Tiffany Heights
1531 Nebraska Street, Mound City, MO 64470 · Holt County · 60 certified beds · avg 39 residents/day · certified since Dec 1, 2002
2/5
Health inspection rating (on-site)
0
Serious findings on record
$0
Fines, last 3 years
3.15
Nurse hours/resident/day (adjusted)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★☆☆☆2/5 · CMS overall rating: 2/5
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.
All citations in the current public record (29)
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 |
|---|---|---|
| Dec 5, 2025 | 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 5, 2025 | E · Potential for harm, repeated | The facility did not give residents important notices in a format and language they can understand — for example, translated documents or accessible formats for those with vision or hearing loss. |
| Dec 5, 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. |
| Dec 5, 2025 | E · Potential for harm, repeated | The facility did not honor residents' right to voice complaints without discrimination or retaliation, or did not have a working complaint process that resolves issues promptly. |
| Dec 5, 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. |
| Dec 5, 2025 | 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. |
| Dec 5, 2025 | E · Potential for harm, repeated | The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. |
| Dec 5, 2025 | 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 5, 2025 | D · Potential for harm, 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. |
| Dec 5, 2025 | D · Potential for harm, 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. |
| Dec 5, 2025 | D · Potential for harm, one-off | 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. |
| Dec 5, 2025 | D · Potential for harm, one-off | The facility did not provide necessary behavioral health care and services — support for residents' mental and emotional wellbeing, including conditions like depression and anxiety. |
| Dec 5, 2025 | D · Potential for harm, one-off | The facility did not electronically submit complete and accurate staffing information to the government, based on payroll and other verifiable records. |
| Dec 5, 2025 | 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. |
| Aug 29, 2024 | E · Potential for harm, repeated | The facility did not allow residents to take their own medications when a clinical review showed they could do so safely. Residents have this right if their care team determines it's appropriate. |
| Aug 29, 2024 | E · Potential for harm, repeated | The facility did not honor residents' right to form and take part in resident or family groups, such as a resident council. |
| Aug 29, 2024 | E · Potential for harm, repeated | 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. |
| Aug 29, 2024 | E · Potential for harm, repeated | The facility did not keep residents' personal and medical information private and confidential. |
| Aug 29, 2024 | 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. |
| Aug 29, 2024 | E · Potential for harm, repeated | The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. |
| Aug 29, 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. |
| Aug 29, 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. |
| Aug 29, 2024 | E · Potential for harm, repeated | The facility did not have a licensed pharmacist review each resident's complete medication regimen and medical chart every month, or did not follow its own rules for reporting medication problems. |
| Aug 29, 2024 | E · Potential for harm, repeated | 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 29, 2024 | E · Potential for harm, repeated | The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature. |
| Aug 29, 2024 | E · Potential for harm, repeated | 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. |
| Aug 29, 2024 | D · Potential for harm, one-off | 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. |
| Aug 29, 2024 | 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. |
| Feb 17, 2023 | E · Potential for harm, repeated | 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. |
Inspection trend by year
Citations from standard inspections stayed about the same across the last two inspection cycles (14 → 14).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 1 | 0 | E |
| 2024 | 14 | 0 | E |
| 2025 | 14 | 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) | 3.15 | 3.66 | 3.95 | bottom 29% in Missouri; bottom 19% in the U.S. |
| Registered Nurse hours | 0.63 | 0.49 | 0.69 | top 19% in Missouri; top 45% in the U.S. |
| Weekend total nurse staffing | 2.58 | 3.22 | 3.50 | bottom 23% in Missouri; bottom 12% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.42 | 0.33 | 0.48 | top 17% in Missouri; top 44% in the U.S. |
| Total nursing staff turnover (%) | 69.0 | 56.0 | 45.8 | bottom 17% in Missouri; bottom 6% in the U.S. |
| RN turnover (%) | 60.0 | 47.8 | 42.9 | bottom 33% in Missouri; bottom 22% 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 3.02, RN 0.60, weekend 2.48. 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: 4/5 · short-stay residents: 3/5
Who owns this facility
For profit - Limited Liability company
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Bruce, Leland | Individual | Indirect Ownership Interest | NOT APPLICABLE | 07/01/2025 |
| Gaytan, Lucy | Individual | Indirect Ownership Interest | NOT APPLICABLE | 07/01/2025 |
| Hixson, Brooke | Individual | Indirect Ownership Interest | NOT APPLICABLE | 07/01/2025 |
| Mound City SNF Operations LLC | Organization | Direct Ownership Interest | NOT APPLICABLE | 07/01/2025 |
| Ramos, Brian | Individual | Indirect Ownership Interest | NOT APPLICABLE | 07/01/2025 |
| Strawberry Fields Reit LTD | Organization | Direct Ownership Interest | NOT APPLICABLE | 07/01/2025 |
| Thuet, Daniel | Individual | Indirect Ownership Interest | NOT APPLICABLE | 07/01/2025 |
| Tide Health Group LLC | Organization | Direct Ownership Interest | NOT APPLICABLE | 07/01/2025 |
| 1531 Nebraska Street LLC | Organization | ADP of the SNF | NOT APPLICABLE | 07/01/2025 |
| Mound City SNF Operations LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 07/01/2025 |
| Mound City SNF Operations LLC | Organization | ADP of the SNF | NOT APPLICABLE | 07/01/2025 |
| Nauman, Jamie | Individual | Operational/Managerial Control | NOT APPLICABLE | 07/01/2025 |
| Nauman, Jamie | Individual | ADP of the SNF | NOT APPLICABLE | 07/01/2025 |
| Ramos, Brian | Individual | Operational/Managerial Control | NOT APPLICABLE | 07/01/2025 |
| Ramos, Brian | Individual | ADP of the SNF | NOT APPLICABLE | 07/01/2025 |
| Strawberry Fields Realty LP | Organization | General Partnership Interest | NOT APPLICABLE | 07/01/2025 |
| Strawberry Fields Reit INC | Organization | ADP of the SNF | NOT APPLICABLE | 03/26/2026 |
| Symonds, John | Individual | Operational/Managerial Control | NOT APPLICABLE | 07/01/2025 |
| Symonds, John | Individual | ADP of the SNF | NOT APPLICABLE | 07/01/2025 |
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 did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
- "How do you communicate important notices to residents who speak another language or have trouble seeing or hearing?"
- "Can we tour the resident rooms, bathrooms, and common areas today, including areas not on the usual tour route?"
- "Walk me through what happens when a resident or family files a grievance — who responds and how fast?"
- "Can you show me an example care plan, and how are families included when it's created and updated?"
- "Can you tell me what this citation involved and what steps you took to bring care back up to standard?"
- "How many residents here use oxygen or breathing equipment, and who checks that equipment each shift?"
- "How many hours a day is a registered nurse physically in the building, including weekends?"
- "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 |
|---|---|---|---|---|---|
| Oregon Care Center | 12.1 mi | Oregon, MO | ★★★☆☆ | 4/5 | |
| Falls City Nursing and Rehabilitation Center | 19.7 mi | Falls City, NE | ★★☆☆☆ | 3/5 | |
| Nodaway Healthcare | 19.9 mi | Maryville, MO | ★☆☆☆☆ | 2/5 |
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Facility data as of CMS processing date 2026-08-01. CCN 265746.