Grand River Health Care

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

CMS overall rating

118 Trenton Rd, Chillicothe, MO 64601-4002 View map

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Grand River Health Care accepts Medicaid, Medicare, and private pay.

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Grand River Health Care accepts Medicaid, Medicare, and private pay.

Overview of Grand River Health Care

Grand River Health Care is a skilled nursing home in Chillicothe, Missouri, operated by N & R Of Chillicothe, Inc. The 60-bed facility is at 118 Trenton Rd, which scores 71 out of 100 for walkability. Most residents and visiting family can handle everyday errands on foot. Medicaid, Medicare, and private pay are accepted, providing families multiple options to cover short-term rehabilitation or longer-term nursing care.

The facility has a wide range of clinical services, including rehabilitation, respite care, skilled nursing care, and physical and occupational therapy. There are also specialized programs in behavioral health and Alzheimer’s care. A doctor is on staff, and the facility provides 24-hour nursing coverage.

Residents with more complex medical needs can access infusion therapy and hospice services. Total nurse staffing averages approximately 4 hours and 43 minutes per resident each day. The care team is composed of registered nursing, licensed practical nursing, and nurse aide support.

The facility’s current occupancy rate is 52%, and residents stay an average of 257 days. The home serves both short-term rehabilitation patients and those needing ongoing skilled care. Residents have access to comprehensive dining services, including nutritious meals tailored to individual preferences. These help support resident recovery and well-being.

State inspections documented concerns in areas related to resident safety and abuse prevention, medication management, infection control, food safety, and the timeliness of protective actions. Families evaluating the facility should carefully review the inspection history and ask how it addresses ongoing matters.

Facility Direct Line (660) 646-0353

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

4h 43m per day

vs avg

4 of 6 metrics below state avg

Standout metric Weekend RN is +29% 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.	32m per day	▲ 15% 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.	26m per day	▼ 37% 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.	1h 57m per day	▼ 16% 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 48m per day	▼ 8% 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	▼ 92% 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.	26m per day	▲ 29% State avg: 20m per day · National avg: 28m per day

Capacity and availability

257 days

60-bed community

A moderately sized community that may balance personal attention with shared amenities and social activities.

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

52%

Lower than the Missouri average: 66.6%

Occupied beds

31 / 60

Average occupied beds in Missouri homes 72 beds

Facility TypeSkilled Nursing Facility

StatusActive

IssuanceOctober 31, 2025

ExpirationOctober 30, 2027

CountyLivingston

License Number053109

CMS Certification Number265480

Certification TypeMedicare / Medicaid

Grand River Health Care is legally operated by N & R Of Chillicothe, Inc., and administered by Barbara Jamison.

Corporate EntityN & R OF CHILLICOTHE, INC

Owner NameN & R Of Chillicothe, Inc

Skilled Nursing Facility

60 units

Total beds

60 units

Accept Medicaid

Accept Medicare

Rehabilitation Services

Respite Care

Short-Term Rehab

Doctor on Staff

24-Hour Staffing

Skilled Nursing Care

Physical And Occupational Therapies

Behavioral And Alzheimer’s Care

Hospice

Pets not allowed

Since 2021 · 5 years of data 99 deficiencies 13 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 2021 vs. Missouri state average

Overall vs. MO average

Latest Inspection January 5, 2026 Complaint Investigation

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.	99	35	This facility has 183% more total deficiencies than a typical Missouri assisted living residence (99 vs. MO avg 35).↑ 183% worse
Deficiencies per year Average deficiencies per year since 2021.	19.8	7	This facility has 183% more deficiencies per year than a typical Missouri assisted living residence (19.8 vs. MO avg 7).↑ 183% worse
Deficiencies per inspection Average deficiencies per inspection.	7.6	2.9	This facility has 162% more deficiencies per inspection than a typical Missouri assisted living residence (7.6 vs. MO avg 2.9).↑ 162% 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.	13	12	This facility has had 8% more total inspections than the Missouri average (13 vs. MO avg 12). More inspections can mean more regulatory scrutiny rather than worse care.↑ 8% more

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

January 5, 2026 inspection substantiated physical abuse by the DON and Administrator causing bruises and arm pain, with immediate jeopardy identified and delayed protective actions.
February 27, 2025 routine survey found 18 deficiencies including medication errors, infection control lapses, abuse threats, poor food safety, and failure to provide dignified care.
Multiple complaint investigations from 2024 to 2025 documented repeated resident abuse by staff and failure to timely report abuse, but corrective actions and staff removals were sometimes implemented.

