01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2024-04-01 | 9 | 2024-04-01 | 7 |
| Cycle 2 | 2022-03-25 | 4 | 2022-03-25 | 1 |
| Cycle 3 | 2019-07-31 | 4 | 2019-07-31 | 1 |
CMS CCN 2657052026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Good Shepherd Community Care And Rehabilitation
200 West 12Th Street · Lockwood, MO 65682 · Dade County
Certified beds69CMS provider file
Recent citation rows26current 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
26 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 4 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2024-04-01 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2024-05-032024-04-01 · HEALTHF0657Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Correction field: Deficient, Provider has date of correction · 2024-04-222024-04-01 · HEALTHF0678Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
Correction field: Deficient, Provider has date of correction · 2024-04-222024-04-01 · HEALTHF0689Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2024-04-222024-04-01 · 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 · 2024-04-222024-04-01 · HEALTHF0755Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Correction field: Deficient, Provider has date of correction · 2024-04-222024-04-01 · 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 · 2024-04-222024-04-01 · 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 · 2024-04-022024-04-01 · HEALTHF0842Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2024-04-222024-04-01 · FIREK0211Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Correction field: Deficient, Provider has date of correction · 2024-04-052024-04-01 · FIREK0324Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2024-04-022024-04-01 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2024-04-022024-04-01 · FIREK0712Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2024-04-022024-04-01 · FIREK0912Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have power receptacles that are properly grounded.
Correction field: Deficient, Provider has date of correction · 2024-04-022024-04-01 · FIREK0918Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Correction field: Deficient, Provider has date of correction · 2024-04-052024-04-01 · 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 · 2024-04-022022-03-25 · HEALTHF0623Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Correction field: Deficient, Provider has date of correction · 2022-03-272022-03-25 · HEALTHF0625Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Correction field: Deficient, Provider has date of correction · 2022-03-272022-03-25 · 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 · 2022-04-012022-03-25 · HEALTHF0921Severity E · pattern; potential for more than minimal harm
Environmental Deficiencies
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Correction field: Deficient, Provider has date of correction · 2022-04-012022-03-25 · FIREK0920Severity E · pattern; 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 · 2022-03-272019-07-31 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2019-08-162019-07-31 · HEALTHF0677Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Correction field: Deficient, Provider has date of correction · 2019-08-162019-07-31 · 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 · 2019-08-1603 / 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 |
|---|---|---|---|
| 2023-09-25 | Fine | $5,293 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- GOOD SHEPHERD NURSING HOMEOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 03/12/2015
- FINLEY, JOYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 05/01/2024
- HAUBEIN, DAVIDIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 05/01/2023
- HIGGINS, JIMIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 05/01/2022
- MAYDEN, JANEIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 04/26/2021
- ROBINSON, AMANDAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 02/27/2019
- HIGGINS, JIMIndividual · CORPORATE OFFICERNOT APPLICABLE · since 05/01/2022
- RICHARDSON, CARENIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/07/2023
- ROBINSON, AMANDAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/27/2019
- MIDWEST PHYSICAL THERAPY PCOrganization · ADP OF THE SNFNOT APPLICABLE · since 10/01/2019
- OLIVER, MALCOLMIndividual · ADP OF THE SNFNOT APPLICABLE · since 07/01/2025
- RICHARDSON, CARENIndividual · ADP OF THE SNFNOT APPLICABLE · since 11/07/2023
- ROBINSON, AMANDAIndividual · ADP OF THE SNFNOT APPLICABLE · since 02/27/2019
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 hours4.37per resident day
RN hours0.54per resident day
Weekend nurse hours3.91per resident day
Staff turnover39.5%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.