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The Overall CMS Rating is scored from 1 to 5 stars and 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.
The Overall CMS Rating is scored from 1 to 5 stars and 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.
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. 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.
| 46m per day | ▲ 64% 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.
| 23m per day | ▼ 44% 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 49m per day | ▼ 22% 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 57m per day | ▼ 3% State avg: 3h 3m per day · National avg: 3h 26m 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.
| 39m per day | ▲ 95% 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 Alyssa Stowers.
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.
| 63 | 35 | This facility has 80% more total deficiencies than a typical Missouri nursing home (63 vs. MO avg 35).↑ 80% worse |
|
Deficiencies per year
Average deficiencies per year since 2021.
| 12.6 | 7 | This facility has 80% more deficiencies per year than a typical Missouri nursing home (12.6 vs. MO avg 7).↑ 80% worse |
|
Deficiencies per inspection
Average deficiencies per inspection.
| 7 | 5 | This facility has 40% more deficiencies per inspection than a typical Missouri nursing home (7 vs. MO avg 5).↑ 40% worse |
Inspections
| This Facility | MO Average | vs. MO Avg |
|---|---|---|---|
|
Total inspections
Combined count of all routine and focused inspections. Excludes complaint investigations.
| 9 | 7 | This facility has 29% more total inspections than a typical Missouri nursing home (9 vs. MO avg 7).↑ 29% worse |
Read the full inspection reports for this facility, including detailed findings and corrective actions.
Show Inspection ReportsMissouri 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% better 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.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
12.4 hoursThis role is partially covered by contractors.
Assists with medical care and medications.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.9 hoursThis role is partially covered by contractors.
Helps with daily care and mobility.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.4 hoursThis role is partially covered by contractors.
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.
| 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 | 72.2% | +8% | 4.58 | +49% | +23% | $12.6k | 9 | 2.3 | 1 | 64 | A+ | 66 | Jane Hull | $9.9M | $6.3M | 63% | 265583 | ||||
| StoneBridge Senior Living Oak Tree |
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.
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. | Jefferson City | 42 | 42.9% | -36% | - | -60% | - | $0 | 21 | 3.5 | 1 | 29 | - | 27 | Ricky Doerhoff | $5.0M | $2.3M | 46.9% | 265819 | ||||
| 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 | 93.9% | +41% | 3.03 | -27% | -19% | $0 | 39 | 6.5 | - | 34 | A+ | 73 | Womens Christian Association Of Kansas City Missouri | $2.9M | $2.4M | 81.6% | 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 | 42.2% | -37% | 4.72 | -6% | +26% | $26.6k | 57 | 8.1 | 3 | 25 | - | 71 | N & R Of Chillicothe, Inc. | $1.9M | $1.1M | 60.8% | 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 | 67.6% | +1% | 3.50 | +4% | -6% | $265.2k | 87 | 7.9 | 13 | 118 | A- | 50 | Mary Grodeon | $15.6M | $7.7M | 49.2% | 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.
Grand River Health Care's occupancy is 52%.
Alyssa Stowers is the administrator of Grand River Health Care.
Grand River Health Care has 60 beds.
Yes — there are 11 photos of Grand River Health Care in the photo gallery on this page.
Grand River Health Care is located at 118 TRENTON RD.
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