Show Inspection Reports

Inspections since 2021

Total health inspections 7

State average N/A

Last Health inspection on Mar 2025

Total health citations

State average N/A

Citations per inspection

8.14

State average N/A

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

46 of 57 citations resulted from standard inspections; 8 of 57 resulted from complaint investigations; and 3 of 57 came from combined inspections (standard and complaint).

Breakdown of citation severity (last 5 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

0 critical citations State average: N/A

3 serious citations State average: N/A

54 moderate citations State average: N/A

0 minor citations State average: N/A

Citations history (last 5 years)

Abuse/Neglect serious citation Mar 25, 2025

Corrected

Abuse/Neglect moderate citation Mar 25, 2025

Corrected

Abuse/Neglect moderate citation Mar 25, 2025

Corrected

Abuse/Neglect moderate citation Feb 27, 2025

Corrected

Total staff 69

Employees 26

Contractors 43

Staff to resident ratio 2.56 : 1

0% compared with State average

State average ratio: 0 : 0

Avg staff/day 11

Average shift 8.6 hours

0% compared with State average

State average: 0 hours

Total staff hours (quarter) 8,726

Nursing staff breakdown

12.4 hours

8.9 hours

8.4 hours

Contractor staffing

1,938 contractor hours this quarter

Certified Nursing Assistant: 27 Licensed Practical Nurse: 4 Medication Aide/Technician: 2 Registered Nurse: 2 Speech Language Pathologist: 1 Occupational Therapy Assistant: 1 Nurse Practitioner: 1 Qualified Social Worker: 1 Occupational Therapy Aide: 1 Respiratory Therapy Technician: 1 Physical Therapy Aide: 1 Physical Therapy Assistant: 1

Staff by category


Certified Nursing Assistant	7	27	34	3,343	92	100%	8.4
Licensed Practical Nurse	3	4	7	1,134	89	97%	8.9
Medication Aide/Technician	3	2	5	1,115	86	93%	11.5
Registered Nurse	3	2	5	1,112	81	88%	12.4
Nurse Aide in Training	4	0	4	697	57	62%	8.6
Administrator	1	0	1	458	60	65%	7.6
Dental Services Staff	4	0	4	435	56	61%	6.9
Nurse Practitioner	1	1	2	305	39	42%	7.8
Qualified Social Worker	0	1	1	37	20	22%	1.9
Speech Language Pathologist	0	1	1	27	17	18%	1.6
Occupational Therapy Aide	0	1	1	24	3	3%	8
Physical Therapy Aide	0	1	1	13	9	10%	1.4
Occupational Therapy Assistant	0	1	1	10	3	3%	3.3
Physical Therapy Assistant	0	1	1	10	2	2%	4.8
Respiratory Therapy Technician	0	1	1	7	7	8%	1

34 Certified Nursing Assistant

% of Days 100%

7 Licensed Practical Nurse

% of Days 97%

5 Medication Aide/Technician

% of Days 93%

5 Registered Nurse

% of Days 88%

4 Nurse Aide in Training

% of Days 62%

1 Administrator

% of Days 65%

4 Dental Services Staff

% of Days 61%

2 Nurse Practitioner

% of Days 42%

1 Qualified Social Worker

% of Days 22%

1 Speech Language Pathologist

% of Days 18%

1 Occupational Therapy Aide

% of Days 3%

1 Physical Therapy Aide

% of Days 10%

1 Occupational Therapy Assistant

% of Days 3%

1 Physical Therapy Assistant

% of Days 2%

1 Respiratory Therapy Technician

% of Days 8%

View All Staffing Data

Total fines amount $27K

64% lower than State average

State average: $73K

Number of fines 1

59% fewer fines than State average

State average: 2.4

Payment Denials 2

191% more payment denials than State average

State average: 0.7

Fines amount comparison

This facility $27K

State average $73K

Penalty History

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

2 penalties in the past 3 years

Multiple penalties were reported in the last 3 years.

