River Oaks Care Center
1001 North Walnut, Steele, MO 63877 · Pemiscot County · 90 certified beds · avg 62 residents/day · certified since Oct 31, 1983
Part of chain: CIRCLE B ENTERPRISES (36 facilities, chain avg rating 2.5★)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★★☆☆3/5 · CMS overall rating: 3/5
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.
Most serious findings (actual harm or immediate jeopardy)
▲ Immediate jeopardy, one-off · Nov 20, 2024 · F-0600 · triggered by a complaint
The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors.
Why it matters: Abuse and neglect cause direct physical and emotional harm and are among the most serious failures a nursing home can have.
Severity (J): Inspectors found a situation that put a resident's life or safety in immediate danger, affecting one or a few residents. The facility must fix it immediately — these citations often come with large fines.
Corrected: Dec 16, 2024 (Deficient, Provider has date of correction)
▲ Immediate jeopardy, one-off · Nov 20, 2024 · F-0610 · triggered by a complaint
The facility did not respond appropriately to alleged violations, such as reports of abuse, neglect, or mistreatment. Facilities must investigate every allegation and protect residents while they do.
Why it matters: When allegations aren't investigated, harm to residents can continue unchecked.
Severity (J): Inspectors found a situation that put a resident's life or safety in immediate danger, affecting one or a few residents. The facility must fix it immediately — these citations often come with large fines.
Corrected: Dec 16, 2024 (Deficient, Provider has date of correction)
All citations in the current public record (15)
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Aug 8, 2025 | E · Potential for harm, repeated | The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. |
| Aug 8, 2025 | D · Potential for harm, one-off | The facility did not create and follow a basic care plan covering a new resident's most immediate needs within 48 hours of admission. The first days are when a new resident is most vulnerable. |
| Aug 8, 2025 | D · Potential for harm, one-off | The facility did not provide care that took into account residents' past trauma or their cultural backgrounds. Care is supposed to be sensitive to what residents have lived through and where they come from. |
| Aug 8, 2025 | D · Potential for harm, one-off | The facility's medication error rate was 5 percent or higher — meaning too many doses were given incorrectly, such as the wrong drug, dose, or time. |
| Aug 8, 2025 | D · Potential for harm, one-off | The facility did not develop and follow policies and procedures for offering residents flu and pneumonia vaccinations. |
| Nov 20, 2024 | ▲ J · Immediate jeopardy, one-off | The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint |
| Nov 20, 2024 | ▲ J · Immediate jeopardy, one-off | The facility did not respond appropriately to alleged violations, such as reports of abuse, neglect, or mistreatment. Facilities must investigate every allegation and protect residents while they do. · from a complaint |
| Aug 16, 2024 | D · Potential for harm, one-off | The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. · from a complaint |
| Aug 16, 2024 | D · Potential for harm, one-off | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. |
| Aug 16, 2024 | D · Potential for harm, one-off | The facility used feeding tubes without a valid medical reason or the resident's agreement, or did not provide proper care to residents who have feeding tubes. |
| Aug 16, 2024 | D · Potential for harm, one-off | The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. |
| Aug 16, 2024 | D · Potential for harm, one-off | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| May 4, 2023 | E · Potential for harm, repeated | The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. |
| May 4, 2023 | D · Potential for harm, one-off | The facility did not create and follow a basic care plan covering a new resident's most immediate needs within 48 hours of admission. The first days are when a new resident is most vulnerable. |
| May 4, 2023 | D · Potential for harm, one-off | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. |
Inspection trend by year
Citations from standard inspections stayed about the same across the last two inspection cycles (5 → 5).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 3 | 0 | E |
| 2024 | 7 | 2 | J ▲ |
| 2025 | 5 | 0 | E |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
Fines and enforcement (last 3 years)
1 fine totaling $41,389.
| Date | Type | Amount / length |
|---|---|---|
| Nov 20, 2024 | Fine | $41,389 |
Nurse staffing (from payroll records, adjusted for how much care residents need)
| Measure | This facility | Missouri avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 3.42 | 3.66 | 3.95 | bottom 42% in Missouri; bottom 32% in the U.S. |
| Registered Nurse hours | 0.34 | 0.49 | 0.69 | bottom 35% in Missouri; bottom 14% in the U.S. |
| Weekend total nurse staffing | 3.04 | 3.22 | 3.50 | bottom 45% in Missouri; bottom 33% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.25 | 0.33 | 0.48 | bottom 45% in Missouri; bottom 21% in the U.S. |
| Total nursing staff turnover (%) | 60.6 | 56.0 | 45.8 | bottom 40% in Missouri; bottom 15% in the U.S. |
| RN turnover (%) | 40.0 | 47.8 | 42.9 | top 37% in Missouri; top 46% in the U.S. |
Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 3.40, RN 0.34, weekend 3.03. Staffing rating: 2/5.
