Livingston Manor Care Center

Nursing Home, Hospice Care, Memory Care & Respite Care · Chillicothe, MO

CMS overall rating

939 E Birch Dr, Chillicothe, MO 64601-2189 View map

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Livingston Manor Care Center accepts Medicaid, Medicare, and private pay.

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Livingston Manor Care Center accepts Medicaid, Medicare, and private pay.

Overview of Livingston Manor Care Center

Livingston Manor, Inc., and administrator Sara Hoover-Shaw coordinate care at Livingston Manor Care Center, a 94-bed skilled nursing community located on East Birch Drive in Chillicothe, Missouri. The business office organizes patient billing through typical setups like Medicare, Medicaid, and private payments. Guests visiting the building can navigate the surrounding area easily on foot, as the neighborhood carries a walkability score of 71 out of 100, letting people handle multiple errands without a car.

On average, residents live in the community for 295 days, a timeframe that highlights a routine balancing continuous residential care with shorter post-hospital recovery schedules. To manage day-to-day medical treatments and physical support, the 24-hour staffing framework provides an average of 3 hours and 25 minutes of total nursing care per resident each day. The building splits this clinical focus across a dedicated Private Medicare Hall and a Special Care Unit designed for individualized rehabilitation.

Inspection reports show that recent surveys cited specific procedural corrections regarding resident banking funds, employee background tracking, nurse staffing adjustments, respiratory care, basic environmental sanitation, and resident safety rules, keeping the overall citation rate above zero.

Older adults can look into the community’s monthly activity setups, social calendars, and tailored rehabilitation programs. The indoor layout is configured to support physical recovery and memory care needs under continuous medical supervision. Families can call the main office directly to look over insurance requirements, ask about specific safety safeguards, or schedule an in-person walkthrough of the residential halls.

Facility Direct Line (660) 646-5177

Quality ratings

Measured by Centers for Medicare & Medicaid Services (CMS)

Staffing hours breakdown

Hours per resident per day — compared to state averages

Total nursing care / resident

3h 25m per day

vs avg

2 of 6 metrics below state avg

Standout metric Registered Nurse (RN) is +60% above state avg

Staff type	Hours / Day / Resident	vs state avg
Registered Nurse (RN) RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes.	45m per day	▲ 60% State avg: 28m per day · National avg: 41m per day
LPN / LVN Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care.	38m per day	▼ 7% State avg: 41m per day · National avg: 52m per day
Nurse Aide Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life.	3h 23m per day	▲ 46% State avg: 2h 19m per day · National avg: 2h 20m per day
Weekend Total Nursing Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.	4h 12m per day	▲ 38% State avg: 3h 3m per day · National avg: 3h 26m per day
Physical Therapist Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.	0m per day	▼ 81% State avg: 2m per day · National avg: 4m per day
Weekend RN Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.	28m per day	▲ 39% State avg: 20m per day · National avg: 28m per day

Capacity and availability

295 days

94-bed community

A larger shared setting that may offer more common spaces and organized community services.

Walk Score: 71 / 100

Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.

About this community

Occupancy

Occupancy rate

33%

Lower than the Missouri average: 66.6%

Occupied beds

31 / 94

Average occupied beds in Missouri homes 72 beds

Facility TypeSkilled Nursing Facility

StatusActive

IssuanceOctober 1, 2025

ExpirationSeptember 30, 2027

CountyLivingston

License Number053036

CMS Certification Number265621

Certification TypeMedicare / Medicaid

Livingston Manor Care Center is legally operated by Livingston Manor, Inc, and administered by Sara Hoover-Shaw.

Corporate EntityLIVINGSTON MANOR, INC

Owner NameLivingston Manor, Inc

Skilled Nursing Facility

94 units

Total beds

94 units

Accept Medicaid

Accept Medicare

Rehabilitation Services

Short-Term Rehab

24-Hour Staffing

Dedicated Alzheimer's Unit

Private Medicare Hall

Special Care Unit

Individualized Rehabilitation Programs

Social Programs And Activities

Activities

Since 2018 · 8 years of data 94 deficiencies 18 inspections

Inspection Scorecard This scorecard compares key inspection, deficiency, and complaint metrics at this facility against the Missouri state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.