Civil Money Penalty Dec 5, 2024

$27K

Payment Denial Dec 5, 2024

2 days

Last updated: Jan 2026

High-risk clinical events score 5.1

53% better than State average

State average: 10.9

Functional decline score 7.2

63% better than State average

State average: 19.5

Long-stay resident measures

Above average State avg: 2.7

Need for Help with Daily Activities Increased 9.6%

52% better than State average

State average: 19.8%

Walking Ability Worsened 8.7%

58% better than State average

State average: 20.6%

Low Risk Residents with Bowel/Bladder Incontinence 3.4%

81% better than State average

State average: 18.1%

Falls with Major Injury 0.0%

100% better than State average

State average: 4.0%

High Risk Residents with Pressure Ulcers 4.0%

21% better than State average

State average: 5.0%

Urinary Tract Infection 3.7%

36% worse than State average

State average: 2.7%

Lost Too Much Weight 3.3%

41% better than State average

State average: 5.6%

Depressive Symptoms 1.1%

92% better than State average

State average: 12.8%

Antipsychotic Use 63.6%

189% worse than State average

State average: 22.0%

Pneumococcal Vaccine 2.7%

97% worse than State average

State average: 85.2%

Influenza Vaccine 96.6%

6% better than State average

State average: 90.9%

Breakdown by payment type

Medicare

10% of new residents, usually for short-term rehab.

Typical stay 1 - 2 months

Private pay

5% of new residents, often for short stays.

Typical stay 4 months

Medicaid

86% of new residents, often for long-term daily care.

Typical stay 1 - 2 years

Total residents 27

Medicare

3.7% of residents

Medicaid

96.3% 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 Grand River Health Care from 2011–2023, based on CMS SNF Cost Reports.

Key figures below are for fiscal year ending in 12/2023.

Occupancy Rate 42.2% ↓ 3.9pp vs 2022

Net Patient Income -$456.7K ↑ ~$88.9K vs 2022

Payroll Costs $1.1M ↓ ~$56.9K vs 2022

Operating Margin -25.1% ↑ 3.5pp vs 2022

Metric	2011	2012	2013	2014	2015	2016	2017	2018	2019	2020	2021	2022	2023
Occupancy %	60.3%	62.1%	71.9%	71.7%	68.0%	72.5%	70.3%	69.7%	76.5%	59.5%	54.8%	46.1%	42.2%
Beds	60	60	60	60	60	60	60	60	60	60	60	60	60
Net Income	-$351,983	-$39,343	$269,144	$283,333	$211,254	$314,564	$401,947	$321,537	$443,789	$429,346	$209,442	-$411,989	-$315,635
Gross Revenue	$2,111,698	$2,320,076	$2,613,056	$2,765,386	$2,552,419	$2,727,105	$2,758,778	$2,856,087	$3,218,664	$2,611,788	$2,318,469	$1,914,306	$1,737,630
Operating Expenses	$2,245,285	$2,140,008	$2,243,361	$2,256,079	$2,222,757	$2,305,494	$2,204,394	$2,276,448	$2,507,636	$2,494,743	$2,431,393	$2,453,681	$2,278,376
Net Patient Income	-$357,992	-$47,718	$260,913	$274,598	$200,057	$301,382	$390,319	$308,784	$425,316	-$66,736	-$120,488	-$545,522	-$456,668
Net Patient Revenue	$1,887,293	$2,092,290	$2,504,274	$2,530,677	$2,422,814	$2,606,876	$2,594,713	$2,585,232	$2,932,952	$2,428,007	$2,310,905	$1,908,159	$1,821,708
Payroll Costs	$892,831	$880,059	$958,284	$928,633	$925,916	$966,950	$844,808	$888,240	$1,055,774	$1,073,862	$1,085,848	$1,113,424	$1,056,512
Operating Margin %	-19.0%	-2.3%	10.4%	10.9%	8.3%	11.6%	15.0%	11.9%	14.5%	-2.8%	-5.2%	-28.6%	-25.1%
Medicare %	4.6%	5.2%	3.3%	4.1%	2.9%	1.7%	2.1%	3.4%	5.4%	6.5%	3.4%	2.4%	0.7%
Medicaid %	80.0%	79.5%	82.6%	85.4%	87.6%	88.4%	90.6%	89.6%	89.1%	88.7%	92.4%	95.1%	97.9%
Private %	15.4%	15.3%	14.1%	10.5%	9.5%	9.9%	7.3%	7.0%	5.6%	4.8%	4.2%	2.5%	1.3%
Net Patient Revenue/Day	$143	$153	$159	$161	$163	$164	$168	$169	$175	$186	$193	$189	$197
Cost/Day	$170	$157	$142	$144	$149	$145	$143	$149	$150	$191	$203	$243	$247
Avg Length of Stay	185.9 days	243.6 days	366.2 days	238.0 days	261.4 days	224.2 days	236.9 days	224.5 days	138.4 days	124.4 days	139.5 days	177.1 days	256.6 days

