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Grand River Health Care
Nursing Home, Hospice Care, Respite Care & Skilled Nursing · Chillicothe, MO
CMS overall rating Info 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.

Grand River Health Care

Nursing Home, Hospice Care, Respite Care & Skilled Nursing · Chillicothe, MO
CMS overall rating Info 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.
118 Trenton Rd, Chillicothe, MO 64601-4002 View map Calculator: See prices in your area
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
Facility Direct Line (660) 646-0353

Quality ratings

Measured by Centers for Medicare & Medicaid Services (CMS)

Overall rating Info 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.
▼ 59.7% Below MO avg. ▼ 59.7% Below MO avg.MO average: 2.5Click the badge to see the full State ranking.Click here to see the full State ranking.
Health Inspection Info 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.
▼ 64.0% Below MO avg. ▼ 64.0% Below MO avg.MO average: 2.8Click the badge to see the full State ranking.Click here to see the full State ranking.
Staffing Info 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.
▼ 54.3% Below MO avg. ▼ 54.3% Below MO avg.MO average: 2.2Click the badge to see the full State ranking.Click here to see the full State ranking.
Quality Measures Info 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.
▼ 24.7% Below MO avg. ▼ 24.7% Below MO avg.MO average: 2.7Click the badge to see the full State ranking.Click here to see the full State ranking.

Staffing hours Info 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.

Hours per resident per day vs Missouri averages

Rank #140 / 268Nurse hours — State benchmarkedThis home is ranked 140th out of 268 homes we track in Missouri for nurse hours. Shows adjusted nurse hours per resident per day benchmarked to the Missouri average, with a ranking across 268 Missouri facilities. More hours mean more direct care. The national average is about 3.5 hrs; below 3.0 is a red flag.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Missouri that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

Total nursing care Info This home is ranked 140th out of 268 homes we track 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.

3h 35m

4% below state avg
Staff type
Hours / day / resident
vs state avg
Registered Nurse (RN) Info 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.
33m
+17% State avg: 28m per day · National avg: 41m per day
LPN / LVN Info 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.
33m
−20% State avg: 41m per day · National avg: 52m per day
Nurse Aide Info 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 30m
+8% State avg: 2h 19m per day · National avg: 2h 20m per day
Weekend Total Nursing Info 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.
3h 29m
+14% State avg: 3h 3m per day · National avg: 3h 26m per day
Physical Therapist Info 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
−79% State avg: 2m per day · National avg: 4m per day
Weekend RN Info 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
+42% State avg: 20m per day · National avg: 28m per day

2 of 6 metrics below state avg

Standout metric: Weekend RN is +42% above Missouri average

Capacity and availability

Residents per day
31
Avg. Length of Stay Info Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
257 days
Bed community size
60-bed community Rank #340 / 450Bed count — State benchmarkedThis home is ranked 340th out of 450 homes we track in Missouri for bed count. Shows this facility's certified or reported bed count compared to other Missouri facilities. Larger communities may offer more amenities, programs, and on-site services for residents and families.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Missouri that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
A moderately sized community that may balance personal attention with shared amenities and social activities.
Walk Score
Walk Score: 71 / 100 Rank #80 / 545Walk Score — State benchmarkedThis home is ranked 80th out of 545 homes we track in Missouri for walk score. Shows how walkable this facility's neighborhood is compared to the average walk score across Missouri facilities. Higher scores benefit residents, families, and staff.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Missouri that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.

About this community

Occupancy

Occupancy rate
52%
Rank #322 / 407Occupancy rate — State benchmarkedThis home is ranked 322nd out of 407 homes we track in Missouri for occupancy. Shows this facility's occupancy rate versus the Missouri average, with its Statewide rank out of 407. Higher occupancy signals strong local demand and financial stability.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Missouri that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Lower than the Missouri average: 66.6%
Occupied beds
31 / 60
Average occupied beds in Missouri homes 72 beds

License Details

Facility TypeSkilled Nursing Facility
StatusActive
IssuanceOctober 31, 2025
ExpirationOctober 30, 2027
CountyLivingston
License Number053109
CMS Certification Number265480
Certification TypeMedicare / Medicaid

