Stonebridge Westphalia
1899 Highway 63, Westphalia, MO 65085 · Osage County · 64 certified beds · avg 58 residents/day · certified since Jan 28, 2004
Part of chain: STONEBRIDGE SENIOR LIVING (12 facilities, chain avg rating 3.3★)
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)
▲ Actual harm, one-off · Oct 12, 2023 · F-0689 · triggered by a complaint
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Nov 8, 2023 (Deficient, Provider has date of correction)
All citations in the current public record (20)
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 |
|---|---|---|
| Jul 24, 2025 | F · Potential for harm, facility-wide | 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. |
| Jul 24, 2025 | E · Potential for harm, repeated | The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. |
| Jul 24, 2025 | E · Potential for harm, repeated | The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. |
| Jul 24, 2025 | E · Potential for harm, repeated | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. |
| Jul 24, 2025 | D · Potential for harm, one-off | The facility did not provide required paperwork or notices about a resident's needs, their right to appeal a transfer or discharge, or the facility's bed-hold policy (how long a bed is saved during a hospital stay). |
| Sep 13, 2024 | E · Potential for harm, repeated | The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow. · from a complaint |
| May 9, 2024 | F · Potential for harm, facility-wide | 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. |
| May 9, 2024 | F · Potential for harm, facility-wide | 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 9, 2024 | E · Potential for harm, repeated | The facility did not provide activities that meet residents' needs and interests. Nursing homes must offer meaningful activity programs, not just leave residents idle. |
| May 9, 2024 | E · Potential for harm, repeated | The facility did not properly inform residents or their representatives about arbitration agreements — contracts that give up the right to sue in court — including their right to refuse to sign. |
| May 9, 2024 | E · Potential for harm, repeated | The facility did not have a working call system — the button or cord residents use to summon help — in each resident's bathroom and bathing area. |
| May 9, 2024 | C · Minimal risk, facility-wide | The facility did not post the names, addresses, and phone numbers of state agencies and advocacy groups, along with a notice that residents may file complaints with the state survey agency. |
| Oct 12, 2023 | ▲ G · Actual 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. · from a complaint |
| Dec 2, 2022 | F · Potential for harm, facility-wide | 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. |
| Dec 2, 2022 | F · Potential for harm, facility-wide | The facility did not have a working call system — the button or cord residents use to summon help — in each resident's bathroom and bathing area. |
| Dec 2, 2022 | E · Potential for harm, repeated | The facility did not have a registered nurse on duty at least 8 hours a day, or did not have a registered nurse serving full-time as director of nursing. |
| Dec 2, 2022 | E · Potential for harm, repeated | 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. |
| Dec 2, 2022 | E · Potential for harm, repeated | The facility did not develop and follow policies and procedures for offering residents flu and pneumonia vaccinations. |
| Dec 2, 2022 | C · Minimal risk, facility-wide | The facility did not post its nurse staffing information every day. Nursing homes must publicly display how many nurses and aides are on duty each day. |
| Dec 2, 2022 | C · Minimal risk, facility-wide | The facility did not designate a qualified infection preventionist — a trained person responsible for running the infection prevention and control program. |
Inspection trend by year
Citations from standard inspections stayed about the same across the last two inspection cycles (6 → 5).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2022 | 7 | 0 | F |
| 2023 | 1 | 1 | G ▲ |
| 2024 | 7 | 0 | F |
| 2025 | 5 | 0 | F |
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)
No fines or payment denials in the published 3-year window.
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) | 3.55 | 3.66 | 3.95 | bottom 48% in Missouri; bottom 39% in the U.S. |
| Registered Nurse hours | 0.47 | 0.49 | 0.69 | top 39% in Missouri; bottom 34% in the U.S. |
| Weekend total nurse staffing | 3.03 | 3.22 | 3.50 | bottom 43% in Missouri; bottom 32% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.25 | 0.33 | 0.48 | bottom 46% in Missouri; bottom 23% in the U.S. |
| Total nursing staff turnover (%) | 56.7 | 56.0 | 45.8 | bottom 49% in Missouri; bottom 22% in the U.S. |
| RN turnover (%) | 20.0 | 47.8 | 42.9 | top 12% in Missouri; top 13% 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 3.63, RN 0.48, weekend 3.09. Staffing rating: 3/5.
