North Village Park
NORTH VILLAGE PARK in MOBERLY, MO — inspection on March 26, 2026.
Found 1 citation. 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 written statement, provided by the facility, dated 03/21/26, showed he/she was trying to talk to Resident #2 calmy.
Next thing he/she knew, Resident #2 had him/her pinned against the door and started punching him/her in the head and knocked his/her teeth out.
He/She did not hit or kick back at Resident #2.
During an interview on 03/24/26 at 12:10 P.M., the resident said the following:-He/She and Resident #2 were roommates;-He/She and Resident #2 had a disagreement over a vape pen. He/She had Resident #2's vape pen, and Resident #2 wanted it back; -He/She gave the vape pen back and wanted to talk to Resident #2, so he/she went to shut the bedroom door to have a private conversation;-Resident #2 opened the door and pinned him/her between the door and the wall in the corner and started hitting him/her;-He/She lost a tooth and chipped two teeth from where Resident #2 hit him/her in the face and head;-Staff immediately intervened and took Resident #2 out of the room and moved Resident #2 from the hall;-He/She did not want to go to the hospital after the incident occurred but later went when his/her teeth were still hurting.
Review of the resident's nursing progress notes, dated 03/14/26 at 2:35 A.M., showed the resident complained of head pain with a pain score of five (out of a zero to ten scale, with zero being no pain to ten being the most pain) and aching.
Staff administered as needed medication.
Review of the resident's nursing progress notes, dated 03/14/26 at 10:11 A.M., showed a new order received to send the resident to urgent care for unresolved dental pain.
Review of the resident's EHR showed a report of consultation for the resident's dental appointment, dated 03/16/26, with recommendations and treatment plan for root canal and crown or extraction of two lower anterior broken teeth. 3.
During an interview on 03/26/26 at 12:30 P.M., Hospitality Aide B said the following: -On the night of 03/14/26 around 12:20 A.M., he/she was charting and heard a shuffling sound and heard someone say, staff; -When entering the room, he/she saw both residents were behind the door, and Resident #2 had Resident #1 pinned against the wall in the corner;-As he/she separated the residents, Resident #2 reached over him/her and hit Resident #1 one time; -Hospitality Aide C removed Resident #2 from the room and took Resident #1 to the nurse for evaluation; -Resident #1 told him/her Resident #2 broke his/her tooth.
During an interview on 03/26/26 at 12:42 P.M., Licensed Practical Nurse (LPN) A, said the following: -He/She was on another unit and was called to the 100/200 hall when staff called a Code Green;-When he/she arrived on the unit, Resident #2 was sitting in the dining room and Resident #1 was sitting on his/her bed in his/her room;-Resident #2 said he/she was angry and tried to leave his/her room;-Resident #1 shut the door and everything escalated from there;-Resident #1 had a cut inside his/her lower lip where a tooth had cut his/her lip, and had a knocked-out tooth and a couple of chipped teeth;-Staff immediately separated both residents and kept Resident #2 in line of sight until they could move him/her to a different room;-Staff moved Resident #2 to another locked unit;-He/She was told later the altercation was about a vape pen that belonged to Resident #2 that Resident #1 had, and Resident #2 wanted it back.
During interviews on 03/26/26 at 8:58 A.M. and email communication on 03/31/26 at 4:18 P.M., the Administrator said following: -Abuse/Neglect education and vape management education began on 03/14/26 and was completed on 03/16/26; -All residents were educated on the vape rules that vapes must stay with the cigarette box and not on their person at any time.
Complaint #2804276
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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.
Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.