Since 2018 vs. Missouri state average

Overall vs. MO average

Latest Inspection August 21, 2025 Annual Inspection

Deficiencies Deficiencies are formal regulatory issues recorded during state inspections.	This Facility	MO Average	vs. MO Avg
Total deficiencies Formal regulatory issues recorded by inspectors across all inspection types.	94	35	This facility has 169% more total deficiencies than a typical Missouri assisted living residence (94 vs. MO avg 35).↑ 169% worse
Deficiencies per year Average deficiencies per year since 2018.	11.8	4.4	This facility has 168% more deficiencies per year than a typical Missouri assisted living residence (11.8 vs. MO avg 4.4).↑ 168% worse
Deficiencies per inspection Average deficiencies per inspection.	5.2	5	This facility has 4% more deficiencies per inspection than a typical Missouri assisted living residence (5.2 vs. MO avg 5).↑ 4% worse

Inspections State inspections evaluate whether the facility meets health and safety standards.	This Facility	MO Average	vs. MO Avg
Total inspections Combined count of all routine and focused inspections. Excludes complaint investigations.	18	7	This facility has 157% more total inspections than a typical Missouri assisted living residence (18 vs. MO avg 7).↑ 157% worse

Inspection Reports Summary An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.

The August 21, 2025 annual inspection found 11 deficiencies including resident fund mismanagement, incomplete background checks, inadequate RN staffing, poor respiratory care, and unsanitary kitchen conditions.
A June 2, 2025 complaint investigation substantiated failure to protect a resident from physical abuse and delayed increased supervision after the incident.
The May 25, 2023 annual inspection found no health deficiencies.

Show Inspection Reports

Inspections since 2019

Total health inspections 7

State average N/A

Last Health inspection on Aug 2025

Total health citations

State average N/A

Citations per inspection

6.29

State average N/A

Health citations are formal notices following inspections when they fail to comply with safety and care standards.

37 of 44 citations resulted from standard inspections; and 7 of 44 resulted from complaint investigations.

Breakdown of citation severity (last 7 years)

Critical health citations

In line with State average

State average: N/A

Serious health citations

In line with State average

State average: N/A

2 critical citations State average: N/A

0 serious citations State average: N/A

42 moderate citations State average: N/A

0 minor citations State average: N/A

Citations history (last 7 years)

Nutrition moderate citation Aug 21, 2025

Corrected

Nutrition moderate citation Aug 21, 2025

Corrected

Abuse/Neglect moderate citation Jun 02, 2025

Corrected

Infection Control moderate citation Apr 05, 2025

Corrected

Total staff 43

Employees 36

Contractors 7

Staff to resident ratio 1.39 : 1

0% compared with State average

State average ratio: 0 : 0

Avg staff/day 16

Average shift 8.3 hours

0% compared with State average

State average: 0 hours

Total staff hours (quarter) 12,204

Nursing staff breakdown

8.5 hours

8.9 hours

9.1 hours

Contractor staffing

517 contractor hours this quarter

Speech Language Pathologist: 2 Physical Therapy Assistant: 1 Physical Therapy Aide: 1 Occupational Therapy Assistant: 1 Respiratory Therapy Technician: 1 Occupational Therapy Aide: 1

