Not rated by CMS — ratings are suppressed for new or low-volume facilities.
The next survey window likely opens around October 2026
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Puxico Nursing And Rehabilitation Center during CMS and state inspections, most recent first.
The facility failed to follow physician's orders for three residents, resulting in improper medication administration and unprocessed lab work. A resident with diabetes refused prescribed insulin dosages without physician notification, another continued receiving a discontinued medication, and a third had lab work orders that were not completed. Staff interviews confirmed these deficiencies.
A facility failed to document ongoing assessment and monitoring of a resident's dialysis access site, including the thrill and bruit, after treatments. Despite the facility's policy and the DON's expectations, an LPN confirmed that these assessments were not performed every shift. The resident had multiple diagnoses, including end-stage renal disease, and was dependent on dialysis.
The facility failed to ensure two nurse aides completed their training within four months of employment, as required by policy. One aide began training well past the deadline, and another was scheduled to start even later. The DON and Administrator were aware of the oversight, which could impact all 31 residents.
The facility failed to reconcile narcotics at each shift change for one medication cart, missing 51 out of 79 documentation opportunities. Despite policy requirements, a nurse admitted to forgetting to sign the log after counting with the off-going nurse. The DON and Administrator expected proper documentation, highlighting a deficiency in pharmaceutical services.
The facility failed to maintain a medication error rate below five percent, resulting in a 7.69% error rate. Two residents were affected: one received a discontinued diabetes medication, and another received a calcium tablet with Vitamin D instead of the prescribed calcium only. RN A administered both incorrect medications, acknowledging the errors during interviews. The DON and Administrator expected a lower error rate.
The facility failed to date two opened vials of Aplisol, used for tuberculosis testing, as required by their policy and the manufacturer's recommendations. The vials were found undated in the medication room's locked refrigerator. Interviews with an RN and the DON revealed inconsistencies in their understanding of the discard period for multi-dose vials.
Failure to Follow Physician's Orders for Medication and Lab Work
Penalty
Summary
The facility failed to adhere to physician's orders for three residents, leading to deficiencies in medication administration and order processing. Resident #21, diagnosed with type 1 diabetes mellitus, frequently refused the prescribed dosage of Humalog insulin, opting for a different dosage instead. Despite the resident's refusals, there was no documentation indicating that the physician was notified of these deviations from the prescribed orders. The Medication Administration Record (MAR) showed multiple instances where the resident's blood sugar levels were elevated, yet the insulin dosage administered did not align with the physician's orders. Resident #23, who had multiple diagnoses including diabetes mellitus and congestive heart failure, continued to receive Actos despite a physician's order to discontinue the medication. The MAR indicated that the resident received 28 doses of Actos after the discontinuation order. Additionally, Resident #33, with diagnoses including heart failure and diabetes mellitus, had lab work ordered that was not processed or completed. Interviews with the Director of Nursing (DON) and other staff confirmed that the orders were not followed as written, contributing to the deficiencies observed during the survey.
Failure to Document Dialysis Monitoring
Penalty
Summary
The facility failed to provide adequate documentation and monitoring for a resident receiving dialysis care. Specifically, the facility did not document ongoing assessment and monitoring of the resident's dialysis access site, including the thrill and bruit, after returning from treatments. The facility's policy requires checking for signs of infection, assessing the color and temperature of the fingers, and checking the patency of the site at regular intervals. However, the resident's medical record lacked documentation of these assessments, and there was no current order for hemodialysis or for assessing the thrill and bruit of the fistula site. The resident involved had multiple diagnoses, including end-stage renal disease and dependence on renal dialysis, and was admitted with a right arm fistula for dialysis access. Despite the facility's policy and the Director of Nursing's expectations, the Licensed Practical Nurse confirmed that the thrill and bruit were not assessed or documented every shift. This oversight indicates a failure to adhere to the facility's policy and ensure comprehensive monitoring of the resident's dialysis access site.
