Nursing Care Index

Twin Pines Adult Care Center

Kirksville, Adair County, Missouri · CCN 265198 · Non-profit (Other) · not part of a chain

CMS rates Twin Pines Adult Care Center 2 of 5 overall as of August 2026. 120 certified beds, 71 residents a day on average. 35 citations on record from the current inspection cycles; no fines on record.

CMS’s ratings

The Five-Star Quality Rating System, as CMS publishes it. Where CMS gives no rating, the reason CMS gives is printed instead.

Overall★★☆☆☆ 2 of 5
Health inspections★★☆☆☆ 2 of 5
Staffing★★★★☆ 4 of 5
Quality measures★★☆☆☆ 2 of 5
Quality: long-stay / short-stay2 / 1 of 5

Staffing

Total nurse staffing3.42018 hours per resident per day
Registered nurses0.38163 hours per resident per day
Weekend total2.88223 hours per resident per day
Nursing staff turnover44.3% (registered nurses 0%)
Administrators who left0

Citations from health inspections

Each is a finding by a state surveyor on the date shown, in CMS’s words. The severity is CMS’s scope-and-severity grid, spelled out: harm on the left, how widespread on the right.

SurveyFindingSeverityStatus
2026-02-24
complaint survey
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · tag F0550
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-04-03
2026-02-24
complaint survey
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Nutrition and Dietary Deficiencies · tag F0804
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-04-03
2026-02-24
complaint survey
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Resident Rights Deficiencies · tag F0580
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-03
2024-10-11 Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Resident Rights Deficiencies · tag F0585
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-11-19
2024-10-11 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · tag F0812
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-12-13
2024-10-11 Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
Administration Deficiencies · tag F0944
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-11-19
2024-10-11 Not hire anyone with a finding of abuse, neglect, exploitation, or theft.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0606
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-11-19
2024-10-11 Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Resident Rights Deficiencies · tag F0623
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-11-19
2024-10-11 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.
Resident Rights Deficiencies · tag F0625
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-11-19
2024-10-11 Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Resident Assessment and Care Planning Deficiencies · tag F0640
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-11-19
2024-10-11 Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
Nursing and Physician Services Deficiencies · tag F0947
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-11-19
2024-10-11 Allow residents to self-administer drugs if determined clinically appropriate.
Resident Rights Deficiencies · tag F0554
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-11-19
2024-10-11
complaint survey
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · tag F0684
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-11-19
2024-10-11 Make sure that a working call system is available in each resident's bathroom and bathing area.
Environmental Deficiencies · tag F0919
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-11-19
2023-01-30 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · tag F0812
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2023-03-16
2023-01-30 Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Resident Assessment and Care Planning Deficiencies · tag F0657
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-03-16
2023-01-30 Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Quality of Life and Care Deficiencies · tag F0700
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-03-16
2023-01-30 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.
Pharmacy Service Deficiencies · tag F0761
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-03-16
2023-01-30 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-03-16
2023-01-30 Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning Deficiencies · tag F0658
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-03-16
2023-01-30 Provide safe, appropriate pain management for a resident who requires such services.
Quality of Life and Care Deficiencies · tag F0697
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-03-16
2023-01-30 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.
Nursing and Physician Services Deficiencies · tag F0728
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-03-16
2023-01-30 Develop and implement policies and procedures for flu and pneumonia vaccinations.
Infection Control Deficiencies · tag F0883
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-03-16
2023-01-30 Post nurse staffing information every day.
Nursing and Physician Services Deficiencies · tag F0732
B No actual harm, with potential for minimal harm; pattern Deficient, Provider has date of correction
2023-03-16
2019-06-07 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · tag F0812
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2019-07-17
2019-06-07 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2019-07-17
2019-06-07 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.
Resident Rights Deficiencies · tag F0584
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2019-07-17
2019-06-07 Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Resident Assessment and Care Planning Deficiencies · tag F0657
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2019-07-17
2019-06-07 Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies · tag F0677
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2019-07-17
2019-06-07 Provide activities to meet all resident's needs.
Quality of Life and Care Deficiencies · tag F0679
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2019-07-17
2019-06-07 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2019-07-17
2019-06-07 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Nutrition and Dietary Deficiencies · tag F0804
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2019-07-17
2019-06-07 Develop and implement policies and procedures for flu and pneumonia vaccinations.
Infection Control Deficiencies · tag F0883
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2019-07-17
2019-06-07 Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning Deficiencies · tag F0658
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2019-07-17
2019-06-07 Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies · tag F0686
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2019-07-17

Fines and payment denials

No fines or payment denials on record since 2023.

Who owns and runs it

Every owner, officer and manager CMS lists, as filed. These are the names in CMS’s ownership record; anyone named in the ownership record can ask about it on the about page.

NameRoleShareSince
Adair County Nursing Home District
Organization
adp of the snf2018-11-15
Adair County Nursing Home District
Organization
operational/managerial control2018-11-15
Bell, Aurora
Individual
adp of the snf2023-10-01
Besler, Wendy
Individual
adp of the snf2008-06-01
Richardson, James
Individual
adp of the snf2012-12-01
Richardson, James
Individual
corporate director2012-12-01
Bell, Aurora
Individual
operational/managerial control2023-10-01
Besler, Wendy
Individual
operational/managerial control2008-06-01
Richardson, James
Individual
operational/managerial control2012-12-01

What changed

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Source: Centers for Medicare & Medicaid Services, Provider Data Catalog (public domain), files dated 2026-08-01. Ratings are CMS’s; citations are state surveyors’ findings; nothing here is estimated or a recommendation. Every nursing home in Adair County.