Staff by category


Certified Nursing Assistant	18	0	18	5,706	92	100%	9.1
Licensed Practical Nurse	3	0	3	1,440	83	90%	8.9
Nurse Aide in Training	5	0	5	1,396	85	92%	7.7
Nurse Practitioner	2	0	2	998	73	79%	10
Registered Nurse	4	0	4	687	68	74%	8.5
Dietitian	1	0	1	559	57	62%	9.8
Medication Aide/Technician	1	0	1	533	46	50%	11.6
Mental Health Service Worker	1	0	1	364	52	57%	7
Speech Language Pathologist	0	2	2	364	65	71%	5.6
Physical Therapy Aide	0	1	1	79	45	49%	1.8
Physical Therapy Assistant	0	1	1	32	14	15%	2.3
Occupational Therapy Aide	0	1	1	22	3	3%	7.3
Respiratory Therapy Technician	0	1	1	14	21	23%	0.7
Occupational Therapy Assistant	0	1	1	7	2	2%	3.5
Administrator	1	0	1	4	1	1%	3.5

18 Certified Nursing Assistant

% of Days 100%

3 Licensed Practical Nurse

% of Days 90%

5 Nurse Aide in Training

% of Days 92%

2 Nurse Practitioner

% of Days 79%

4 Registered Nurse

% of Days 74%

1 Dietitian

% of Days 62%

1 Medication Aide/Technician

% of Days 50%

1 Mental Health Service Worker

% of Days 57%

2 Speech Language Pathologist

% of Days 71%

1 Physical Therapy Aide

% of Days 49%

1 Physical Therapy Assistant

% of Days 15%

1 Occupational Therapy Aide

% of Days 3%

1 Respiratory Therapy Technician

% of Days 23%

1 Occupational Therapy Assistant

% of Days 2%

1 Administrator

% of Days 1%

View All Staffing Data

Total fines amount $114K

57% higher than State average

State average: $73K

Number of fines 1

59% fewer fines than State average

State average: 2.4

Payment Denials 0

100% fewer payment denials than State average

State average: 0.7

Fines amount comparison

This facility $114K

State average $73K

Penalty History

Penalties are imposed by CMS for violations of federal nursing home regulations.

1 penalty in the past 3 years

Feb 26, 2024 · $114K

Civil Money Penalty Feb 26, 2024

$114K

Last updated: Jan 2026

High-risk clinical events score 11.5

6% worse than State average

State average: 10.9

Functional decline score 22.4

15% worse than State average

State average: 19.5

Long-stay resident measures

Significantly below average State avg: 2.7

Need for Help with Daily Activities Increased 22.9%

16% worse than State average

State average: 19.8%

Walking Ability Worsened 18.1%

12% better than State average

State average: 20.6%

Low Risk Residents with Bowel/Bladder Incontinence 26.0%

44% worse than State average

State average: 18.1%

Falls with Major Injury 8.3%

106% worse than State average

State average: 4.0%

High Risk Residents with Pressure Ulcers 5.3%

6% worse than State average

State average: 5.0%

Urinary Tract Infection 0.8%

69% better than State average

State average: 2.7%

Lost Too Much Weight 3.1%

45% better than State average

State average: 5.6%

Depressive Symptoms 0.0%

100% better than State average

State average: 12.8%

Antipsychotic Use 63.9%

190% worse than State average

State average: 22.0%

Pneumococcal Vaccine 100.0%

17% better than State average

State average: 85.2%

Influenza Vaccine 100.0%

10% better than State average

State average: 90.9%

Hospitalizations per 1,000 days 1.59

24% better than State average

State average: 2.08

ED visits per 1,000 days 2.80

19% worse than State average

State average: 2.35

Short-stay resident measures

Pneumococcal Vaccine 100.0%

50% better than State average

State average: 66.6%

Antipsychotic medication increase 17.9%

706% worse than State average

State average: 2.2%

Breakdown by payment type

Medicare

58% of new residents, usually for short-term rehab.

Typical stay 1 - 2 months

Private pay

25% of new residents, often for short stays.

Typical stay 1 years

Medicaid

17% of new residents, often for long-term daily care.

Typical stay 3 - 4 years

Total residents 31

Medicare

9.7% of residents

Medicaid

67.7% of residents

Private pay or other

22.6% of residents

Programs & Services

Residents Group

Residents meet regularly to discuss policies, care quality, and activities

Active Resident Council

Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.

