated 2025, showed housekeeping and maintenance services will be provided as necessary to maintain a sanitary, orderly and comfortable environment. Review showed the policy did not contain specific guidance related to the resident shower room. Observation on 04/14/26 during the Life Safety Code tour showed the facility equipped with one shower room for use by all residents. …
The short window
Recent years
| Year | Share of Missouri citations | vs expected |
|---|---|---|
| 2023 | 3.35% | 1.50× |
| 2024 | 3.17% | 1.49× |
| 2025 | 2.42% | 1.15× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Missouri surveyors cite →
Deficiency Index is independent and is not affiliated with, endorsed by, or approved by CMS, Medicare, or any government agency. About this data · Report a correction