How to file a complaint about care →
No fines or payment denials in the published 3-year window.
403 Watercress Road, Box 969, Van Buren, MO 63965 (opens Google Maps) · Carter County · (573) 323-4282· 60 certified beds · avg 43 residents/day · certified since Apr 28, 1989 · Medicare and Medicaid certified
Certified for both programmes. Certification means the facility can bill Medicaid — it does not mean a Medicaid-funded bed is free right now, so ask directly. Who pays for nursing home care →
Part of chain: CIRCLE B ENTERPRISES (36 facilities, chain avg rating 2.5★)
New to these records? How to read an inspection report →
Health inspection rating: ★★★★★5/5 · CMS overall rating: 4/5 · how star ratings work →
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 quality measures from resident assessments and claims.
Showing the latest 3 of 22 inspection findings. Open the full record below to read every finding.
The facility gave residents unnecessary mind-altering (psychotropic) medications, or used drugs in a way that restrained residents by dulling their ability to think, move, or function. F-0605
The facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections. F-0690
The facility did not keep all essential equipment working safely — things like heating and cooling systems, kitchen equipment, and medical devices. F-0908
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed — that window is CMS's, not ours. Within it, every citation CMS publishes for this facility is listed here: none excluded.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Jan 21, 2026 | D · Potential for more than minimal harm, isolated | The facility gave residents unnecessary mind-altering (psychotropic) medications, or used drugs in a way that restrained residents by dulling their ability to think, move, or function. · F-0605 |
| Jan 21, 2026 | D · Potential for more than minimal harm, isolated | The facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections. · F-0690 |
| Jan 21, 2026 | D · Potential for more than minimal harm, isolated | The facility did not keep all essential equipment working safely — things like heating and cooling systems, kitchen equipment, and medical devices. · F-0908 |
| Sep 27, 2024 | D · Potential for more than minimal harm, isolated | The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. · F-0550 |
| Sep 27, 2024 | D · Potential for more than minimal harm, isolated | The facility did not give residents proper notice about what Medicare or Medicaid covers, or about charges the resident might owe for services that aren't covered. · F-0582 |
| Sep 27, 2024 | D · Potential for more than minimal harm, isolated | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. · F-0641 |
| Sep 27, 2024 | D · Potential for more than minimal harm, isolated | The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow. · F-0658 |
| Sep 27, 2024 | D · Potential for more than minimal harm, isolated | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · F-0689 |
| Sep 27, 2024 | D · Potential for more than minimal harm, isolated | The facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections. · F-0690 |
| Sep 27, 2024 | D · Potential for more than minimal harm, isolated | 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. · F-0880 |
| Apr 6, 2023 | F · Potential for more than minimal harm, widespread | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · F-0812 |
| Apr 6, 2023 | E · Potential for more than minimal harm, pattern | The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. · F-0584 |
| Apr 6, 2023 | D · Potential for more than minimal harm, isolated | The facility did not honor residents' rights to request, refuse, or stop treatment, to decline participation in medical research, or to make an advance directive — a written statement of their wishes for future medical care. · F-0578 |
| Apr 6, 2023 | D · Potential for more than minimal harm, isolated | The facility did not give residents proper notice about what Medicare or Medicaid covers, or about charges the resident might owe for services that aren't covered. · F-0582 |
| Apr 6, 2023 | D · Potential for more than minimal harm, isolated | The facility did not give residents (and their representatives and the ombudsman, a state advocate for residents) proper advance notice before a transfer or discharge, including information about their right to appeal. · F-0623 |
| Apr 6, 2023 | D · Potential for more than minimal harm, isolated | The facility did not reassess a resident after a significant change in their condition, such as a sudden decline in health. A full new assessment is required when a resident's condition changes in a major way. · F-0637 |
| Apr 6, 2023 | D · Potential for more than minimal harm, isolated | The facility did not update each resident's care assessment at least once every 3 months. These regular check-ins keep the resident's care plan matched to their current condition. · F-0638 |
| Apr 6, 2023 | D · Potential for more than minimal harm, isolated | The facility did not enter each resident's assessment information into the required format and send it to the state within 7 days of completing the assessment, as the rules require. · F-0640 |
| Apr 6, 2023 | D · Potential for more than minimal harm, isolated | The facility did not properly plan a resident's discharge to meet the resident's goals and needs after leaving. · F-0660 |
| Apr 6, 2023 | D · Potential for more than minimal harm, isolated | When a resident had a planned discharge, the facility did not make sure the necessary information was communicated to the resident and to the doctors or facility taking over their care. · F-0661 |
| Apr 6, 2023 | D · Potential for more than minimal harm, isolated | 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. · F-0693 |
| Apr 6, 2023 | D · Potential for more than minimal harm, isolated | The facility did not have firmly secured handrails on both sides of its hallways. · F-0924 |
Citations from standard inspections decreased between the last two inspection cycles (7 → 3).
