01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-01-14 | 4 | 2025-01-14 | 3 |
| Cycle 2 | 2023-07-05 | 7 | 2023-07-05 | 13 |
| Cycle 3 | 2021-08-30 | 9 | 2021-08-30 | 14 |
CMS CCN 2650952026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
John Knox Village Care Center
600 Nw Pryor Road · Lees Summit, MO 64081 · Jackson County
Certified beds324CMS provider file
Recent citation rows50current 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
50 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 14 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-04-30 · HEALTHF0552Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Ensure that residents are fully informed and understand their health status, care and treatments.
Correction field: Past Non-Compliance · 2025-04-29 · complaint2025-01-14 · FIREE0015Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Address subsistence needs for staff and patients.
Correction field: Deficient, Provider has date of correction · 2025-02-272025-01-14 · HEALTHF0582Severity D · isolated; 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 · 2025-02-272025-01-14 · HEALTHF0657Severity D · isolated; 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 · 2025-02-272025-01-14 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2025-02-272025-01-14 · 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 · 2025-02-272025-01-14 · FIREK0293Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Have properly located and lighted "Exit" signs.
Correction field: Deficient, Provider has date of correction · 2025-02-272025-01-14 · 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 · 2025-02-272024-07-16 · HEALTHF0689Severity D · isolated; 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: Past Non-Compliance · 2024-07-09 · complaint2023-07-05 · HEALTHF0689Severity D · isolated; 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 · 2023-08-162023-07-05 · HEALTHF0695Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2023-08-162023-07-05 · 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 · 2023-08-162023-07-05 · HEALTHF0761Severity E · pattern; 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 · 2023-08-162023-07-05 · 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 · 2023-08-162023-07-05 · 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 · 2023-08-162023-07-05 · FIREK0291Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Install emergency lighting that can last at least 1 1/2 hours.
Correction field: Deficient, Provider has date of correction · 2023-08-162023-07-05 · FIREK0343Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Have a fire alarm with audible and visual signals that transmits the alarm automatically to notify emergency forces in event of fire.
Correction field: Deficient, Provider has date of correction · 2023-08-162023-07-05 · FIREK0351Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install an approved automatic sprinkler system.
Correction field: Deficient, Provider has date of correction · 2023-08-162023-07-05 · 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 · 2023-08-162023-07-05 · FIREK0355Severity E · pattern; 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 · 2023-08-162023-07-05 · FIREK0522Severity F · widespread; potential for more than minimal harm
Services Deficiencies
Have an externally vented heating system.
Correction field: Deficient, Provider has date of correction · 2023-08-162023-07-05 · FIREK0700Severity D · isolated; potential for more than minimal harm
Miscellaneous Deficiencies
Meet requirements for operating features, such as evacuation plans, fire drills, smoking regulations, draperies, decorations and the inspection, testing and maintenance of fire doors.
Correction field: Deficient, Provider has date of correction · 2023-08-162023-07-05 · 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 · 2023-08-162023-07-05 · FIREK0761Severity D · isolated; potential for more than minimal harm
Miscellaneous Deficiencies
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Correction field: Deficient, Provider has date of correction · 2023-08-1603 / 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 |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- JOHN KNOX VILLAGEOrganization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 02/01/1974
- BROHAMMER, RONALDIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/04/2026
- CLEMENTS, GABRIELIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2021
- DEMAREST, DIANEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2021
- DYKMAN, TIMOTHYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 08/06/2025
- GROSS, MELVINIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2021
- HARRELSON, LINDAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2021
- MCQUEEN, CLYDEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/04/2026
- ROBB, CHARLESIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/01/2016
- SMITH, TINAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2024
- COLUMBATTO, ANTHONYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 07/01/2021
- JOHNSON, LAURIEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 07/11/2017
- SEGGERMAN, STEVENIndividual · CORPORATE OFFICERNOT APPLICABLE · since 05/03/2025
- STOKER, MICHAELIndividual · CORPORATE OFFICERNOT APPLICABLE · since 04/05/2026
- TIMBERLAKE, MARIAIndividual · CORPORATE OFFICERNOT APPLICABLE · since 09/30/2007
- JOHN KNOX VILLAGEOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/01/1974
- PREMIERLIFEOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/11/2006
- COLUMBATTO, ANTHONYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 07/01/2025
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 hours4.08per resident day
RN hours0.76per resident day
Weekend nurse hours3.55per resident day
Staff turnover42.9%CMS reported field
06 / LOCAL RECORDS
Open the Lees Summit ledger →