Livingston Manor Care Center
Nursing Home, Hospice Care, Memory 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.

Livingston Manor Care Center

Nursing Home, Hospice Care, Memory 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.
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Livingston Manor Care Center accepts Medicaid, Medicare, and private pay.

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 2018 · 8 years of data 94 deficiencies 18 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 2018 vs. Missouri state average
Overall vs. MO average 2 Worse Metrics worse than Missouri average:
• Total deficiencies (169% above)
• Deficiencies per inspection (79% 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. 9435 This facility has 169% more total deficiencies than a typical Missouri nursing home (94 vs. MO avg 35).↑ 169% worse
Deficiencies per inspection Info Average deficiencies per inspection. 5.22.9 This facility has 79% more deficiencies per inspection than a typical Missouri nursing home (5.2 vs. MO avg 2.9).↑ 79% 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. 1812 This facility has had 50% more total inspections than the Missouri average (18 vs. MO avg 12). More inspections can mean more regulatory scrutiny rather than worse care.↑ 50% more

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

  • The August 21, 2025 annual inspection found 11 deficiencies including resident fund mismanagement, incomplete background checks, inadequate RN staffing, poor respiratory care, and unsanitary kitchen conditions.
  • A June 2, 2025 complaint investigation substantiated failure to protect a resident from physical abuse and delayed increased supervision after the incident.
  • The May 25, 2023 annual inspection found no health deficiencies.

Health Inspection History

Inspections since 2019
Total health inspections 7

State average 6.6


Last Health inspection on Aug 2025

Total health citations
44 Rank #195 / 274Health citations — State benchmarkedThis home is ranked 195th out of 274 homes 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.Facilities with the same value for a metric share the same rank. Rankings are based only on facilities in Missouri that report data for that category. Facilities without available data are excluded from the ranking.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
6.29 Rank #186 / 274Citations per inspection — State benchmarkedThis home is ranked 186th out of 274 homes 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.Facilities with the same value for a metric share the same rank. Rankings are based only on facilities in Missouri that report data for that category. Facilities without available data are excluded from the ranking.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.

37 of 44 citations resulted from standard inspections; and 7 of 44 resulted from complaint investigations.

Breakdown of citation severity (last 7 years)
Critical health citations
2
186% worse than State average

State average: 0.7


Serious health citations
0
100% better than State average

State average: 1

2 critical citations State average: 0.7

0 serious citations State average: 1

42 moderate citations State average: 33.6

0 minor citations State average: 1.2
Citations history (last 7 years)
Nutrition moderate citation Aug 21, 2025
Corrected

Nutrition moderate citation Aug 21, 2025
Corrected

Abuse/Neglect moderate citation Jun 02, 2025
Corrected

Infection Control moderate citation Apr 05, 2025
Corrected

Staffing Data

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

Total staff 43
Employees 36
Contractors 7
Staff to resident ratio 1.39 : 1
18% fewer staff per resident than Missouri average
Missouri average ratio: 1.69 : 1 Missouri average ratio: 1.69 : 1See full Missouri ranking
Avg staff/day 16
Average shift 8.3 hours
0% compared with Missouri average
Missouri average: 8.1 hours Missouri average shift: 8.1 hoursSee full Missouri ranking
Total staff hours (quarter) 12,204

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 All 4 RN Staff are full-time employees. No contractors work on this role. 4
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 8.5 hours
Licensed Practical Nurse

Assists with medical care and medications.

LPN Staff Info All 3 LPN Staff are full-time employees. No contractors work on this role. 3
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 All 18 CNA Staff are full-time employees. No contractors work on this role. 18
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 9.1 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

4.2%

517 contractor hours this quarter

Speech Language Pathologist: 2 Physical Therapy Assistant: 1 Physical Therapy Aide: 1 Occupational Therapy Assistant: 1 Respiratory Therapy Technician: 1 Occupational Therapy Aide: 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 Assistant180185,70692100%9.1
Licensed Practical Nurse3031,4408390%8.9
Nurse Aide in Training5051,3968592%7.7
Nurse Practitioner2029987379%10
Registered Nurse4046876874%8.5
Dietitian1015595762%9.8
Medication Aide/Technician1015334650%11.6
Mental Health Service Worker1013645257%7
Speech Language Pathologist0223646571%5.6
Physical Therapy Aide011794549%1.8
Physical Therapy Assistant011321415%2.3
Occupational Therapy Aide0112233%7.3
Respiratory Therapy Technician011142123%0.7
Occupational Therapy Assistant011722%3.5
Administrator101411%3.5
18 Certified Nursing Assistant
% of Days 100%
3 Licensed Practical Nurse
% of Days 90%
5 Nurse Aide in Training
% of Days 92%
2 Nurse Practitioner
% of Days 79%
4 Registered Nurse
% of Days 74%
1 Dietitian
% of Days 62%
1 Medication Aide/Technician
% of Days 50%
1 Mental Health Service Worker
% of Days 57%
2 Speech Language Pathologist
% of Days 71%
1 Physical Therapy Aide
% of Days 49%
1 Physical Therapy Assistant
% of Days 15%
1 Occupational Therapy Aide
% of Days 3%
1 Respiratory Therapy Technician
% of Days 23%
1 Occupational Therapy Assistant
% of Days 2%
1 Administrator
% of Days 1%

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 $114K Rank #252 / 276Federal fines — State benchmarkedThis home is ranked 252nd out of 276 homes 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.Facilities with the same value for a metric share the same rank. Rankings are based only on facilities in Missouri that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
57% higher 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. 0
100% fewer payment denials than Missouri average