Self-reported quality measures
Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.
Quality measures rating: 3/5 · long-stay residents: 3/5 · short-stay residents: —/5
Who owns this facility
For profit - Individual
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Circle B Enterprises Holding Company INC | Organization | 5% or Greater Direct Ownership Interest | 100% | 01/01/1996 |
| Agh1 LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 12/02/2016 |
| Agh1 LLC | Organization | ADP of the SNF | NOT APPLICABLE | 03/25/2025 |
| Arshad, Abdullah | Individual | Operational/Managerial Control | NOT APPLICABLE | 04/25/2017 |
| Arshad, Abdullah | Individual | ADP of the SNF | NOT APPLICABLE | 04/25/2017 |
| Beaird, Todd | Individual | Corporate Officer | NOT APPLICABLE | 01/01/2022 |
| Beaird, Todd | Individual | ADP of the SNF | NOT APPLICABLE | 01/01/2022 |
| Bedell, Bryan | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 05/12/2025 |
| Bedell, Donald | Individual | Corporate Director | NOT APPLICABLE | 10/31/2000 |
| Bedell, Donald | Individual | Corporate Officer | NOT APPLICABLE | 01/06/1997 |
| Bedell, Donald | Individual | Operational/Managerial Control | NOT APPLICABLE | 01/06/1997 |
| DCB Real Estate Partnership LP | Organization | ADP of the SNF | NOT APPLICABLE | 04/11/2025 |
| FG LLC | Organization | ADP of the SNF | NOT APPLICABLE | 12/02/2016 |
| Forvis Mazars LLP | Organization | ADP of the SNF | NOT APPLICABLE | 08/16/2021 |
| Mid States INC | Organization | ADP of the SNF | NOT APPLICABLE | 11/01/2010 |
| Sovereign Healthcare Group LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 04/23/2021 |
| Sovereign Healthcare Group LLC | Organization | ADP of the SNF | NOT APPLICABLE | 04/06/2025 |
| Spence, Elizabeth | Individual | Operational/Managerial Control | NOT APPLICABLE | 01/02/2026 |
| Spence, Elizabeth | Individual | ADP of the SNF | NOT APPLICABLE | 01/02/2026 |
| Steele Development Properties LLC | Organization | ADP of the SNF | NOT APPLICABLE | 01/01/2010 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "Tell me about this abuse or neglect citation — what happened, and what specific changes did you make afterward?"
- "If someone reports suspected abuse or neglect here, what happens in the first 24 hours?"
- "Can we tour the resident rooms, bathrooms, and common areas today, including areas not on the usual tour route?"
- "What does the care plan for a brand-new resident cover in the first 48 hours, and who writes it?"
- "How do you learn about each resident's background and history, and how does that shape their care?"
- "What is your current medication error rate, and what have you changed to bring errors down?"
- "What percentage of your residents and staff are vaccinated against flu and pneumonia, and how do you offer the vaccines?"
- "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the results and plan of correction from your most recent state inspection?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Southgate Living Center | 11.2 mi | Caruthersville, MO | ★★★★☆ | 5/5 | |
| Heritage Square Healthcare Center | 12.3 mi | Blytheville, AR | ★★★★☆ | 4/5 | |
| Gosnell Health and Rehab | 12.5 mi | Gosnell, AR | ★★★☆☆ | 3/5 | |
| NHC Healthcare, Kennett | 17.0 mi | Kennett, MO | ★★★★★ | 5/5 | |
| Heritage Nursing Center - Skilled Nursing by Ameri | 17.9 mi | Kennett, MO | ★★★★☆ | 4/5 |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 265210.