Ownership & Operating Entity

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

Type Of Units

Skilled Nursing Facility
60 units
Total beds
60 units

Payment & Insurance

2 services
Accept Medicaid
Accept Medicare

Therapy & Rehabilitation

3 services
Rehabilitation Services
Respite Care
Short-Term Rehab

Staffing & Medical

2 services
Doctor on Staff
24-Hour Staffing

Additional Services

4 services
Skilled Nursing Care
Physical And Occupational Therapies
Behavioral And Alzheimer’s Care
Hospice

Additional Policies & Features

Pets not allowed

Amenities & Lifestyle

Specific ProgramsProfessional Medical Care, Infusion Treatment, Rehab Services, Geri-Psychiatric, Behavioral Health Services, Complete Dining Services, Medicare & Medicaid Certified, Transportation Available, Behavioral Health Services – Horizons, IV Therapy

Contact Grand River Health Care

Inspection History

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.

Since 2021 · 5 years of data These figures come from state-published and/or federal inspection records. The period covered can vary depending on document availability. 99 deficiencies 13 inspections

Inspection Scorecard Info 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 2 Worse Metrics worse than Missouri average:
• Total deficiencies (55% above)
• Deficiencies per inspection (43% above) 0 Better No metrics in this bucket.

Deficiencies Info Deficiencies are formal regulatory issues recorded during state inspections.

This FacilityMO Averagevs. MO Avg
Total deficiencies Info Formal regulatory issues recorded by inspectors across all inspection types. 9964 This facility has 55% more total deficiencies than a typical Missouri nursing home (99 vs. MO avg 64).↑ 55% worse
Deficiencies per inspection Info Average deficiencies per inspection. 7.65.3 This facility has 43% more deficiencies per inspection than a typical Missouri nursing home (7.6 vs. MO avg 5.3).↑ 43% worse

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

This FacilityMO Averagevs. MO Avg
Total inspections Info Combined count of all inspections conducted at this facility. 1312 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
Show Inspection Reports

CMS Health Inspection History

Federal inspection data published by CMS, covering this home's Medicare and/or Medicaid-certified skilled-nursing/nursing beds only.

Inspections Since 2021 · 5 years of data
Total health inspections 7

State average 6.6

Last Health inspection on Mar 2025

Total health citations
57 Rank #235 / 274Health citations — State benchmarkedThis home is ranked 235th out of 274 homes we track in Missouri for health citations. Shows this facility's total health deficiency citations benchmarked to the Missouri State average, with a ranking across all 274 MO facilities. Lower citation counts earn a better rank.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Missouri that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

State average 36.5

Citations per inspection
8.14 Rank #239 / 274Citations per inspection — State benchmarkedThis home is ranked 239th out of 274 homes we track in Missouri for citations per inspection. Shows average deficiency citations per CMS inspection for this facility versus the Missouri mean across 274 facilities with citation data. Lower is better.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Missouri that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

State average 5.67

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
0
100% better than State average

State average: 0.7

Serious health citations
3
200% worse than State average

State average: 1

0 critical citations State average: 0.7
3 serious citations State average: 1
54 moderate citations State average: 33.6
0 minor citations State average: 1.2
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

Data sourced from CMS Health Deficiencies reports, which cover the Medicare and/or Medicaid-certified skilled-nursing and nursing beds and no other part of the community. Citation severity codes range from A (least serious) to L (most serious). Immediate Jeopardy (J-L) citations indicate situations where the facility's noncompliance has placed residents at risk of death or serious harm.

Staffing Data

Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.

Total staff 69
Employees 26
Contractors 43
Staff to resident ratio 2.56 : 1
51% more staff per resident than Missouri average
Missouri average ratio: 1.69 : 1 Missouri average ratio: 1.69 : 1See full Missouri ranking
Avg staff/day 11
Average shift 8.6 hours
6% better than Missouri average
Missouri average: 8.1 hours Missouri average shift: 8.1 hoursSee full Missouri ranking
Total staff hours (quarter) 8,726

Nursing staff breakdown

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Registered Nurse

Manages medical care and health needs.

