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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.
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.
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 39th 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.
| 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 |
Lower than the Missouri average: 66.6%Grand River Health Care is legally operated by N & R Of Chillicothe, Inc., and administrated by Barbara Jamison.
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.
| 99 | 35 | This facility has 183% more total deficiencies than a typical Missouri nursing home (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 nursing home (19.8 vs. MO avg 7).↑ 183% worse |
|
Deficiencies per inspection
Average deficiencies per inspection.
| 7.6 | 5 | This facility has 52% more deficiencies per inspection than a typical Missouri nursing home (7.6 vs. MO avg 5).↑ 52% worse |
Inspections
| This Facility | MO Average | vs. MO Avg |
|---|---|---|---|
|
Total inspections
Combined count of all routine and focused inspections. Excludes complaint investigations.
| 13 | 7 | This facility has 86% more total inspections than a typical Missouri nursing home (13 vs. MO avg 7).↑ 86% 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 Mar 2025
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.
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).
100% better than Missouri averageMissouri average: 0.7
200% 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.
51% more staff per resident than Missouri average
6% better 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.
5 total: 3 full-time employees and 2 contractors.
5
Average shift length. Calculated as total hours divided by days worked and average staff per day.
12.4 hoursAssists with medical care and medications.
7 total: 3 full-time employees and 4 contractors.
7
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.9 hoursHelps with daily care and mobility.
34 total: 7 full-time employees and 27 contractors.
34
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.4 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
1,938 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| 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 |
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)
64% lower than Missouri averageMissouri average: $73K
59% fewer fines than Missouri averageMissouri average: 2.4
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
2
191% more payment denials than Missouri averageMissouri average: 0.7
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.
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Dec 5, 2024
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
Dec 5, 2024Last updated: Jan 2026
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.
5.1
53% better than Missouri averageMissouri average: 10.9
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
7.2
63% better 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
9.6%
52% better than Missouri averageMissouri average: 19.8%
Percent of long-stay residents whose ability to move independently worsened
8.7%
58% better than Missouri averageMissouri average: 20.6%
Percent of low risk long-stay residents who lose control of their bowels or bladder
3.4%
81% better than Missouri averageMissouri average: 18.1%
Percent of long-stay residents experiencing one or more falls with major injury
0.0%
100% better than Missouri averageMissouri average: 4.0%
Percent of long-stay high risk residents with pressure ulcers
4.0%
21% better than Missouri averageMissouri average: 5.0%
Percent of long-stay residents with a urinary tract infection
3.7%
36% worse than Missouri averageMissouri average: 2.7%
Percent of long-stay residents who lose too much weight
3.3%
41% better than Missouri averageMissouri average: 5.6%
Percent of long-stay residents who have depressive symptoms
1.1%
92% better than Missouri averageMissouri average: 12.8%
Percent of long-stay residents who received an antipsychotic medication
63.6%
189% worse than Missouri averageMissouri average: 22.0%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
2.7%
97% worse than Missouri averageMissouri average: 85.2%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
96.6%
6% better than Missouri averageMissouri average: 90.9%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
10% of new residents, usually for short-term rehab.
5% of new residents, often for short stays.
86% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
27Residents 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 Grand River Health Care 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 #281 / 286Payroll — State benchmarkedThis home is ranked 281st 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.
Most residents stay for extended periods and receive ongoing daily care.
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.
Add your location
Grand River Health Care is located in CHILLICOTHE, 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.
| 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 | ||||
| Grand River Health Care |
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. | Chillicothe | 60
Facility
60
MO AVG
97
Rank
#343 / 454 |
51.7%
Facility
51.7%
MO AVG
66.6%
Rank
#328 / 428 | -22% | 4.72
Facility
4.72
MO AVG
3.74
Rank
#39 / 276 | -6% | +26% | $63.0k
Facility
$63.0k
MO AVG
$76.9k
Rank
#207 / 283 | 57
Facility
57
MO AVG
36.5
Rank
#240 / 281 | 8.1
Facility
8.1
MO AVG
5.7
Rank
#247 / 281 | 3 | 29 | - |
71
Facility
71
MO AVG
45
Rank
#80 / 563 | N & R Of Chillicothe, Inc. | $1.9M
Facility
$1.9M
MO AVG
$8.4M
Rank
#280 / 286 | $1.1M
Facility
$1.1M
MO AVG
$3.3M
Rank
#281 / 286 | 60.8%
Facility
60.8%
MO AVG
45.6%
Rank
#84 / 286 | 265480 | ||||
| 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 Grand River Health Care is N & R Of Chillicothe, Inc..
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.
According to MO state health department records, Grand River Health Care's license number is 053109.
According to MO state health department records, Grand River Health Care's license expires on October 30, 2027.
Grand River Health Care's occupancy is 52%.
Barbara Jamison is the administrator of Grand River Health Care.
Grand River Health Care has 60 beds.
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