Failure to Ensure Timely Completion of Nurse Aide Training
Penalty
Summary
The facility failed to ensure that two nurse aides completed a nurse aide training program within four months of their employment, as required by the facility's policy and federal regulations. The policy mandates that any nurse aide employed for more than four months must be competent to provide nursing care and have completed a state-approved training and competency evaluation program. However, the records showed that one nurse aide, hired on October 26, 2023, only began training on May 7, 2024, well beyond the four-month requirement. Another nurse aide, hired on December 28, 2023, was scheduled to start training on August 14, 2024, also exceeding the four-month timeframe. Interviews with the Director of Nursing and the Administrator revealed that both were aware of the lapse in ensuring timely completion of the training program. The Director of Nursing acknowledged the oversight, while the Administrator confirmed the expectation that nurse aides should complete their training within the stipulated four months. This deficiency had the potential to affect all residents in the facility, which had a census of 31 at the time of the survey.
Failure to Reconcile Narcotics at Shift Change
Penalty
Summary
The facility failed to ensure that staff reconciled narcotics at each shift change for one of the two medication carts, potentially affecting all residents. The facility's policy on controlled substances, last revised in November 2022, mandates that nursing staff count controlled medication inventory at the end of each shift, with both the incoming and outgoing nurses conducting the count together and documenting any discrepancies. However, a review of the Nurse Medication Cart Eight Hour/Shift Verification of Controlled Substances Count log revealed that there were 51 missed opportunities for documentation out of 79, indicating a significant lapse in adherence to the policy. Interviews conducted during the investigation revealed that a registered nurse admitted to counting the narcotics with the off-going nurse but forgot to sign the log. Both the Director of Nursing and the Administrator confirmed their expectation that nurses should count and document narcotics at each shift change. This oversight in documentation and reconciliation of narcotics inventory represents a deficiency in the facility's pharmaceutical services, as it failed to comply with its own policies and procedures designed to prevent loss or diversion of controlled substances.
Medication Error Rate Exceeds Acceptable Threshold
Penalty
Summary
The facility failed to maintain a medication error rate of less than five percent, resulting in an error rate of 7.69%. This deficiency was identified through observation, interview, and record review, affecting two residents out of five sampled. The first incident involved a resident with a diagnosis of diabetes mellitus, who was administered Actos, a medication that had been discontinued according to the physician's order. Despite the order to discontinue Actos being noted in the resident's medical record, the medication was still given by RN A, who later acknowledged the error during an interview. The second incident involved another resident with diagnoses of dorsalgia and vitamin deficiency, who was prescribed calcium 500 mg twice a day. However, RN A administered a calcium tablet combined with Vitamin D, which was not in accordance with the physician's order. This deviation from the prescribed medication regimen was also confirmed by RN A during an interview. The Director of Nursing and the Administrator expressed their expectation for a medication error rate of less than five percent, highlighting the facility's failure to meet this standard.
Failure to Date Opened Vials of Aplisol
Penalty
Summary
The facility failed to ensure that two vials of Aplisol, a solution used for tuberculosis testing, were dated when opened. This oversight was identified during an observation of the locked refrigerator in the medication room, where the two opened vials were found without dates. The facility's policy, revised in February 2023, mandates that multi-dose vials be dated when opened and discarded within 28 days unless the manufacturer specifies otherwise. The manufacturer's recommendations for Aplisol, revised in November 2013, state that the medication should be discarded 30 days after being opened. Interviews with a Registered Nurse and the Director of Nursing revealed inconsistencies in their understanding of the policy, with the RN stating that vials should be discarded if not used in 28 days, while the DON mentioned a discard period of 20 to 30 days after opening.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Puxico
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Prairie View Skilled Nursing | 13.1 mi | — | 0 | 0 |
| Crowley Ridge Care Center | 14.7 mi | — | 0 | 0 |
| Cypress Point-skilled Nursing By Americare | 15.5 mi | — | 7 | 0 |
| Memory Lane Of Dexter | 15.8 mi | — | 0 | 0 |
| Aspire Senior Living Advance | 16.6 mi | — | 13 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release August 2026) and official state health department websites.