RN Staff Info 5 total: 3 full-time employees and 2 contractors. 5
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 12.4 hours
Licensed Practical Nurse

Assists with medical care and medications.

LPN Staff Info 7 total: 3 full-time employees and 4 contractors. 7
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 8.9 hours
Certified Nursing Assistant

Helps with daily care and mobility.

CNA Staff Info 34 total: 7 full-time employees and 27 contractors. 34
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 8.4 hours

Contractor staffing

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.

Total hours from contractors

22.2%

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

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Certified Nursing Assistant727343,34392100%8.4
Licensed Practical Nurse3471,1348997%8.9
Medication Aide/Technician3251,1158693%11.5
Registered Nurse3251,1128188%12.4
Nurse Aide in Training4046975762%8.6
Administrator1014586065%7.6
Dental Services Staff4044355661%6.9
Nurse Practitioner1123053942%7.8
Qualified Social Worker011372022%1.9
Speech Language Pathologist011271718%1.6
Occupational Therapy Aide0112433%8
Physical Therapy Aide01113910%1.4
Occupational Therapy Assistant0111033%3.3
Physical Therapy Assistant0111022%4.8
Respiratory Therapy Technician011778%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%
View All Staffing Data

Penalties and fines

Includes penalties issued in 2024

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 (Data as of Jan 2026)

Total fines amount $27K Rank #224 / 276Federal fines — State benchmarkedThis home is ranked 224th out of 276 homes we track in Missouri for federal fines. Shows this facility's cumulative CMS federal fine dollars versus the Missouri average among facilities with fines, and where it ranks among 276 facilities in the pool. Lower total dollars mean a better rank.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Missouri that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
64% lower than Missouri average

Missouri average: $73K

Number of fines 1
59% fewer fines than Missouri average

Missouri average: 2.4

Payment Denials Info Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed. 2
191% more payment denials than Missouri average

Missouri average: 0.7

Fines amount comparison
Fines amount comparison
This facility $27K
Missouri 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 Info Fines imposed for noncompliance, which can be assessed per day or per instance of violation. Dec 5, 2024
$27K
Payment Denial Info Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed. Dec 5, 2024
2 days

Last updated: Jan 2026

Quality of care over time

These measures show how residents usually do over time at this home, based on health outcomes and preventive care.

High-risk clinical events score Info A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline. 5.1
53% better than Missouri average

Missouri average: 10.9

Functional decline score Info A composite score based on activities of daily living decline, walking ability decline, and incontinence. 7.2
63% better than Missouri average

Missouri average: 19.5

Long-stay resident measures
Below average Missouri avg: 2.7 Info CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Need for Help with Daily Activities Increased Info Percent of long-stay residents whose need for help with daily activities has increased 9.6%
52% better than Missouri average

Missouri average: 19.8%

Walking Ability Worsened Info Percent of long-stay residents whose ability to move independently worsened 8.7%
58% better than Missouri average

Missouri average: 20.6%

Low Risk Residents with Bowel/Bladder Incontinence Info Percent of low risk long-stay residents who lose control of their bowels or bladder 3.4%
81% better than Missouri average

Missouri average: 18.1%

Falls with Major Injury Info Percent of long-stay residents experiencing one or more falls with major injury 0.0%
100% better than Missouri average

Missouri average: 4.0%

High Risk Residents with Pressure Ulcers Info Percent of long-stay high risk residents with pressure ulcers 4.0%
21% better than Missouri average

Missouri average: 5.0%

Urinary Tract Infection Info Percent of long-stay residents with a urinary tract infection 3.7%
36% worse than Missouri average

Missouri average: 2.7%

Lost Too Much Weight Info Percent of long-stay residents who lose too much weight 3.3%
41% better than Missouri average

Missouri average: 5.6%

Depressive Symptoms Info Percent of long-stay residents who have depressive symptoms 1.1%
92% better than Missouri average

Missouri average: 12.8%

Antipsychotic Use Info Percent of long-stay residents who received an antipsychotic medication 63.6%
189% worse than Missouri average

Missouri average: 22.0%

Pneumococcal Vaccine Info Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine 2.7%
97% worse than Missouri average

Missouri average: 85.2%

Influenza Vaccine Info Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine 96.6%
6% better than Missouri average

Missouri average: 90.9%

Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.

