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Complaint Investigation

Livingston Manor Care Center

Inspection Date: August 21, 2025
Total Violations 2
Facility ID 265621
Location CHILLICOTHE, MO
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Inspection Findings

F-Tag F0803

Nutrition and Dietary Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0803 Level of Harm - Minimal harm or potential for actual harm

talking to family members about food choices;-The wrong menu was posted in the memory care unit;-The menu should be changed every day;-The dietary department is responsible for changing the menus;-An alternate menu should be posted.During an interview on 08/18/2025 at 2302 P.M. the Activities Director said:-The resident's have a choice of what they eat;-She does not ask the resident's on the memory care unit what they would like to eat for meals;-The kitchen staff were responsible for that.Intake #2586257

Residents Affected - Some

FORM CMS-2567 (02/99) Previous Versions Obsolete

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

08/21/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Livingston Manor Care Center

939 East Birch Chillicothe, MO 64601

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

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F-Tag F0812

Nutrition and Dietary Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many

FORM CMS-2567 (02/99) Previous Versions Obsolete

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Based on observation, interview, and record review, the facility failed to ensure staff stored food in a sanitary manner and failed to maintain the kitchen in a sanitary manner. The facility census was 31.Review of the facility's Sanitation of Dining and Food Service Areas, undated., showed: The dining services manager will be responsible for ensuring the cleaning and sanitation is maintained in the kitchen and dining areas.- All staff will be trained on the frequency of cleaning.- A cleaning schedule will be posted for all cleaning tasks. - Observation of the kitchen on 08/18/25 at 10:46 A.M., showed: - Area under the three compartment sink covered with food debris;-The floor under the prep table covered with dirt and debris;-A metal storage rack above the prep table covered in dirt and dust;-A cake uncovered sat under the dirty and dusty metal storage rack;-The handles of the refrigerator covered with a sticky substance;- A black substance along the drain on the floor in the dish room;-A fan covered with dust and debris blew across a tray with open glasses with ice in them;-The trash can by the prep table with no lid;-A window by the prep table covered in dirt and debris; Dry storage:-A box containing 4 large cans of baked beans sat on the floor;

The freezer:-An undated, opened package of sausage patties;-An undated opened package of chicken patties;-An undated opened package of French toast sticks. During an interview on 08/20/25 at 12:45 P.M., [NAME] A said:-Food should be dated and stored in a closed container;-The kitchen should be kept clean;-The kitchen staff try to work together to keep the kitchen clean;-Sometimes things fall through the cracks.During an interview on 08/20/25 at 01:45 P.M., the Dietary Manager said:-Food should be closed and dated;-The kitchen should be clean and sanitary;-The kitchen staff was responsible for cleaning the kitchen.During an interview on 08/20/25 at 02:15 P.M., the Registered Dietitian said:-Food should be stored

in a safe and sanitary manner;-Food should be dated and kept in a closed container;-The kitchen should be kept clean and sanitary.During an interview on 08/20/25, at 02:26 P.M., the Administrator said:-She expected the dietary department to keep the kitchen clean;-She expected food to be stored properly;-She expected the dietary staff to take care of needs of the kitchen.

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Facility ID:

If continuation sheet

📋 Inspection Summary

LIVINGSTON MANOR CARE CENTER in CHILLICOTHE, MO inspection on recent inspection.

Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.

What this means: Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. All deficiencies must be corrected within required timeframes and are subject to follow-up verification.

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in CHILLICOTHE, MO, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from LIVINGSTON MANOR CARE CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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