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CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
N & R Of California, Inc handles operations at California Care Center, a 60-bed skilled nursing facility located at 1106 South Oak Street in California, Missouri. The administrative team structures billing across conventional avenues like Medicare, Medicaid, and private pay. For family visits, the surrounding layout scores 61 out of 100 for walkability, meaning the grid is moderately pedestrian-friendly, so guests can manage a few basic tasks on foot while a vehicle remains necessary for longer trips.
Operational charts report that the building runs at a 48 percent occupancy rate, with residents maintaining an average stay of roughly 197 days. This operational timeframe indicates a business pattern that balances standard long-term clinical care with short-term post-hospital therapy. To monitor daily recovery and routine treatments, the continuous 24-hour staffing schedule delivers an average of 3 hours and 15 minutes of total nursing care per resident each day, utilizing a combined rotation of registered nurses, practical nurses, and aides.
Recent health evaluations came back with clear surveys, though broader historical data from the tracking period flagged specific procedural corrections regarding medication logging accuracy and general housekeeping protocols, meaning the property’s overall cumulative citations-per-inspection rate is above zero.
Interested individuals can evaluate how the facility coordinates daily clinical resources like intravenous therapy, an on-staff physician, and specialized pharmaceutical care. The community pairs these medical tracks with standard services, including specialized dining options, scheduled religious services, beauty salon treatments, and resident medical transportation.
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.
This home is ranked 203rd out of 276 homes in Missouri for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
| 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.
| 17m per day | ▼ 39% 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.
| 37m per day | ▼ 10% 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.
| 2h 6m per day | ▼ 10% 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.
| 2h 36m per day | ▼ 15% 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.
| 1m per day | ▼ 62% 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.
| 19m per day | ▼ 6% State avg: 20m per day · National avg: 28m per day |
Lower than the Missouri average: 66.6%California Care Center is legally operated by N & R Of California, Inc., and administrated by Debra Dunham.
In Missouri, the Department of Health and Senior Services, Division of Regulation and Licensure performs the inspections and unannounced surveys required for all long-term care providers.
This scorecard compares key inspection, citation, 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
| This Facility | MO Average | vs. MO Avg |
|---|---|---|---|
|
Total deficiencies
Formal regulatory issues recorded by inspectors across all inspection types.
| 47 | 35 | This facility has 34% more total deficiencies than a typical Missouri nursing home (47 vs. MO avg 35).↑ 34% worse |
|
Deficiencies per year
Average deficiencies per year since 2018.
| 5.9 | 4.4 | This facility has 34% more deficiencies per year than a typical Missouri nursing home (5.9 vs. MO avg 4.4).↑ 34% worse |
|
Deficiencies per inspection
Average deficiencies per inspection.
| 4.3 | 5 | This facility has 14% fewer deficiencies per inspection than a typical Missouri nursing home (4.3 vs. MO avg 5).↓ 14% better |
Inspections
| This Facility | MO Average | vs. MO Avg |
|---|---|---|---|
|
Total inspections
Combined count of all routine and focused inspections. Excludes complaint investigations.
| 11 | 7 | This facility has 57% more total inspections than a typical Missouri nursing home (11 vs. MO avg 7).↑ 57% worse |
An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.
Missouri average 6.6
Last Health inspection on May 2024
Missouri average 36.5
Missouri average 5.67
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
4 of 6 citations resulted from standard inspections; and 2 of 6 resulted from complaint investigations.
100% better than Missouri averageMissouri average: 0.7
100% worse than Missouri averageMissouri average: 1
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
180% more staff per resident than Missouri average
11% worse than Missouri average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
9 total: 3 full-time employees and 6 contractors.
9
Average shift length. Calculated as total hours divided by days worked and average staff per day.
6.8 hoursAssists with medical care and medications.
11 total: 3 full-time employees and 8 contractors.
11
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.7 hoursHelps with daily care and mobility.
61 total: 5 full-time employees and 56 contractors.