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

Facility Characteristics

Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)

Total residents 27
Medicare
1
3.7% of residents
Medicaid
26
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.

Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.

Finances and operations

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

For-profit
Corporation
Net patient revenue Info Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
$1.8M
Net patient income Info Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
-$456.7K
For-profit Corporation
Net patient revenue Info Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
$1.8M Rank #250 / 251Net patient revenue — State benchmarkedThis home is ranked 250th out of 251 homes we track in Missouri. Shows this facility's net patient revenue compared to the Missouri average, among facilities reporting a recent fiscal year. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Missouri that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.
Net patient income Info Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
-$456.7K
Other income Info Money the home earns outside of resident care — such as investments, grants, rentals and other non-operating sources (CMS cost report, Worksheet G-3). It is tracked separately from net patient revenue: it is not part of that figure, and it is not included in net patient income.
$141.0K
Payroll costs Info Staff salaries plus wage-related costs — benefits such as payroll taxes, health insurance and retirement — from the home's own accounting records (CMS cost report, Worksheet A). Contract or agency labor is counted separately, under other operating costs. Rank #251 / 251Payroll costs — State benchmarkedThis home is ranked 251st out of 251 homes we track in Missouri. Shows total staff payroll — salaries plus wage-related benefits — benchmarked to the Missouri average, among facilities reporting a recent fiscal year. Higher payroll relative to peers often signals better staffing and less reliance on contract labor.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Missouri that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.
$1.1M 58% of net patient revenue Info Payroll as a share of revenue: staff salaries and wage-related benefits divided by net patient revenue. A higher figure means more of each revenue dollar goes to staff pay. Rank #86 / 251Payroll % of net patient revenue — State benchmarkedThis home is ranked 86th out of 251 homes we track in Missouri. Shows payroll as a percentage of net patient revenue versus the Missouri average, among facilities reporting a recent fiscal year. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Missouri that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.
Other operating costs Info Everything it costs to run the home apart from payroll — food, utilities, supplies, maintenance, contract labor and administration. Calculated as total operating expense minus payroll (staff salaries and wage-related benefits).
$1.2M
Total costs Info The home's total operating expense for the year — all the costs of running it, salaries included (CMS cost report, Worksheet G-3).
$2.3M
How we calculate these figures

This home is administered by Barbara Jamison.

This home is owned by N & R Of Chillicothe, Inc

Certified by the Centers for Medicare & Medicaid Services authority — CMS Certification Number: 265480

Show certification details

Who this home usually serves

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.

Admissions
20 total

Coverage residents most often arrive under.

Medicare 10%
Private pay 5%
Medicaid 86%
Discharges
36 total

Coverage residents most often leave under.

Medicare 6%
Private pay 3%
Medicaid 92%

Admissions and discharges reflect care patterns over time — they are not used to rate this facility.

How we assess these insights

Places of interest near Grand River Health Care

Address 0.0 miles from city center Info Estimated distance in miles from Chillicothe's city center to Grand River Health Care's address, calculated via Google Maps.

Calculate Travel Distance to Grand River Health Care

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Address

Compare Nursing Homes around the area

Info below is compiled from CMS reports & the MO Dept. of Health & Senior Services (DHSS), senior community websites & trusted data sources such as Walk Score & BBB.

Communities are listed from highest to lowest based on our ranking methodology.