Missouri average: 0.7

Fines amount comparison
Fines amount comparison
This facility $114K
Missouri average $73K
Penalty History

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

1 penalty in the past 3 years

Feb 26, 2024 · $114K

Civil Money Penalty Info Fines imposed for noncompliance, which can be assessed per day or per instance of violation. Feb 26, 2024
$114K

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. 11.5
6% worse 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. 22.4
15% worse than Missouri average

Missouri average: 19.5

Long-stay resident measures
Significantly 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 22.9%
16% worse than Missouri average

Missouri average: 19.8%

Walking Ability Worsened Info Percent of long-stay residents whose ability to move independently worsened 18.1%
12% 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 26.0%
44% worse 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 8.3%
106% worse than Missouri average

Missouri average: 4.0%

High Risk Residents with Pressure Ulcers Info Percent of long-stay high risk residents with pressure ulcers 5.3%
6% worse than Missouri average

Missouri average: 5.0%

Urinary Tract Infection Info Percent of long-stay residents with a urinary tract infection 0.8%
69% better than Missouri average

Missouri average: 2.7%

Lost Too Much Weight Info Percent of long-stay residents who lose too much weight 3.1%
45% better than Missouri average

Missouri average: 5.6%

Depressive Symptoms Info Percent of long-stay residents who have depressive symptoms 0.0%
100% better than Missouri average

Missouri average: 12.8%

Antipsychotic Use Info Percent of long-stay residents who received an antipsychotic medication 63.9%
190% worse than Missouri average

Missouri average: 22.0%

Pneumococcal Vaccine Info Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine 100.0%
17% better than Missouri average

Missouri average: 85.2%

Influenza Vaccine Info Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine 100.0%
10% better than Missouri average

Missouri average: 90.9%

Hospitalizations per 1,000 days Info Number of hospitalizations per 1,000 long-stay resident days. 1.59
24% better than Missouri average

Missouri average: 2.08

ED visits per 1,000 days Info Number of outpatient emergency department visits per 1,000 long-stay resident days. 2.80
19% worse than Missouri average

Missouri average: 2.35

Short-stay resident measures
Pneumococcal Vaccine Info Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine 100.0%
50% better than Missouri average

Missouri average: 66.6%

Antipsychotic medication increase Info Percent of short-stay residents who newly received an antipsychotic medication 17.9%
706% worse than Missouri average

Missouri average: 2.2%

Breakdown by payment type

Medicare

58% of new residents, usually for short-term rehab.

Typical stay 1 - 2 months

Private pay

25% of new residents, often for short stays.

Typical stay 1 years

Medicaid

17% of new residents, often for long-term daily care.

Typical stay 3 - 4 years

Facility Characteristics

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

Total residents 31
Medicare
3
9.7% of residents
Medicaid
21
67.7% of residents
Private pay or other
7
22.6% 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.

Finances and operations

Based on CMS SNF Cost Report for fiscal year ending in 06/2024.

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."
$2.6M
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."
-$544.7K
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."
$2.6M Rank #262 / 277Revenue — State benchmarkedThis home is ranked 262nd out of 277 homes in Missouri for revenue. Shows this facility's annual revenue compared to the Missouri average. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %.Facilities with the same value for a metric share the same rank. Rankings are based only on facilities in Missouri that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
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."
-$544.7K
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.
$7.3K
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 #243 / 277Payroll — State benchmarkedThis home is ranked 243rd out of 277 homes in Missouri for payroll. 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.Facilities with the same value for a metric share the same rank. Rankings are based only on facilities in Missouri that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
$1.7M 68.4% 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 #22 / 277Payroll % — State benchmarkedThis home is ranked 22nd out of 277 homes in Missouri for payroll %. Shows payroll as a percentage of revenue versus the Missouri average. Well-run Missouri facilities typically land around 60–72% — the top third Statewide. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Facilities with the same value for a metric share the same rank. Rankings are based only on facilities in Missouri that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
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).
$1.4M
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).
$3.1M

Who this home usually serves

TYPE OF STAY

Mostly short-term rehab stays

Most residents typically stay for a few weeks or months before returning home or moving on.

Most new residents arrive under Medicare (58% of admissions), and a typical Medicare stay runs around 1 - 2 months.

Admissions
36 total

Coverage residents most often arrive under.

Medicare 58%
Private pay 25%
Medicaid 17%
Discharges
40 total

Coverage residents most often leave under.

Medicare 30%
Private pay 30%
Medicaid 40%

Places of interest near Livingston Manor Care Center

Address 0.0 miles from city center Info Estimated distance in miles from Chillicothe's city center to Livingston Manor Care Center's address, calculated via Google Maps.

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Address

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Frequently Asked Questions about Livingston Manor Care Center

Who is the owner of Livingston Manor Care Center?

Livingston Manor Care Center is legally operated by Livingston Manor, Inc, and administered by Sara Hoover-Shaw.

Is Livingston Manor Care Center in a walkable area?

Livingston Manor Care Center 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 Livingston Manor Care Center?

According to MO state health department records, Livingston Manor Care Center's license number is 053036.

When does Livingston Manor Care Center's license expire?

According to MO state health department records, Livingston Manor Care Center's license expires on September 30, 2027.

What is the occupancy rate at Livingston Manor Care Center?

Livingston Manor Care Center's occupancy is 33%.

Are pets allowed at Livingston Manor Care Center?

No, Livingston Manor Care Center has a no-pet policy.

Does Livingston Manor Care Center operate as a for-profit or non-profit?

Livingston Manor Care Center is registered as a for-profit in MO.

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