Financial Trends

Historical financial and operational data for Livingston Manor Care Center from 2012–2024, based on CMS SNF Cost Reports.

Occupancy Rate 34.3% ↓ 5.8pp vs 2023

Net Patient Income -$544.7K ↓ ~$239.3K vs 2023

Payroll Costs $1.7M ↑ ~$61.2K vs 2023

Operating Margin -21.3% ↓ 10.4pp vs 2023

Metric	2012	2013	2014	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
Occupancy %	46.6%	43.4%	42.9%	41.6%	45.2%	38.0%	35.1%	39.7%	49.3%	39.7%	35.4%	40.1%	34.3%
Beds	94	94	94	94	94	94	94	94	94	94	94	94	94
Net Income	$42,785	$143,132	-$50,109	-$118,235	$120,171	-$435,247	-$449,561	$20,538	$520,131	-$491,422	-$619,729	-$296,446	-$537,383
Gross Revenue	$3,361,598	$3,700,073	$3,117,166	$3,714,385	$3,251,749	$2,872,341	$2,457,678	$3,037,968	$3,782,177	$3,139,241	$2,804,303	$3,210,152	$2,699,795
Operating Expenses	$2,437,279	$2,410,474	$2,423,291	$2,531,105	$2,623,359	$2,770,421	$2,542,867	$2,543,750	$3,098,915	$3,450,345	$3,052,809	$3,110,373	$3,102,165
Net Patient Income	-$45,346	$26,492	-$99,643	-$131,527	$105,224	-$446,522	-$461,059	$11,135	$163,639	-$643,679	-$626,558	-$305,420	-$544,684
Net Patient Revenue	$2,391,933	$2,436,966	$2,323,648	$2,399,578	$2,728,583	$2,323,899	$2,081,808	$2,554,885	$3,262,554	$2,806,666	$2,426,251	$2,804,953	$2,557,481
Payroll Costs	$1,360,466	$1,390,129	$1,401,396	$1,435,205	$1,425,625	$1,509,152	$1,452,144	$1,342,263	$1,619,937	$1,898,333	$1,705,315	$1,687,417	$1,748,590
Operating Margin %	-1.9%	1.1%	-4.3%	-5.5%	3.9%	-19.2%	-22.2%	0.4%	5.0%	-22.9%	-25.8%	-10.9%	-21.3%
Medicare %	8.3%	12.2%	10.6%	10.2%	9.5%	8.7%	7.5%	11.7%	10.0%	12.8%	9.3%	9.5%	7.0%
Medicaid %	64.4%	67.1%	60.8%	63.8%	59.4%	64.5%	64.6%	65.4%	62.5%	65.2%	70.0%	67.4%	64.1%
Private %	27.3%	20.7%	28.6%	26.0%	31.0%	26.8%	27.8%	22.9%	27.5%	21.9%	20.7%	23.1%	28.9%
Net Patient Revenue/Day	$149	$164	$158	$168	$175	$178	$173	$187	$193	$206	$200	$204	$217
Cost/Day	$152	$162	$165	$177	$169	$213	$211	$187	$183	$254	$251	$226	$263
Avg Length of Stay	197.7 days	158.5 days	175.0 days	158.6 days	155.6 days	178.5 days	167.3 days	160.4 days	192.6 days	189.0 days	253.0 days	180.9 days	294.9 days

Finances and operations

Based on CMS SNF Cost Report for fiscal year ending in 06/2024.

Net patient revenue

$2.6M

Net patient income

-$544.7K

For-profit Corporation

Net patient revenue

$2.6M

Net patient income

-$544.7K

Other income

$7.3K

Payroll costs

$1.7M 68.4% of net patient revenue

Other operating costs

$1.4M

Total costs

$3.1M

TYPE OF STAY

Mostly short-term rehab stays

Most residents typically stay for a few weeks or months before returning home or moving on.