The facility name. Click to view the full profile page on Assisted Living Magazine, including photos, services, and contact info.
CMS (Centers for Medicare & Medicaid Services, the federal agency that regulates nursing homes) Overall 5-star rating — a composite of Health Inspection, Staffing, and Quality Measures scores. 5 stars = top 10% nationally. 1 star = bottom 10%. The single most important number to start with when comparing facilities.
Care Types in This Table AL (Assisted Living): Housing with help for daily activities like bathing, dressing, and medication, without 24-hour skilled nursing. NH (Nursing Home): 24/7 skilled nursing care for residents with complex, ongoing medical needs. SNF (Skilled Nursing Facility): Round-the-clock nursing care, often for recovery after surgery, injury, or illness. MC (Memory Care): Secured, specialized care for people living with Alzheimer's or dementia. RC (Respite Care): Short-term temporary care that gives family caregivers a break. IL (Independent Living): Community living with dining, activities, and transportation for active seniors who need little personal care. HOS (Hospice Care): Comfort-focused care for those with a terminal illness, prioritizing quality of life over treatment.
Neighborhood or city area where the facility is located. Proximity to family, hospitals, and green space matters for both quality of life and ease of visitation. Consider drive time and transit access when evaluating location.
Licensed bed capacity. Larger facilities (300+ beds) often have more specialized programs but can feel institutional. Smaller homes (under 150 beds) tend to deliver more personalized care. Compare with Avg Res/Day to understand how full the facility typically runs.
Percentage of licensed beds filled on an average day. Color indicates financial health: green (90%+) = operationally strong, typically profitable. Amber (80–89%) = stable but leaving revenue on the table. Orange (70–79%) = financial strain likely, may struggle with fixed costs. Red (<70%) = significant distress, closure or ownership change risk increases sharply.
This facility's occupancy rate compared to the statewide average for similar facilities. A positive number means above-average demand. Facilities running 5%+ above the state average are typically the most sought-after in their market — a strong proxy for reputation.
CMS-adjusted total nurse hours per resident per day (RN + LPN + CNA combined). The national average is approximately 3.5 hrs. Higher is better — more direct care time per resident. Below 3.0 is a red flag. CMS weights RN hours more heavily because RNs handle complex clinical decisions that CNAs cannot.
CMS Health Inspection star rating (1–5 stars), based on the 3 most recent annual state surveys plus any complaint investigations. This is the hardest rating to manipulate — it reflects real surveyor findings on-site. 5 stars = fewest deficiencies found. 1 star = most. It carries the heaviest weight in the Overall CMS rating.
CMS Staffing star rating (1–5 stars), based on daily nurse staffing hours submitted to CMS via verified payroll data. Compares RN, LPN, and CNA coverage relative to resident acuity level. 5 stars = well above expected staffing. Weekend staffing is evaluated separately, as that's where many facilities quietly reduce coverage.
CMS Quality Measures star rating (1–5 stars), based on 15 clinical outcome metrics including fall rates, pressure ulcers, antipsychotic drug use, and hospital readmissions. Captures actual resident health outcomes, not just compliance. High QM combined with low Health Inspection scores can indicate a facility with strong care but weak documentation practices.
Registered Nurse hours per resident/day compared to the statewide average. RNs are the highest-skilled nursing staff — they assess residents, manage medications, and respond to emergencies. A value of +50% means RN coverage is 50% above the state norm. Negative values are a concern for residents with complex or acute medical needs.
