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Twin Pines Adult Care Center
1900 S Jamison, Kirksville, MO 63501 (opens Google Maps) · Adair County · (660) 665-2887· 120 certified beds · avg 71 residents/day · certified since Sep 1, 1983 · 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 →
2/5
Health inspection rating (on-site)
inspected Oct 11, 2024
0
Serious findings on record
$0
Fines, last 3 years
4.79
Nurse hours/resident/day (adjusted)
Every record stays on this page.
What health inspectors found (on-site government inspections — the most independent evidence available)
New to these records? How to read an inspection report →
Health inspection rating: ★★☆☆☆2/5 · CMS overall rating: 2/5 · 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.
Inspection findings in the public record
Showing the latest 3 of 35 inspection findings. Open the full record below to read every finding.
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. · from a complaint F-0550
The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature. · from a complaint F-0804
The facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away. · from a complaint F-0580
View all 35 inspection findingsShow only the latest 3 findings
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 |
|---|---|---|
| Feb 24, 2026 | E · Potential for more than minimal harm, pattern | 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. · from a complaint · F-0550 |
| Feb 24, 2026 | E · Potential for more than minimal harm, pattern | The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature. · from a complaint · F-0804 |
| Feb 24, 2026 | D · Potential for more than minimal harm, isolated | The facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away. · from a complaint · F-0580 |
| Oct 11, 2024 | F · Potential for more than minimal harm, widespread | 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. · F-0585 |
| Oct 11, 2024 | 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 |
| Oct 11, 2024 | F · Potential for more than minimal harm, widespread | The facility did not give all staff the required training on its quality improvement program — the internal system for finding problems and making care better. · F-0944 |
| Oct 11, 2024 | E · Potential for more than minimal harm, pattern | The facility hired someone with an official finding of abuse, neglect, exploitation, or theft against them. Facilities are not allowed to employ people with such findings. · F-0606 |
| Oct 11, 2024 | E · Potential for more than minimal harm, pattern | 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 |
| Oct 11, 2024 | E · Potential for more than minimal harm, pattern | The facility did not give the resident or their representative written notice of how long it would hold the resident's bed during a hospital stay or approved leave. · F-0625 |
| Oct 11, 2024 | E · Potential for more than minimal harm, pattern | 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 |
| Oct 11, 2024 | E · Potential for more than minimal harm, pattern | The facility did not make sure its nurse aides had the skills needed to care for residents, including training in dementia care and abuse prevention. · F-0947 |
| Oct 11, 2024 | D · Potential for more than minimal harm, isolated | 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. · F-0554 |
| Oct 11, 2024 | D · Potential for more than minimal harm, isolated | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · from a complaint · F-0684 |
| Oct 11, 2024 | D · Potential for more than minimal harm, isolated | 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. · F-0919 |
| Jan 30, 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 |
| Jan 30, 2023 | E · Potential for more than minimal harm, pattern | 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. · F-0657 |
| Jan 30, 2023 | E · Potential for more than minimal harm, pattern | The facility used bed rails without first trying safer alternatives, or without assessing the resident's safety risk, discussing the risks and benefits with the resident or family, getting consent, and installing the rails correctly. · F-0700 |
| Jan 30, 2023 | E · Potential for more than minimal harm, pattern | 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. · F-0761 |
| Jan 30, 2023 | E · Potential for more than minimal harm, pattern | 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 |
| Jan 30, 2023 | 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 |
| Jan 30, 2023 | D · Potential for more than minimal harm, isolated | The facility did not provide safe and appropriate pain management for a resident who needed it. · F-0697 |
