01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-05-14 | 3 | 2026-05-14 | 2 |
| Cycle 2 | 2025-01-31 | 3 | 2025-01-31 | 2 |
| Cycle 3 | 2023-12-06 | 2 | 2023-12-06 | 1 |
CMS CCN 2654162026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Clark'S Mountain Nursing Center
2100 Barnes · Piedmont, MO 63957 · Wayne County
Certified beds91CMS provider file
Recent citation rows13current CMS citation release
Penalty rows0current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
13 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 1 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-05-14 · HEALTHF0628Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Correction field: Deficient, Provider has date of correction · 2026-06-222026-05-14 · HEALTHF0761Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Correction field: Deficient, Provider has date of correction · 2026-06-222026-05-14 · HEALTHF0812Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2026-06-222026-05-14 · FIREK0351Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Install an approved automatic sprinkler system.
Correction field: Deficient, Provider has date of correction · 2026-06-222026-05-14 · FIREK0923Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have proper medical gas storage and administration areas.
Correction field: Deficient, Provider has date of correction · 2026-06-222025-01-31 · HEALTHF0728Severity D · isolated; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Ensure that nurse aides who have worked more than 4 months, are trained and competent; and nurse aides who have worked less than 4 months are enrolled in appropriate training.
Correction field: Deficient, Provider has date of correction · 2025-03-162025-01-31 · HEALTHF0847Severity D · isolated; potential for more than minimal harm
Administration Deficiencies
Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse.
Correction field: Deficient, Provider has date of correction · 2025-03-162025-01-31 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2025-03-162025-01-31 · FIREK0355Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Properly select, install, inspect, or maintain portable fire extinguishes.
Correction field: Deficient, Provider has date of correction · 2025-03-162025-01-31 · FIREK0374Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Correction field: Deficient, Provider has date of correction · 2025-03-162023-12-06 · HEALTHF0584Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Correction field: Deficient, Provider has date of correction · 2024-01-182023-12-06 · HEALTHF0812Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2024-01-182023-12-06 · FIREK0920Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure proper usage of power strips and extension cords.
Correction field: Deficient, Provider has date of correction · 2024-01-1803 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- HWJ LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 01/01/2012
- FORD, JULIANNAIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST33% · since 01/01/2012
- MONTGOMERY, HENLEYIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST33% · since 01/01/2012
- MONTGOMERY, WILLIAMIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST33% · since 01/01/2012
- TURNER, WILLIAMIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 01/01/2013
- SCHADE, KYLEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 03/01/2021
- AMERICARE SYSTEMS, INC.Organization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2012
- CROSSON, CLAYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/29/2001
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours3.70per resident day
RN hours0.33per resident day
Weekend nurse hours3.09per resident day
Staff turnover38.5%CMS reported field
06 / LOCAL RECORDS
Open the Missouri ledger →Other published facilities nearby
No second facility in the same city met the directory rule.