Total nursing staff hours (RN + LPN + CNA combined) per resident/day vs. the statewide average. A broader measure than RN vs State — it captures the entire care team. A facility can have high total staffing but low RN hours, meaning more aides and fewer nurses. Read both columns together for the full picture.
Total dollar amount of federal monetary fines (civil money penalties) issued by CMS in the past 3 years. Fines are only levied for serious violations — typically actual harm to residents, repeated uncorrected deficiencies, or systemic non-compliance. Even a single fine is noteworthy. Multiple fines strongly suggest a pattern, not isolated incidents.
Total health deficiency citations from the most recent standard inspection cycle. Minor citations (scope A–C) are common and often administrative in nature. Higher counts aren't always disqualifying, but should be read alongside Severe Citations to understand actual harm levels. Under 10 is strong for a large facility; 30+ warrants a closer look.
Average deficiency citations per CMS inspection (survey) in the reporting window — total citations divided by the number of inspections. Lower is better; compare alongside total Citations and Severe Citations for context.
Citations at CMS scope/severity level G or higher — G–I means actual harm occurred; J–L means residents were placed in immediate jeopardy. (D–F is potential for harm only). Examples include unaddressed falls, medication errors causing injury, neglect, or abuse.
Average number of residents in the building on any given day, derived from annual census data. Reflects true operating scale — a 400-bed facility running 200 residents/day operates very differently from one at 390. Higher resident counts generally mean more funded staffing hours.
Better Business Bureau rating (A+ to F). Reflects complaint history, business transparency, and how family disputes were resolved. A+ means no significant unresolved complaints. A blank (—) means the facility isn't BBB-accredited, which is common for healthcare providers and not necessarily a negative signal.
Walk Score® (0–100). Measures walkability of the surrounding area. 90–100 = Walker's Paradise. 70–89 = Very Walkable. 50–69 = Somewhat Walkable. Below 50 = Car-Dependent. Higher scores benefit family visitors, resident outings, and staff commuting.
The licensed owner or operator of record filed with CMS — the individual or organization legally accountable for the facility. Searching the operator name across other facilities can reveal chain or multi-site ownership, which matters: chain-operated homes tend to have more variable quality outcomes than independently run facilities.
What the home actually collects for resident care, after contractual allowances, bad debt and discounts — not gross billings. Taken from the latest complete annual cost report, so it is comparable across homes reporting the same period. Revenue alone doesn't indicate care quality, but it funds staffing and capital reinvestment. Pair with Payroll %. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
Staff salaries plus wage-related benefits from the latest complete annual cost report. Contract and agency labour is counted separately, under other operating costs, so a home leaning on agency staff can show a low figure here. Payroll is the cost most directly tied to care quality — compare with Payroll % for full context. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
Payroll as a share of NET PATIENT REVENUE (not gross revenue). Both figures come from the same cost-report year. A higher figure means more of each revenue dollar goes to staff pay. Read with the Staffing star rating to judge whether spend translates into coverage — and note that homes whose patient revenue covers only part of their operation can read implausibly high. The Missouri average is: 54.9% Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
CMS Certification Number: the unique federal identifier for this skilled nursing provider.
