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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.
Troy Manor is a 150-bed skilled nursing facility and assisted living community that has operated for 31 years under a mixed-care model. The property handles a blend of long-term care and short-term rehabilitation, resulting in an average resident stay of 188 days. Admissions lean heavily toward Medicaid-dependent individuals, who account for 82% of the total census. Business records indicate notable financial and operational strain, highlighted by a declining 65% occupancy rate and a net operating loss of $1.1 million.
Official health department and licensing databases show severe, long-standing compliance issues alongside substantial staffing shortages. Over the past seven years, regulators have documented 71 total deficiencies, creating an annual average of 10.1 citations that doubles the Missouri state baseline. The facility has compiled four critical and four serious citations since 2019, including a May 2025 substantiated complaint regarding the verbal abuse of a resident and a failure to notify state authorities.
Past inspection cycles also flagged a major 97-day medication mix-up in 2023 that resulted in a resident hospitalization, as well as recurring issues with infection control, pressure ulcer management, and elopement protocols. These challenges have led to $208,000 in total federal financial fines and two separate government payment blocks that temporarily suspended admissions. Daily staffing numbers track well below average, with registered nurse hours running 61% below the state norm and certified nursing aide hours trailing by 37%.
Older adults evaluating regional long-term skilled nursing or assisted living options can review these public tracking archives to analyze the provider’s operational history. Since the state documentation confirms significant historical financial penalties, multiple admission freezes, and thin front-line staffing volumes alongside persistent clinical care deficiencies, the files show a care environment facing heavy administrative and safety challenges.
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.
| 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.
| 11m per day | ▼ 61% 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.
| 33m per day | ▼ 20% 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 28m per day | ▼ 37% 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 3m per day | ▼ 33% 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.
| 1m per day | ▼ 50% 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.
| 10m per day | ▼ 50% State avg: 20m per day · National avg: 28m per day |
Similar to the Missouri average: 66.6%Troy Manor is legally operated by N & R Of Troy, Llc, and administrated by Dylan Hagler.
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.
| 71 | 35 | This facility has 103% more total deficiencies than a typical Missouri nursing home (71 vs. MO avg 35).↑ 103% worse |
|
Deficiencies per year
Average deficiencies per year since 2019.
| 10.1 | 5 | This facility has 102% more deficiencies per year than a typical Missouri nursing home (10.1 vs. MO avg 5).↑ 102% worse |
|
Deficiencies per inspection
Average deficiencies per inspection.
| 7.1 | 5 | This facility has 42% more deficiencies per inspection than a typical Missouri nursing home (7.1 vs. MO avg 5).↑ 42% worse |
Inspections
| This Facility | MO Average | vs. MO Avg |
|---|---|---|---|
|
Total inspections
Combined count of all routine and focused inspections. Excludes complaint investigations.
| 10 | 7 | This facility has 43% more total inspections than a typical Missouri nursing home (10 vs. MO avg 7).↑ 43% worse |
Missouri average 6.6
Last Health inspection on May 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.
54 of 74 citations resulted from standard inspections; 18 of 74 resulted from complaint investigations; and 2 of 74 came from combined inspections (standard and complaint).
471% worse than Missouri averageMissouri average: 0.7
300% 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.
43% worse than Missouri average
7% worse 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.
All 4 RN Staff are full-time employees. No contractors work on this role.
4
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.2 hoursAssists with medical care and medications.
All 18 LPN Staff are full-time employees. No contractors work on this role.
18
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.4 hoursHelps with daily care and mobility.
All 24 CNA Staff are full-time employees. No contractors work on this role.