Most new residents arrive under Medicare (58% of admissions), and a typical Medicare stay runs around 1 - 2 months.

Coverage residents most often arrive under.

Medicare 58%

Private pay 25%

Medicaid 17%

Coverage residents most often leave under.

Medicare 30%

Private pay 30%

Medicaid 40%

0.0 miles from city center Estimated distance in miles from Chillicothe's city center to Livingston Manor Care Center's address, calculated via Google Maps.

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The information below is reported by the Missouri Department of Health and Senior Services, Division of Regulation and Licensure.


Livingston Manor Care Center	NH HC MC RC	Chillicothe	-	94	-	71	-
Breeze Park – Lutheran Senior Services	NH AL IL MC	Weldon Spring	-	50	A+	2	1 Bed / 2 Bed
John Knox Village	NH AL HC IL MC RC	Lee's Summit	-	408	A+	58	1 Bed / 2 Bed
Ignite Medical Resort Blue Springs	NH PC	Blue Springs	-	90	-	68	-
Moore-Few Care Center	NH HC MC PC RC	-	-	108	-	39	Private Suites

Nursing Home Explorer

Who is the owner of Livingston Manor Care Center?

Livingston Manor Care Center is legally operated by Livingston Manor, Inc, and administered by Sara Hoover-Shaw.

Is Livingston Manor Care Center in a walkable area?

Livingston Manor Care Center has a walk score of 71. Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.

What is the license number of Livingston Manor Care Center?

According to MO state health department records, Livingston Manor Care Center's license number is 053036.

When does Livingston Manor Care Center's license expire?

According to MO state health department records, Livingston Manor Care Center's license expires on September 30, 2027.

What is the occupancy rate at Livingston Manor Care Center?

Livingston Manor Care Center's occupancy is 33%.

Does Livingston Manor Care Center operate as a for-profit or non-profit?

Livingston Manor Care Center is registered as a for-profit in MO.

Who is the administrator of Livingston Manor Care Center?

Sara Hoover-Shaw is the administrator of Livingston Manor Care Center.

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Livingston Manor Care Center

Overview of Livingston Manor Care Center

Quality ratings

Staffing hours breakdown

Capacity and availability

About this community

Occupancy

License Details

Ownership & Operating Entity

Type Of Units

Payment & Insurance

Therapy & Rehabilitation

Staffing & Medical

Memory & Specialized Care

Amenities & Lifestyle

Contact Livingston Manor Care Center

Inspection History

Inspection Scorecard This scorecard compares key inspection, deficiency, and complaint metrics at this facility against the Missouri state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.

Deficiencies Deficiencies are formal regulatory issues recorded during state inspections.

Inspections State inspections evaluate whether the facility meets health and safety standards.

Inspection Reports Summary An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.

Health Inspection History

Inspections since 2019

Breakdown of citation severity (last 7 years)

Citations history (last 7 years)

Staffing Data

Nursing staff breakdown

Registered Nurse

Licensed Practical Nurse

Certified Nursing Assistant

Contractor staffing

Staff by category

18 Certified Nursing Assistant

3 Licensed Practical Nurse

5 Nurse Aide in Training

2 Nurse Practitioner

4 Registered Nurse

1 Dietitian

1 Medication Aide/Technician

1 Mental Health Service Worker

2 Speech Language Pathologist

1 Physical Therapy Aide

1 Physical Therapy Assistant

1 Occupational Therapy Aide

1 Respiratory Therapy Technician

1 Occupational Therapy Assistant

1 Administrator

Penalties and fines

Fines amount comparison

Fines amount comparison

Penalty History

Quality of care over time

Long-stay resident measures

Short-stay resident measures

Breakdown by payment type

Medicare

Private pay

Medicaid

Facility Characteristics

Programs & Services

Residents Group

Active Resident Council

Financial Trends

Financial Performance

Payroll & Labor Costs

Payer Mix (percentage)

Finances and operations

Who this home usually serves

Mostly short-term rehab stays

Admissions

Discharges

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