Laclede Groves ★ ★ ★ ★ ★
NH
AL
IL
MC
SNF
St. Louis
251
Facility 251
MO AVG 96
Rank #3 / 450
40.9%
Facility 40.9%
MO AVG 66.5%
Rank #365 / 407
-39%
5.27
Facility 5.27
MO AVG 3.74
Rank #20 / 268
 ★ ★ ★ ★ ☆ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ +48%+41%
$0
Facility $0
MO AVG $76.9k
Rank #1 / 276
9
Facility 9
MO AVG 36.5
Rank #10 / 274
4.5
Facility 4.5
MO AVG 5.7
Rank #99 / 274
-103-
35
Facility 35
MO AVG 46
Rank #353 / 545
John Komlos
$24.9MFiscal year ending 12/2023
Facility $24.9MFiscal year ending 12/2023
MO AVG $7.4M
Rank #3 / 251
$27.4MFiscal year ending 12/2023
Facility $27.4MFiscal year ending 12/2023
MO AVG $3.9M
Rank #2 / 251
109.9%Fiscal year ending 12/2023
Facility 109.9%Fiscal year ending 12/2023
MO AVG 54.9%
Rank #1 / 251
265600
Linden Woods Village ★ ★ ★ ★ ★
NH
AL
IL
SNF
Gladstone
40
Facility 40
MO AVG 96
Rank #415 / 450
85.0%
Facility 85.0%
MO AVG 66.5%
Rank #73 / 407
+28%
4.20
Facility 4.20
MO AVG 3.74
Rank #65 / 268
 ★ ★ ★ ★ ☆ ★ ★ ★ ★ ☆ ★ ★ ★ ★ ★ +31%+12%
$0
Facility $0
MO AVG $76.9k
Rank #1 / 276
12
Facility 12
MO AVG 36.5
Rank #27 / 274
4.0
Facility 4.0
MO AVG 5.7
Rank #71 / 274
-34-
53
Facility 53
MO AVG 46
Rank #216 / 545
Amanda Fizer
$8.5MFiscal year ending 12/2023
Facility $8.5MFiscal year ending 12/2023
MO AVG $7.4M
Rank #67 / 251
$3.8MFiscal year ending 12/2023
Facility $3.8MFiscal year ending 12/2023
MO AVG $3.9M
Rank #93 / 251
44.8%Fiscal year ending 12/2023
Facility 44.8%Fiscal year ending 12/2023
MO AVG 54.9%
Rank #207 / 251
265855
St. Clair Nursing Center ★ ★ ★ ★ ★
NH
HOS
MC
SNF
St Clair
79
Facility 79
MO AVG 96
Rank #273 / 450
73.4%
Facility 73.4%
MO AVG 66.5%
Rank #159 / 407
+10%
3.81
Facility 3.81
MO AVG 3.74
Rank #116 / 268
 ★ ★ ★ ★ ★ ★ ★ ★ ☆ ☆ ★ ★ ★ ★ ★ -19%+2%
$12.7k
Facility $12.7k
MO AVG $76.9k
Rank #170 / 276
7
Facility 7
MO AVG 36.5
Rank #6 / 274
2.3
Facility 2.3
MO AVG 5.7
Rank #10 / 274
-58A+
48
Facility 48
MO AVG 46
Rank #261 / 545
St. Clair Nursing LLC
$5.7MFiscal year ending 12/2023
Facility $5.7MFiscal year ending 12/2023
MO AVG $7.4M
Rank #125 / 251
$3.1MFiscal year ending 12/2023
Facility $3.1MFiscal year ending 12/2023
MO AVG $3.9M
Rank #131 / 251
55.5%Fiscal year ending 12/2023
Facility 55.5%Fiscal year ending 12/2023
MO AVG 54.9%
Rank #105 / 251
265495
Farmington Presbyterian Manor ★ ★ ★ ★ ★
NH
AL
IL
MC
SNF
Farmington
90
Facility 90
MO AVG 96
Rank #225 / 450
74.4%
Facility 74.4%
MO AVG 66.5%
Rank #147 / 407
+12%
4.33
Facility 4.33
MO AVG 3.74
Rank #59 / 268
 ★ ★ ★ ★ ★ ★ ★ ★ ☆ ☆ ★ ★ ★ ☆ ☆ +49%+16%
$12.6k
Facility $12.6k
MO AVG $76.9k
Rank #169 / 276
9
Facility 9
MO AVG 36.5
Rank #10 / 274
2.3
Facility 2.3
MO AVG 5.7
Rank #10 / 274
167A+
66
Facility 66
MO AVG 46
Rank #113 / 545
Jane Hull
$8.7MFiscal year ending 06/2024
Facility $8.7MFiscal year ending 06/2024
MO AVG $7.4M
Rank #65 / 251
$4.7MFiscal year ending 06/2024
Facility $4.7MFiscal year ending 06/2024
MO AVG $3.9M
Rank #61 / 251
53.6%Fiscal year ending 06/2024
Facility 53.6%Fiscal year ending 06/2024
MO AVG 54.9%
Rank #128 / 251
265583
Grand River Health Care ★ ☆ ☆ ☆ ☆
NH
HOS
RC
SNF
Chillicothe
60
Facility 60
MO AVG 96
Rank #340 / 450
51.7%
Facility 51.7%
MO AVG 66.5%
Rank #322 / 407
-22%
3.59
Facility 3.59
MO AVG 3.74
Rank #140 / 268
 ★ ☆ ☆ ☆ ☆ ★ ☆ ☆ ☆ ☆ ★ ★ ☆ ☆ ☆ -6%-4%
$63.0k
Facility $63.0k
MO AVG $76.9k
Rank #224 / 276
57
Facility 57
MO AVG 36.5
Rank #235 / 274
8.1
Facility 8.1
MO AVG 5.7
Rank #239 / 274
331-
71
Facility 71
MO AVG 46
Rank #80 / 545
N & R Of Chillicothe, Inc
$1.8MFiscal year ending 12/2023
Facility $1.8MFiscal year ending 12/2023
MO AVG $7.4M
Rank #250 / 251
$1.1MFiscal year ending 12/2023
Facility $1.1MFiscal year ending 12/2023
MO AVG $3.9M
Rank #251 / 251
58%Fiscal year ending 12/2023
Facility 58%Fiscal year ending 12/2023
MO AVG 54.9%
Rank #86 / 251
265480
Nursing Home Explorer

Frequently Asked Questions about Grand River Health Care

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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