24
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
998 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 24 | 0 | 24 | 7,376 | 92 | 100% | 8 |
| Licensed Practical Nurse | 18 | 0 | 18 | 4,836 | 92 | 100% | 8.4 |
| Medication Aide/Technician | 13 | 0 | 13 | 4,617 | 92 | 100% | 7.9 |
| Nurse Aide in Training | 12 | 0 | 12 | 3,452 | 92 | 100% | 7.3 |
| RN Director of Nursing | 3 | 0 | 3 | 1,195 | 77 | 84% | 7.4 |
| Registered Nurse | 4 | 0 | 4 | 1,119 | 90 | 98% | 7.2 |
| Nurse Practitioner | 1 | 1 | 2 | 653 | 61 | 66% | 7.5 |
| Other Dietary Services Staff | 4 | 0 | 4 | 627 | 68 | 74% | 6.1 |
| Administrator | 2 | 0 | 2 | 598 | 65 | 71% | 7.8 |
| Dental Services Staff | 1 | 0 | 1 | 460 | 65 | 71% | 7.1 |
| Dietitian | 1 | 0 | 1 | 434 | 56 | 61% | 7.8 |
| Physical Therapy Assistant | 0 | 1 | 1 | 315 | 50 | 54% | 6.3 |
| Physical Therapy Aide | 0 | 1 | 1 | 176 | 59 | 64% | 3 |
| Respiratory Therapy Technician | 0 | 1 | 1 | 146 | 59 | 64% | 2.5 |
| Occupational Therapy Aide | 0 | 1 | 1 | 54 | 8 | 9% | 6.7 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 35 | 8 | 9% | 4.4 |
| Speech Language Pathologist | 0 | 2 | 2 | 35 | 9 | 10% | 3.9 |
| Qualified Social Worker | 0 | 1 | 1 | 34 | 27 | 29% | 1.3 |
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)
185% higher than Missouri averageMissouri average: $73K
23% more 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.
4 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.
Oct 3, 2024
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
Oct 3, 2024
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Apr 9, 2024
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
Apr 9, 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.
9.6
12% better than Missouri averageMissouri average: 10.9
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
15.5
20% 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
20.1%
In line with Missouri averageMissouri average: 19.8%
Percent of long-stay residents whose ability to move independently worsened
14.7%
29% better than Missouri averageMissouri average: 20.6%
Percent of low risk long-stay residents who lose control of their bowels or bladder
11.7%
36% better than Missouri averageMissouri average: 18.1%
Percent of long-stay residents experiencing one or more falls with major injury
4.6%
14% worse than Missouri averageMissouri average: 4.0%
Percent of long-stay high risk residents with pressure ulcers
7.8%
56% worse than Missouri averageMissouri average: 5.0%
Percent of long-stay residents with a urinary tract infection
0.6%
79% better than Missouri averageMissouri average: 2.7%
Percent of long-stay residents who lose too much weight
0.9%
83% better than Missouri averageMissouri average: 5.6%
Percent of long-stay residents who have depressive symptoms
5.9%
54% better than Missouri averageMissouri average: 12.8%
Percent of long-stay residents who received an antipsychotic medication
25.1%
14% worse than Missouri averageMissouri average: 22.0%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
99.1%
16% better than Missouri averageMissouri average: 85.2%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
98.9%
9% better than Missouri averageMissouri average: 90.9%
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
92.1%
38% better than Missouri averageMissouri average: 66.6%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
9% of new residents, usually for short-term rehab.
21% of new residents, often for short stays.
70% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
95Residents 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 Troy Manor 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 #87 / 286Payroll — State benchmarkedThis home is ranked 87th 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 Troy's city center to Troy Manor's address, calculated via Google Maps.
Add your location
Troy Manor is located in TROY, 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.
| Troy 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. | Troy | 150 | 64.7% | -3% | - | -44% | - | $207.9k | 74 | 6.7 | 8 | 95 | A+ | 68 | Janice Conover | $6.4M | $4.6M | 71.6% | 265702 | ||||
| Lincoln County Nursing &Amp; Rehab |
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. | Troy | 90 | 88.9% | +33% | 3.53 | -25% | -5% | $235.4k | 113 | 12.6 | 8 | 80 | - | 68 | N & R Of Lincoln County, Inc. | $4.8M | $3.4M | 70.2% | 265433 |
The legal owner and operator of Troy Manor is N & R Of Troy, Llc.
Troy Manor has a walk score of 68. Moderately walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.
According to MO state health department records, Troy Manor's license number is 052741, 052742.
According to MO state health department records, Troy Manor's license expires on May 31, 2027.
Troy Manor's occupancy is 65%.
Dylan Hagler is the administrator of Troy Manor.
Troy Manor has 150 beds.
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