61
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.5 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
5,959 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 5 | 56 | 61 | 5,257 | 92 | 100% | 7.5 |
| Licensed Practical Nurse | 3 | 8 | 11 | 1,664 | 92 | 100% | 8.7 |
| Medication Aide/Technician | 4 | 9 | 13 | 1,032 | 92 | 100% | 8.7 |
| Nurse Aide in Training | 3 | 0 | 3 | 628 | 58 | 63% | 8.5 |
| Registered Nurse | 3 | 6 | 9 | 525 | 64 | 70% | 6.8 |
| Dental Services Staff | 1 | 0 | 1 | 508 | 64 | 70% | 7.9 |
| Administrator | 1 | 0 | 1 | 461 | 63 | 68% | 7.3 |
| Nurse Practitioner | 1 | 0 | 1 | 408 | 61 | 66% | 6.7 |
| Speech Language Pathologist | 0 | 3 | 3 | 402 | 67 | 73% | 5.2 |
| Physical Therapy Assistant | 0 | 1 | 1 | 394 | 65 | 71% | 6.1 |
| RN Director of Nursing | 2 | 0 | 2 | 361 | 46 | 50% | 7.2 |
| Qualified Social Worker | 0 | 1 | 1 | 87 | 53 | 58% | 1.6 |
| Respiratory Therapy Technician | 0 | 1 | 1 | 42 | 19 | 21% | 2.2 |
| Physical Therapy Aide | 0 | 3 | 3 | 34 | 10 | 11% | 3.4 |
| Occupational Therapy Aide | 0 | 1 | 1 | 24 | 3 | 3% | 8 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 13 | 3 | 3% | 4.4 |
| Medical Director | 0 | 1 | 1 | 1 | 1 | 1% | 1 |
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database
No penalties in the past 3 years
No civil money penalties or payment denials were reported in the last 3 years.
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
14.2
30% worse than Missouri averageMissouri average: 10.9
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
26.7
37% worse than Missouri averageMissouri average: 19.5
CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Percent of long-stay residents whose need for help with daily activities has increased
24.4%
23% worse than Missouri averageMissouri average: 19.8%
Percent of long-stay residents whose ability to move independently worsened
33.2%
61% worse than Missouri averageMissouri average: 20.6%
Percent of low risk long-stay residents who lose control of their bowels or bladder
22.4%
24% worse than Missouri averageMissouri average: 18.1%
Percent of long-stay residents experiencing one or more falls with major injury
2.1%
49% better than Missouri averageMissouri average: 4.0%
Percent of long-stay high risk residents with pressure ulcers
6.5%
30% worse than Missouri averageMissouri average: 5.0%
Percent of long-stay residents with a urinary tract infection
2.2%
20% better than Missouri averageMissouri average: 2.7%
Percent of long-stay residents who lose too much weight
4.9%
12% better than Missouri averageMissouri average: 5.6%
Percent of long-stay residents who have depressive symptoms
0.0%
100% better than Missouri averageMissouri average: 12.8%
Percent of long-stay residents who received an antipsychotic medication
17.7%
19% better than Missouri averageMissouri average: 22.0%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
100.0%
17% better than Missouri averageMissouri average: 85.2%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
100.0%
10% better than Missouri averageMissouri average: 90.9%
CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
92.8%
39% better than Missouri averageMissouri average: 66.6%
Percent of short-stay residents who newly received an antipsychotic medication
2.9%
29% worse than Missouri averageMissouri average: 2.2%
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
11.9%
53% better than Missouri averageMissouri average: 25.3%
Percentage of short-stay residents who had an outpatient emergency department visit.
0.0%
100% better than Missouri averageMissouri average: 13.4%
Percentage of SNF residents who experience falls with major injury during their stay.
4.8%
518% worse than Missouri averageMissouri average: 0.8%
Rate of successful return to home or community from a skilled nursing facility.
45.6%
10% worse than Missouri averageMissouri average: 50.6%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
22% of new residents, usually for short-term rehab.
58% of new residents, often for short stays.
20% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
24Residents meet regularly to discuss policies, care quality, and activities
Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.
Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
Historical financial and operational data for California Care Center based on CMS SNF Cost Reports.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #270 / 286Payroll — State benchmarkedThis home is ranked 270th out of 286 homes in Missouri. Shows total annual staff payroll benchmarked to the Missouri average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
This home supports both short-term rehab and long-term care, with residents staying for a wide range of durations.
0.0 miles from city center
Estimated distance in miles from California's city center to California Care Center's address, calculated via Google Maps.
Add your location
California Care Center is located in ROUTE 3, Missouri.
Here are the financial assistance programs available to residents in Missouri.
The information below is reported by the Missouri Department of Health and Senior Services, Division of Regulation and Licensure.
