01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-09-04 | 4 | 2025-09-04 | 4 |
| Cycle 2 | 2024-09-03 | 14 | 2024-09-03 | 13 |
| Cycle 3 | 2023-01-12 | 5 | 2023-01-12 | 25 |
CMS CCN 2657182026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Golden Age Nursing Home
12498 Se Highway 116 · Braymer, MO 64624 · Caldwell County
Certified beds83CMS provider file
Recent citation rows65current CMS citation release
Penalty rows1current 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
65 rows in the current release
1 rows carry G–L scope/severity codes; 0 carry J–L. 12 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-09-04 · HEALTHF0628Severity E · pattern; 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 · 2025-10-172025-09-04 · HEALTHF0812Severity E · pattern; 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 · 2025-10-172025-09-04 · HEALTHF0867Severity C · widespread; potential for minimal harm
Administration Deficiencies
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Correction field: Deficient, Provider has date of correction · 2025-10-172025-09-04 · HEALTHF0880Severity E · pattern; 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 · 2025-10-172025-09-04 · FIREK0324Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2025-10-172025-09-04 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2025-10-172025-09-04 · FIREK0523Severity E · pattern; potential for more than minimal harm
Services Deficiencies
Ensure that HVAC heat units are suspended and out of the reach of patients and can be shut off if unit is working improperly.
Correction field: Deficient, Provider has date of correction · 2025-10-172025-09-04 · 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 · 2025-10-172024-09-03 · FIREE0036Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish emergency prep training and testing.
Correction field: Deficient, Provider has date of correction · 2024-10-252024-09-03 · HEALTHF0582Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Correction field: Deficient, Provider has date of correction · 2024-10-132024-09-03 · HEALTHF0584Severity E · pattern; 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 · 2024-10-132024-09-03 · HEALTHF0600Severity G · isolated actual harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Correction field: Deficient, Provider has date of correction · 2024-10-13 · complaint2024-09-03 · HEALTHF0606Severity E · pattern; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Not hire anyone with a finding of abuse, neglect, exploitation, or theft.
Correction field: Deficient, Provider has date of correction · 2024-10-132024-09-03 · HEALTHF0607Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Correction field: Deficient, Provider has date of correction · 2024-10-13 · complaint2024-09-03 · HEALTHF0609Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Deficient, Provider has date of correction · 2024-10-13 · complaint2024-09-03 · HEALTHF0726Severity E · pattern; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Correction field: Deficient, Provider has date of correction · 2024-10-132024-09-03 · HEALTHF0728Severity E · pattern; 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 · 2024-10-132024-09-03 · HEALTHF0835Severity F · widespread; potential for more than minimal harm
Administration Deficiencies
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Correction field: Deficient, Provider has date of correction · 2024-10-13 · complaint2024-09-03 · HEALTHF0838Severity F · widespread; potential for more than minimal harm
Administration Deficiencies
Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
Correction field: Deficient, Provider has date of correction · 2024-10-132024-09-03 · HEALTHF0865Severity E · pattern; potential for more than minimal harm
Administration Deficiencies
Have a plan that describes the process for conducting QAPI and QAA activities.
Correction field: Deficient, Provider has date of correction · 2024-10-132024-09-03 · HEALTHF0868Severity E · pattern; potential for more than minimal harm
Administration Deficiencies
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Correction field: Deficient, Provider has date of correction · 2024-10-132024-09-03 · HEALTHF0940Severity E · pattern; potential for more than minimal harm
Administration Deficiencies
Develop, implement, and/or maintain an effective training program for all new and existing staff members.
Correction field: Deficient, Provider has date of correction · 2024-10-132024-09-03 · HEALTHF0947Severity E · pattern; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
Correction field: Deficient, Provider has date of correction · 2024-10-132024-09-03 · FIREK0161Severity E · pattern; potential for more than minimal harm
Construction Deficiencies
Use approved construction type or materials.
Correction field: Deficient, Provider has date of correction · 2024-10-2503 / 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 |
|---|---|---|---|
| 2024-09-03 | Payment Denial | $0 | 15 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- GOLDEN AGE NURSING HOME DISTRICTOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/01/1969
- BILLS, TOMIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2024
- CLEVENGER, GERALDIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2024
- HAYES, KESLEYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2024
- HUDSON, LAURIEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2024
- KELLY, MICHAELIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2024
- KINCAID, KARLAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2024
- MURDOCK, TAMMYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/20/2004
- NEELY, JAMESIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/2008
- POLLARD, MARJORIEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2024
- STONE, JOYCEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2024
- GOLDEN AGE NURSING HOME DISTRICTOrganization · ADP OF THE SNFNOT APPLICABLE · since 05/01/1969
- HAYES, KESLEYIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2024
- HUDSON, LAURIEIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2024
- MURDOCK, TAMMYIndividual · ADP OF THE SNFNOT APPLICABLE · since 11/20/2004
- NEELY, JAMESIndividual · ADP OF THE SNFNOT APPLICABLE · since 02/01/2008
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 hours3.42per resident day
RN hours0.49per resident day
Weekend nurse hours2.83per resident day
Staff turnover55.6%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.