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: 2/5 · long-stay residents: 1/5 · short-stay residents: 4/5
Who owns this facility
For profit - Corporation
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Lierman, Mark | Individual | 5% or Greater Direct Ownership Interest | 100% | 11/01/2021 |
| Berhorst, Tracy | Individual | Operational/Managerial Control | NOT APPLICABLE | 01/25/2024 |
| Berhorst, Tracy | Individual | ADP of the SNF | NOT APPLICABLE | 01/25/2024 |
| Bridge Rehabilitation INC | Organization | Operational/Managerial Control | NOT APPLICABLE | 02/01/2024 |
| Bridge Rehabilitation INC | Organization | ADP of the SNF | NOT APPLICABLE | 04/22/2025 |
| Busey Corporation | Organization | Operational/Managerial Control | NOT APPLICABLE | 09/10/2023 |
| Ciegel, Steven | Individual | Operational/Managerial Control | NOT APPLICABLE | 04/01/2022 |
| Ciegel, Steven | Individual | ADP of the SNF | NOT APPLICABLE | 04/01/2022 |
| Doerhoff, Eric | Individual | Operational/Managerial Control | NOT APPLICABLE | 11/01/2021 |
| Doerhoff, Eric | Individual | ADP of the SNF | NOT APPLICABLE | 11/01/2021 |
| Dudenhoeffer, Michael | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/01/2014 |
| Dudenhoeffer, Michael | Individual | ADP of the SNF | NOT APPLICABLE | 05/01/2014 |
| Eldercare Management Services INC | Organization | Operational/Managerial Control | NOT APPLICABLE | 03/12/2008 |
| Eldercare Management Services INC | Organization | ADP of the SNF | NOT APPLICABLE | 04/22/2025 |
| Forvis Mazars LLP | Organization | ADP of the SNF | NOT APPLICABLE | 01/25/2016 |
| Knight, Kara | Individual | Operational/Managerial Control | NOT APPLICABLE | 03/01/2018 |
| Knight, Kara | Individual | ADP of the SNF | NOT APPLICABLE | 03/01/2018 |
| Lierman Family Co VI, LLC | Organization | ADP of the SNF | NOT APPLICABLE | 05/01/2008 |
| Lierman, Mark | Individual | Corporate Officer | NOT APPLICABLE | 11/01/2021 |
| Lierman, Mark | Individual | Operational/Managerial Control | NOT APPLICABLE | 11/01/2021 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
- "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
- "Can you show me an example care plan, and how are families included when it's created and updated?"
- "How many aides are on each shift, and how do you make sure every resident gets timely help with bathing, dressing, and meals?"
- "What written notices do we get before any transfer or discharge, and what is your bed-hold policy?"
- "Can you tell me what this citation involved and what steps you took to bring care back up to standard?"
- "Can you show me how medications are stored and secured on the units, including controlled drugs?"
- "Can I see this month's activities calendar, and what do you offer residents who can't leave their rooms?"
- "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 |
|---|---|---|---|---|---|
| Stonebridge Adams Street | 13.0 mi | Jefferson City, MO | ★★☆☆☆ | 2/5 | |
| Capitol River Wellness & Rehabilitation | 13.5 mi | Jefferson City, MO | ★★☆☆☆ | 3/5 | |
| Stonebridge Villa Marie | 13.7 mi | Jefferson City, MO | ★☆☆☆☆ | 3/5 | |
| Jefferson City Manor Care Center | 14.0 mi | Jefferson City, MO | ★☆☆☆☆ | 3/5 | |
| Heisinger Bluffs Rehab and Healthcare Center | 14.1 mi | Jefferson City, MO | ★★★★☆ | 4/5 | |
| Heisinger Bluffs Healthcare Western Campus | 14.4 mi | Jefferson City, MO | ★★★★★ | 5/5 | |
| River City Living Community | 16.5 mi | Jefferson City, MO | ★☆☆☆☆ | 1/5 | |
| Stonebridge Oak Tree | 16.5 mi | Jefferson City, MO | ★★★★☆ | 4/5 | |
| Maries Manor | 17.5 mi | Vienna, MO | ★★★☆☆ | 3/5 | |
| Riverview Nursing Center | 17.8 mi | Mokane, MO | ★★★★☆ | 5/5 |
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Facility data as of CMS processing date 2026-08-01. CCN 265777.