| California Care Center |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Route 3 | 60
Facility
60
MO AVG
97
Rank
#343 / 454 |
48.3%
Facility
48.3%
MO AVG
66.6%
Rank
#340 / 428 | -28% | 3.25
Facility
3.25
MO AVG
3.74
Rank
#203 / 276 | +3% | -13% | $0
Facility
$0
MO AVG
$76.9k
Rank
#1 / 283 | 6
Facility
6
MO AVG
36.5
Rank
#5 / 281 | 2.0
Facility
2.0
MO AVG
5.7
Rank
#6 / 281 | 2 | 36 | - |
61
Facility
61
MO AVG
45
Rank
#154 / 563 | N & R Of California Inc | $2.6M
Facility
$2.6M
MO AVG
$8.4M
Rank
#274 / 286 | $1.6M
Facility
$1.6M
MO AVG
$3.3M
Rank
#270 / 286 | 63.1%
Facility
63.1%
MO AVG
45.6%
Rank
#72 / 286 | 265396 | ||||
| Breeze Park – Lutheran Senior Services |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk. | Weldon Spring | 50
Facility
50
MO AVG
97
Rank
#390 / 454 | - | - | 5.01
Facility
5.01
MO AVG
3.74
Rank
#31 / 276 | -16% | +34% | $41.3k
Facility
$41.3k
MO AVG
$76.9k
Rank
#222 / 283 | 16
Facility
16
MO AVG
36.5
Rank
#55 / 281 | 4.0
Facility
4.0
MO AVG
5.7
Rank
#75 / 281 | 2 | 46 | A+ |
2
Facility
2
MO AVG
45
Rank
#545 / 563 | Holly Stevens | $20.9M
Facility
$20.9M
MO AVG
$8.4M
Rank
#17 / 286 | $12.2M
Facility
$12.2M
MO AVG
$3.3M
Rank
#6 / 286 | 58.6%
Facility
58.6%
MO AVG
45.6%
Rank
#105 / 286 | 265767 | ||||
| Farmington Presbyterian Manor |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk. | Farmington | 90
Facility
90
MO AVG
97
Rank
#227 / 454 |
74.4%
Facility
74.4%
MO AVG
66.6%
Rank
#150 / 428 | +12% | 4.58
Facility
4.58
MO AVG
3.74
Rank
#43 / 276 | +49% | +23% | $12.6k
Facility
$12.6k
MO AVG
$76.9k
Rank
#167 / 283 | 9
Facility
9
MO AVG
36.5
Rank
#11 / 281 | 2.3
Facility
2.3
MO AVG
5.7
Rank
#11 / 281 | 1 | 70 | A+ |
66
Facility
66
MO AVG
45
Rank
#113 / 563 | Jane Hull | $9.9M
Facility
$9.9M
MO AVG
$8.4M
Rank
#73 / 286 | $6.3M
Facility
$6.3M
MO AVG
$3.3M
Rank
#52 / 286 | 63%
Facility
63%
MO AVG
45.6%
Rank
#74 / 286 | 265583 | ||||
| Armour Oaks Senior Living Community |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support. | Kansas City (Waldo Homes) | 38
Facility
38
MO AVG
97
Rank
#424 / 454 |
100.0%
Facility
100.0%
MO AVG
66.6%
Rank
#1 / 428 | +50% | 3.03
Facility
3.03
MO AVG
3.74
Rank
#230 / 276 | -27% | -19% | $0
Facility
$0
MO AVG
$76.9k
Rank
#1 / 283 | 39
Facility
39
MO AVG
36.5
Rank
#183 / 281 | 6.5
Facility
6.5
MO AVG
5.7
Rank
#200 / 281 | - | 100 | A+ |
73
Facility
73
MO AVG
45
Rank
#70 / 563 | Womens Christian Association Of Kansas City Missouri | $2.9M
Facility
$2.9M
MO AVG
$8.4M
Rank
#264 / 286 | $2.4M
Facility
$2.4M
MO AVG
$3.3M
Rank
#221 / 286 | 81.6%
Facility
81.6%
MO AVG
45.6%
Rank
#13 / 286 | 265802 | ||||
| Sunrise of Des Peres |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk. | Des Peres | 102
Facility
102
MO AVG
97
Rank
#169 / 454 |
72.5%
Facility
72.5%
MO AVG
66.6%
Rank
#166 / 428 | +9% | 3.50
Facility
3.50
MO AVG
3.74
Rank
#168 / 276 | +4% | -6% | $334.9k
Facility
$334.9k
MO AVG
$76.9k
Rank
#277 / 283 | 87
Facility
87
MO AVG
36.5
Rank
#272 / 281 | 7.9
Facility
7.9
MO AVG
5.7
Rank
#243 / 281 | 13 | 74 | A+ |
50
Facility
50
MO AVG
45
Rank
#244 / 563 | Mary Grodeon | $15.6M
Facility
$15.6M
MO AVG
$8.4M
Rank
#32 / 286 | $7.7M
Facility
$7.7M
MO AVG
$3.3M
Rank
#31 / 286 | 49.2%
Facility
49.2%
MO AVG
45.6%
Rank
#186 / 286 | 265834 |
The legal owner and operator of California Care Center is N & R Of California, Inc..
California Care Center has a walk score of 61. Moderately walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.
According to MO state health department records, California Care Center's license number is 052595.
According to MO state health department records, California Care Center's license expires on March 31, 2027.
California Care Center's occupancy is 48%.
Debra Dunham is the administrator of California Care Center.
California Care Center has 60 beds.
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