01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-12-12 | 34 | 2025-12-12 | 18 |
| Cycle 2 | 2023-11-20 | 37 | 2023-11-20 | 12 |
| Cycle 3 | 2021-04-15 | 58 | 2021-04-15 | 21 |
CMS CCN 2653302026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
North Village Park
2041 Silva Lane · Moberly, MO 65270 · Randolph County
Certified beds183CMS provider file
Recent citation rows180current CMS citation release
Penalty rows17current 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
180 rows in the current release
25 rows carry G–L scope/severity codes; 10 carry J–L. 44 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-03-26 · 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: Past Non-Compliance · complaint2026-03-04 · 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 · complaint2026-02-19 · HEALTHF0600Severity J · isolated immediate jeopardy
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 · 2026-02-20 · complaint2026-02-19 · HEALTHF0742Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder.
Correction field: Deficient, Provider has date of correction · 2026-02-20 · complaint2026-01-16 · HEALTHF0569Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
Correction field: Deficient, Provider has date of correction · 2026-01-26 · complaint2026-01-16 · HEALTHF0600Severity D · isolated; potential for more than minimal 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: Past Non-Compliance · 2026-01-05 · complaint2025-12-12 · 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 · 2026-01-262025-12-12 · FIREE0037Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish staff and initial training requirements.
Correction field: Deficient, Provider has date of correction · 2026-01-262025-12-12 · FIREE0039Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Correction field: Deficient, Provider has date of correction · 2026-01-262025-12-12 · HEALTHF0567Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to manage his or her financial affairs.
Correction field: Deficient, Provider has date of correction · 2026-01-26 · complaint2025-12-12 · HEALTHF0568Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.
Correction field: Deficient, Provider has date of correction · 2026-01-262025-12-12 · HEALTHF0576Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Ensure residents have reasonable access to and privacy in their use of communication methods.
Correction field: Deficient, Provider has date of correction · 2026-01-262025-12-12 · HEALTHF0577Severity C · widespread; potential for minimal harm
Resident Rights Deficiencies
Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.
Correction field: Deficient, Provider has date of correction · 2026-01-262025-12-12 · HEALTHF0584Severity F · widespread; 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 · 2026-01-26 · complaint2025-12-12 · HEALTHF0607Severity E · pattern; 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 · 2026-01-262025-12-12 · 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 · 2026-01-262025-12-12 · HEALTHF0641Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2026-01-262025-12-12 · 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 · 2026-01-262025-12-12 · HEALTHF0658Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
Correction field: Deficient, Provider has date of correction · 2026-01-26 · complaint2025-12-12 · HEALTHF0684Severity J · isolated immediate jeopardy
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2026-01-26 · complaint2025-12-12 · HEALTHF0692Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Correction field: Deficient, Provider has date of correction · 2026-01-26 · complaint2025-12-12 · 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 · 2026-01-262025-12-12 · HEALTHF0732Severity C · widespread; potential for minimal harm
Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
Correction field: Deficient, Provider has date of correction · 2026-01-262025-12-12 · HEALTHF0804Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Correction field: Deficient, Provider has date of correction · 2026-01-26 · complaint03 / 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 |
|---|---|---|---|
| 2026-03-26 | Fine | $22,315 | 0 |
| 2025-11-18 | Fine | $22,315 | 0 |
| 2025-11-18 | Fine | $22,315 | 0 |
| 2025-11-18 | Fine | $26,650 | 0 |
| 2025-11-18 | Fine | $80,700 | 0 |
| 2025-11-18 | Payment Denial | $0 | 39 |
| 2025-05-29 | Fine | $64,311 | 0 |
| 2025-05-29 | Payment Denial | $0 | 30 |
| 2025-04-24 | Fine | $16,823 | 0 |
| 2024-10-03 | Fine | $41,470 | 0 |
| 2024-06-20 | Fine | $32,449 | 0 |
| 2024-06-20 | Payment Denial | $0 | 8 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- RC TIER PROPERTIES, L.L.C.Organization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 09/28/2018
- RCG INCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 09/28/2018
- RELIANT CARE GROUP LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 09/28/2018
- RICHARD J DESTEFANE REVOCABLE LIVING TRUSTOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 03/01/2018
- DESTEFANE, RICHARDIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 03/01/2018
- DESTEFANE, RICHARDIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/06/1998
- RELIANT CARE MANAGEMENT COMPANY LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 09/28/1989
- ARSHAD, ABDULLAHIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 09/15/2024
- PAIS, ROYSTANIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 07/02/2025
- RELIANT CARE MANAGEMENT COMPANY LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 09/18/2025
- ARSHAD, ABDULLAHIndividual · ADP OF THE SNFNOT APPLICABLE · since 09/15/2024
- PAIS, ROYSTANIndividual · ADP OF THE SNFNOT APPLICABLE · since 07/02/2025
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 hours1.60per resident day
RN hours0.18per resident day
Weekend nurse hours1.33per resident day
Staff turnover69.8%CMS reported field
06 / LOCAL RECORDS
Open the Moberly ledger →