All bars start at zero. Exact values and supporting details remain below.
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 12 | 0 | F |
| 2024 | 7 | 0 | D |
| 2026 | 3 | 0 | D |
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.
How to file a complaint about care →
No fines or payment denials in the published 3-year window.
What these staffing numbers mean →
All bars start at zero. Exact values and supporting details remain below.
| Measure | This facility | Missouri avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 3.36 | 3.66 | 3.95 | bottom 39% in Missouri; bottom 29% in the U.S. |
| Registered Nurse hours | 0.63 | 0.49 | 0.69 | top 18% in Missouri; top 44% in the U.S. |
| Weekend total nurse staffing | 2.85 | 3.22 | 3.50 | bottom 36% in Missouri; bottom 23% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.31 | 0.33 | 0.48 | top 40% in Missouri; bottom 34% in the U.S. |
| Total nursing staff turnover (%) | 50.0 | 56.0 | 45.8 | top 32% in Missouri; bottom 38% in the U.S. |
| RN turnover (%) | 50.0 | 47.8 | 42.9 | top 46% in Missouri; bottom 39% in the U.S. |
Hours are per resident per day for the most recent quarter of payroll data in this CMS release (2026-08-01) — the same quarter for every facility — 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 3.27, RN 0.61, weekend 2.78.Comparing with Medicare Care Compare? Care Compare shows the raw figure (3.27 here, displayed there as hours and minutes), not the adjusted one above. Both are correct; they answer different questions. Staffing rating: 2/5.
Note: CMS combines facility-reported resident assessments (MDS) with claims-based measures. These are different sources from on-site inspection findings. Read the measures alongside inspection and staffing records; a high QM rating does not establish that a home is safe.
Quality measures rating: 1/5 · long-stay residents: 1/5 · short-stay residents: 1/5
Price evidence · separate from quality
No verified facility-specific private-pay price is available in our data for Riverways Manor. CMS inspection and staffing records do not tell us what this home will charge you.
Use a written private-pay quote. This worksheet adds only the amounts you enter; it does not calculate Medicare, Medicaid or insurance benefits.
Formula: (room rate + daily extras) × days + one-time charges. A 30-day scenario is not a calendar-month quote. Refundable deposits, rate changes and charges you omit are not automatically included. Entries are not saved or sent to our server.
Understand who pays for care · How we handle price evidence · Report an incorrect price
How to read ownership records →
Ownership records as published by CMS on 2026-08-01. CMS records when an owner joined but not when they left. Listed here and no longer involved? Tell us →
For profit - Individual
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| The Pamela D Bedell Exempt Trust | Organization | 5% or Greater Direct Ownership Interest | 100% | 10/31/2000 |
| Agh1 LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 12/02/2016 |
| Agh1 LLC | Organization | ADP of the SNF | NOT APPLICABLE | 05/05/2025 |
| 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 | 01/01/2001 |
| Bedell, Donald | Individual | Corporate Officer | NOT APPLICABLE | 01/06/1997 |
| Bedell, Donald | Individual | Operational/Managerial Control | NOT APPLICABLE | 01/06/1997 |
| 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 |
| Rubi, Rodney | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/01/2017 |
| Rubi, Rodney | Individual | ADP of the SNF | NOT APPLICABLE | 05/01/2017 |
| Scott, Amanda | Individual | Operational/Managerial Control | NOT APPLICABLE | 09/11/2025 |
| Scott, Amanda | Individual | ADP of the SNF | NOT APPLICABLE | 09/11/2025 |
| 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 |
| The Pamela D Bedell Exempt Trust | Organization | Trustee of the SNF | NOT APPLICABLE | 10/31/2000 |
| The Pamela D Bedell Exempt Trust | Organization | ADP of the SNF | NOT APPLICABLE | 10/31/2000 |
Showing 20 of 21 parties CMS has on file for this facility; 1 are not displayed. The full list is in the CMS Ownership dataset.
CMS lists this facility under the chain Circle B Enterprises — 36 facilities in the current records. Chain membership says who operates these homes. It says nothing about how any individual one of them was inspected; each has its own record.
Listed by state, then facility name — not a ranking. Showing 8 of the 35 others, continuing from this facility's own place in that list.
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Brent B Tinnin Manor | 16.7 mi | Ellington, MO | ★☆☆☆☆ | 3/5 |
Facility data as of CMS processing date 2026-08-01. CCN 265363.
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