North Village Park
NORTH VILLAGE PARK in MOBERLY, MO — inspection on August 13, 2025.
Found 3 citations. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
Review of the resident's
would prefer using a crutch;-Therapy consulted and stated due to the nature of unit it could be used a
of the resident's Progress Note, dated 8/12/25 at 4:38 P.M., showed the following:-Treatment to bilateral feet completed and appeared to be healing and getting smaller;-The resident denied pain and discomfort;-The resident was non-compliant with using his/her wheelchair and continued to ambulate on his/her foot;-Will continue with plan of care.
Review of the resident's skin check, dated 8/13/25, showed the following:-The resident's skin was warm and dry, skin color was within normal limits and turgor was normal;-Skin issue #1: skin has not been evaluated, the left foot amputated wound was present on admission, and it was unknown how long the wound has been present;-Skin issue #2: skin has not been evaluated, the right foot had an open are on top and bottom of the foot.
The wound was present on admission and was unknown how long the wound had been present.
The wound was staged by in-house nursing;-No documentation on the skin check to show the in-house nurse staged the wounds on the resident's feet;-No documentation on the skin check to show the measurements or size of the wounds.
During an interview on 8/12/25 at 10:23 A.M.
Licensed Practical Nurse (LPN) A said the following:-The resident was not supposed to be on his/her foot very much;-The resident could get up as he/she wanted.
During an interview on 8/13/25 at 12:35 P.M. the Physical Therapy Assistant Q said he/she had not been consulted by any of the facility staff to evaluate Resident #10 for non-weight bearing status.
During an interview on 8/13/25 at 12:40 P.M. the Therapy Program Manager said the following:-She was notified for the first time on 8/12/25 about Resident #10's non-weight bearing status;-She told the staff member the therapy department did have crutches available, but the resident would have to be evaluated and have a trial with the crutch before she would allow the resident to use it;-She told the staff member she did not typically give out crutches because in the past residents used them as a weapon;-She told the staff member she would need a referral to evaluate Resident #10;-There had been no referral for the resident received.
During an interview on 8/12/25 at 3:15 P.M. the Director of Nursing (DON) said the following:-Resident #10 had an order for non-weight bearing to his/her right foot on 7/9/25.
She just saw the order yesterday (8/11/25) and added it to the resident's POS;-She expected nurses to call and report non-compliance for dressing changes or non-weight bearing status to the physician;-When residents returned from appointments it was the responsibility of the receptionist to collect their paperwork and scan it.
Then a copy is supposed to go to her, medical records, and the nurse;-It was the nurse's responsibility to enter any new order for residents after an appointment;-She expected the nurse to complete the wound care for residents, and not to have the residents complete it.
During an interview on 8/13/25 at 11:31 A.M. the physician said the following:-He never received communication from the facility about Resident #10's dressing coming off in the night, that the resident would remove the dressing for showers, and that the resident refused a wheelchair to be non-weight bearing;-He would expect the resident to use a walker, wheelchair or whatever Resident #10 would use to be offloading on his/her right foot;-He never received communication from the facility about Resident #9 not being compliant offloading his/her left foot, why the resident did not make it to scheduled appointments, and why dressing changes were not completed;-He would expect the nursing staff to provide all wound care and not allow Resident #9 to clean his/her own wound;-The residents should not be allowed to leave the facility without dressings covering their feet;-There had been times when the residents' arrived at their appointments without a dressing covering their wounds. Resident #9 came to a few appointments without shoes on;-When the facility did not follow his wound care orders, the residents were at risk for infection and amputation. 2583338
265330 08/13/2025
North Village Park 2041 Silva Lane Moberly, MO 65270
Review of the resident's care plan, dated 8/11/25, showed the following:-The resident had a physical altercation where he/she was the aggressor;-The resident was one-on-one until he/she was sent to the hospital;-Allowed time for resident to vent and verbalize feelings;-The resident was educated on appropriate behavior and social skills;-The resident randomly refused medications, not with a particular staff member. He/She said they poison him/her and the resident only needed to take them sometimes because he/she was not a psychotic.
The resident said the physician said he/she did not have to take his/her medications;-The resident was offered counseling and refused;-No as needed medications were utilized.
Observation of Resident #3 on 8/11/25 at 3:58 P.M. showed the following:-The resident had a swollen right eye with purple bruising extending around his/her eye, to above the eyebrow and onto his/her nose;-The resident had about a quarter inch size cut on his/her left lower lip.
During an interview on 8/11/25 at 3:58 P.M., Resident #3 said the following:-He/She tried to turn in an inhaler to CMT R;-CMT R got upset because he/she knew a physician wouldn't let CMT R touch the inhaler;-Resident #4 hit him/her in the face and Resident #4's twin stepped on his/her belly and tried to rip it open (Resident #4 did not have a twin in the facility).
Review of the resident's MAR, dated 8/11/25, showed the following:-The resident refused to take aripiprazole 10 mg at 7:00 A.M. and 4:00 P.M.;-The resident refused to take buspirone 20 mg at 7:00 A.M., 11:00 A.M., and 4:00 P.M.;-The resident refused to take melatonin 3 mg at 5:00 P.M.;-The resident refused to take quetiapine 50 mg at 5:00 P.M.;-The resident refused to take trazodone 50 mg at 5:00 P.M.
There was no documentation in the resident's medical record the staff notified physician the resident refused medication.
Review of the resident's progress note, dated 8/12/25 at 11:07 A.M., showed the following:-The IDT met with the resident;-The resident expressed delusions.
Review of the resident's MAR, dated 8/12/25, showed the following:-The resident refused to take aripiprazole 10 mg at 7:00 A.M.;-The resident refused to take buspirone 20 mg at 7:00 A.M., 11:00 A.M.
Review of the resident's progress note, dated 8/12/25 at 2:50 P.M., showed the following:-The facility received notice the resident was accepted for an inpatient psychological evaluation;-Staff informed the resident and he/she immediately became aggressive.
The resident was very delusional and talked in different voices;-The resident did finally agree to go to the hospital and left with a driver and two other staff members.
During an interview on 8/12/25 at 9:34 A.M. Resident #4 said the following:-He/She and Resident #3 had each other by the shirt and swung at each other;-He/She hit Resident #3;-He/She did not have a problem with Resident #3, he/she just defended himself/herself.
During an interview on 8/13/25 at 8:30 A.M.
Nursing Assistant (NA)/Housekeeper I said the following:-Resident #3 has cussed NA I out and not let him/her clean Resident #3's room;-When Resident #3 did not take his/her medications, he/she yelled, cussed, would not let housekeeping clean his/her room and walked down the hallway and randomly hit others.
During an interview on 8/13/25 at 8:41 NA H said the following:-Resident #3 acted aggressive and snapped at the littlest of things on 8/4/25;-Resident #3 got upset when Resident #15 kept changing the channel on the TV;-Resident #14 stood up and took off his/her jacket and Resident #3 thought Resident #14 was going to hit him/her;-NA S walked Resident #14 to his/her room and Resident #3 followed but nothing happened between them;-Resident [TRUNCATED]
265330 08/13/2025
North Village Park 2041 Silva Lane Moberly, MO 65270
During an interview on 8/12/25 at 3:15 P.M. the Director of Nursing (DON) said the following:-Resident #9 should have EBP signage and PPE outside his/her door/room;-Resident #9 moved rooms and the sign must not have gone with him/her;-Staff should wear gowns and gloves when providing wound care to residents;-She expected the nurse to complete the wound care for residents, and not have the resident complete.2583338
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Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.
Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.
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