Not rated by CMS — ratings are suppressed for new or low-volume facilities.
A standard survey is most likely before around December 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 Ridge Crest Nursing Center during CMS and state inspections, most recent first.
Several residents dependent on staff for bathing did not consistently receive the required number of baths or showers, as confirmed by gaps in documentation, resident reports of missed showers, and observations of poor hygiene. Staff interviews revealed that insufficient staffing and inconsistent documentation practices led to missed baths, especially when the designated bath aide was unavailable.
The facility did not provide adequate oversight or implement appropriate interventions after multiple residents experienced falls, including repeated falls with injuries. Fall investigations and root-cause analyses were not completed, neurological assessments were missed after unwitnessed falls, and care plans were not updated to reflect new interventions. Staff interviews revealed confusion about responsibilities and a lack of documentation regarding fall prevention measures.
The facility failed to provide adequate grooming for residents due to insufficient staffing, resulting in residents not receiving scheduled showers. Four residents reported not receiving regular showers, leading to dissatisfaction and unkempt appearances. Staff interviews revealed a lack of a designated Shower Aide and insufficient CNAs to meet the facility's grooming standards.
The facility failed to employ a certified Infection Preventionist, leaving the Director of Nursing to perform these duties without proper certification. Staff interviews revealed a lack of awareness and training regarding infection control measures, including COVID-19 protocols. The facility has been without a designated Infection Preventionist for six months, and efforts to hire an Assistant Director of Nursing to fill this role are ongoing.
Failure to Provide Required Bathing Assistance Due to Staffing and Documentation Issues
Penalty
Summary
The facility failed to ensure that residents who required staff assistance with bathing received baths or showers according to their needs. Four residents who were dependent on staff for bathing did not consistently receive the minimum standard of two baths or showers per week, as evidenced by gaps in documentation and resident interviews. For example, one resident with legal blindness and glaucoma reported receiving only one shower since admission and expressed dissatisfaction, noting staff cited being short-handed as the reason for not providing showers. Observations confirmed the resident had body odor and greasy, uncombed hair. Another resident with hemiplegia and legal blindness required substantial staff assistance for bathing but reported going about a month without a shower before finally receiving one. Documentation for this and other residents showed inconsistent or missing records of baths/showers, with some residents receiving only one or two baths in a month. Observations of these residents revealed signs of poor hygiene, such as greasy hair and body odor, and in some cases, residents were unable to communicate their needs due to cognitive impairment. Interviews with staff, including CNAs and an LPN, confirmed that baths and showers were not provided on days when the designated bath aide was off, due to insufficient staffing. The bath aide was sometimes reassigned to other duties, and CNAs reported not having enough help to provide showers as scheduled. Documentation practices were inconsistent, with some staff using electronic records and others using paper sheets, further contributing to the lack of reliable records for resident bathing.
Failure to Investigate and Address Resident Falls and Update Care Plans
Penalty
Summary
The facility failed to ensure a safe environment free from accident hazards and did not provide adequate supervision to prevent accidents for multiple residents. One resident experienced two falls in a single day, resulting in head lacerations that required emergency care, and then suffered another fall a week later. Despite these incidents, the facility did not complete thorough fall investigations, including root-cause analysis (RCA), nor did they document or implement new interventions after each fall. The care plan for this resident was not updated to reflect new interventions or changes in condition following the falls, and there was a lack of documentation regarding the use of fall prevention measures beyond fall mats and a helmet, which was not consistently recorded in the care plan. For two additional residents, the facility also failed to conduct proper fall investigations and did not update care plans to include interventions implemented after falls. One resident had an unwitnessed fall, but neurological assessments were not completed as required by facility policy, and the care plan was not revised to address the actual fall or any new interventions. Another resident experienced both witnessed and unwitnessed falls, but the facility did not document any new fall interventions or complete a root-cause analysis for these incidents. In all cases, the lack of comprehensive documentation and follow-up after falls was evident. Interviews with staff, including the DON, LPNs, and CNAs, revealed confusion and inconsistency regarding responsibilities for fall investigations, neurological assessments, and care plan updates. Staff were often unaware of the facility's policies or the specific interventions in place for residents who had fallen. The DON confirmed that fall investigations and RCAs were not consistently completed and that interventions such as frequent checks were not always documented. The physician interviewed was not informed of all interventions and was unaware that thorough fall investigations and care plan updates were not being performed. These failures resulted in a lack of oversight and appropriate response to resident falls, as required by facility policy.
Inadequate Grooming Due to Insufficient Staffing
Penalty
Summary
The facility failed to ensure that residents were adequately groomed by not offering showers or baths to four sampled residents out of seven. The facility's policy required that residents be offered two showers a week, and any refusals should be revisited. However, the records showed that residents did not receive showers as scheduled, and there was a lack of documentation indicating that showers were offered or refused. This deficiency was observed in the cases of four residents who were not provided with the necessary assistance for personal hygiene, leading to them feeling unkempt and expressing dissatisfaction with their care. Resident #1, who was cognitively intact and required substantial assistance for bathing, did not receive showers as per the schedule from August 1 to August 6, 2024. The resident appeared unkempt with oily hair during an observation. Similarly, Resident #2, who was moderately cognitively impaired and needed moderate assistance, reported not receiving regular showers and having to clean themselves at the sink. Resident #3, who required partial assistance, also expressed dissatisfaction with the lack of regular showers, stating that they did not feel as clean with sponge baths. Resident #4, who needed substantial help, reported not receiving the scheduled showers and having to wash up at the sink. Interviews with staff, including CNAs, a GLN, an LPN, the Administrator, and the DON, revealed that there was insufficient staffing to provide the required showers. The facility did not have a designated Shower Aide, and CNAs were expected to provide showers to residents on their assigned hallways. However, due to staffing shortages, residents were not receiving even one shower a week. The staff acknowledged the lack of documentation on shower sheets and the failure to offer showers at different times if initially refused. The DON and Administrator were aware of the issue but cited staffing challenges as the reason for not meeting the facility's grooming standards.
Lack of Certified Infection Preventionist in Facility
Penalty
Summary
The facility failed to employ a certified Infection Preventionist, which is a requirement for managing the infection prevention and control program. The facility, with a census of 49 residents, did not have a policy for an Infection Preventionist, and the Administrator had only completed the first module of the Infection Prevention and Control Program training. Interviews revealed that the Graduate Practical Nurse (GPN) was unaware of the location of Personal Protective Equipment (PPE) and had not received education about COVID-19 or the facility's infection prevention expectations. The Director of Nursing (DON) was performing the Infection Preventionist's duties without having completed the necessary certification. The facility had been without a designated Infection Preventionist for six months, following the resignation of the previous individual in that role. Efforts to hire an Assistant Director of Nursing (ADON) to assume the Infection Preventionist responsibilities were ongoing, but no one had been employed in that capacity. Interviews with staff, including a Licensed Practical Nurse (LPN), confirmed the lack of a designated Infection Preventionist and indicated that some education on COVID-19 protocols had been provided, but it was insufficient. The Administrator acknowledged the absence of a certified Infection Preventionist and noted that both he and the DON were enrolled in an online course to address this gap.
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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 Warrensburg
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Warrensburg Manor Care Center | 0.9 mi | — | 0 | 0 |
| Country Club Rehab And Healthcare Center | 1 mi | — | 0 | 0 |
| Johnson County Care Center | 1 mi | — | 17 | 0 |
| Holden Manor Health & Rehabilitation | 14.9 mi | — | 1 | 0 |
| Lutheran Nursing Home | 18.3 mi | — | 4 | 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.