Finances and operations

Based on CMS SNF Cost Report for fiscal year ending in 12/2023.

Net patient revenue

$1.8M

Net patient income

-$456.7K

For-profit Corporation

Net patient revenue

$1.8M

Net patient income

-$456.7K

Other income

$141.0K

Payroll costs

$1.1M 58% of net patient revenue

Other operating costs

$1.2M

Total costs

$2.3M

TYPE OF STAY

Mostly long-term care residents

Most residents stay for extended periods and receive ongoing daily care.

Most new residents arrive under Medicaid (86% of admissions), and a typical Medicaid stay runs around 1 - 2 years.

Coverage residents most often arrive under.

Medicare 10%

Private pay 5%

Medicaid 86%

Coverage residents most often leave under.

Medicare 6%

Private pay 3%

Medicaid 92%

0.0 miles from city center Estimated distance in miles from Chillicothe's city center to Grand River Health Care'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.


Laclede Groves	NH AL IL MC	St. Louis	-	251	-	35	-
Republic Nursing and Rehab	NH SNF	Republic	-	127	-	48	Private / Semi-Private Rooms
Chaffee Nursing Center	NH HOS SNF	Chaffee	-	71	-	25	Studio
Heisinger Bluffs	NH AL IL MC RC SNF	Jefferson City	-	111	-	32	1 Bed / 2 Bed / 3 Bed
Grand River Health Care	NH HOS RC SNF	Chillicothe	-	60	-	71	-

Nursing Home Explorer

Who is the owner of Grand River Health Care?

Grand River Health Care is legally operated by N & R Of Chillicothe, Inc., and administered by Barbara Jamison.

Is Grand River Health Care in a walkable area?

Grand River Health Care 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 Grand River Health Care?

According to MO state health department records, Grand River Health Care's license number is 053109.

When does Grand River Health Care's license expire?

According to MO state health department records, Grand River Health Care's license expires on October 30, 2027.

What is the occupancy rate at Grand River Health Care?

Grand River Health Care's occupancy is 52%.

Are pets allowed at Grand River Health Care?

No, Grand River Health Care has a no-pet policy.

Does Grand River Health Care operate as a for-profit or non-profit?

Grand River Health Care is registered as a for-profit in MO.

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Grand River Health Care

Overview of Grand River Health Care

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

Additional Services

Additional Policies & Features

Amenities & Lifestyle

Contact Grand River Health Care

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 2021

Breakdown of citation severity (last 5 years)

Citations history (last 5 years)

Staffing Data

Nursing staff breakdown

Registered Nurse

Licensed Practical Nurse

Certified Nursing Assistant

Contractor staffing

Staff by category

34 Certified Nursing Assistant

7 Licensed Practical Nurse

5 Medication Aide/Technician

5 Registered Nurse

4 Nurse Aide in Training

1 Administrator

4 Dental Services Staff

2 Nurse Practitioner

1 Qualified Social Worker

1 Speech Language Pathologist

1 Occupational Therapy Aide

1 Physical Therapy Aide

1 Occupational Therapy Assistant

1 Physical Therapy Assistant

1 Respiratory Therapy Technician

Penalties and fines

Fines amount comparison

Fines amount comparison

Penalty History

Quality of care over time

Long-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 long-term care residents

Admissions

Discharges

Places of interest near Grand River Health Care

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