| Jan 30, 2023 | D · Potential for more than minimal harm, isolated | The facility did not make sure its nurse aides were properly trained — aides working more than 4 months must be trained and competent, and newer aides must be enrolled in training. · F-0728 |
| Jan 30, 2023 | D · Potential for more than minimal harm, isolated | The facility did not develop and follow policies and procedures for offering residents flu and pneumonia vaccinations. · F-0883 |
| Jan 30, 2023 | B · Potential for minimal harm, pattern | 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. · F-0732 |
| Jun 7, 2019 | 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 |
| Jun 7, 2019 | F · Potential for more than minimal harm, widespread | 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 |
| Jun 7, 2019 | 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 |
| Jun 7, 2019 | E · Potential for more than minimal harm, pattern | 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. · F-0657 |
| Jun 7, 2019 | E · Potential for more than minimal harm, pattern | 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. · F-0677 |
| Jun 7, 2019 | E · Potential for more than minimal harm, pattern | The facility did not provide activities that meet residents' needs and interests. Nursing homes must offer meaningful activity programs, not just leave residents idle. · F-0679 |
| Jun 7, 2019 | E · Potential for more than minimal harm, pattern | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · F-0689 |
| Jun 7, 2019 | E · Potential for more than minimal harm, pattern | The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature. · F-0804 |
| Jun 7, 2019 | E · Potential for more than minimal harm, pattern | The facility did not develop and follow policies and procedures for offering residents flu and pneumonia vaccinations. · F-0883 |
| Jun 7, 2019 | 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 |
| Jun 7, 2019 | D · Potential for more than minimal harm, isolated | The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving. · F-0686 |
Inspection trend by year
Citations from standard inspections stayed about the same across the last two inspection cycles (10 → 11).
All citationsSerious citations (G–L)
2019
All citations: 11
Serious citations (G–L): 0
2023
All citations: 10
Serious citations (G–L): 0
2024
All citations: 11
Serious citations (G–L): 0
2026
All citations: 3
Serious citations (G–L): 0
All bars start at zero. Exact values and supporting details remain below.
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2019 | 11 | 0 | F |
| 2023 | 10 | 0 | F |
| 2024 | 11 | 0 | F |
| 2026 | 3 | 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)
Nurse staffing (from payroll records, adjusted for how much care residents need)
What these staffing numbers mean →
This facilityMissouri averageU.S. average
Total nurse staffing (hours per resident per day)
This facility: 4.79
Missouri average: 3.66
U.S. average: 3.95
Registered Nurse hours
This facility: 0.53
Missouri average: 0.49
U.S. average: 0.69
Weekend total nurse staffing
This facility: 4.04
Missouri average: 3.22
U.S. average: 3.50
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) | 4.79 | 3.66 | 3.95 | top 13% in Missouri; top 17% in the U.S. |
| Registered Nurse hours | 0.53 | 0.49 | 0.69 | top 32% in Missouri; bottom 43% in the U.S. |
| Weekend total nurse staffing | 4.04 | 3.22 | 3.50 | top 17% in Missouri; top 22% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.21 | 0.33 | 0.48 | bottom 31% in Missouri; bottom 14% in the U.S. |
| Total nursing staff turnover (%) | 44.3 | 56.0 | 45.8 | top 22% in Missouri; top 48% in the U.S. |
| RN turnover (%) | 0.0 | 47.8 | 42.9 | top 1% in Missouri; top 1% 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 3.42, RN 0.38, weekend 2.88.Comparing with Medicare Care Compare? Care Compare shows the raw figure (3.42 here, displayed there as hours and minutes), not the adjusted one above. Both are correct; they answer different questions. Staffing rating: 4/5.
Quality measures: assessments & claims
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: 2/5 · long-stay residents: 2/5 · short-stay residents: 1/5
Costs & payment
Price evidence · separate from quality
No verified facility-specific private-pay price is available in our data for Twin Pines Adult Care Center. CMS inspection and staffing records do not tell us what this home will charge you.
Calculate a stay from a quote you receive
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.
Before you compare prices
- Request the room type, effective date and itemized daily rate in writing.
- Ask about therapy, medicines, supplies, care-level charges, deposits, refunds and annual increases.
- Confirm insurance or Medicaid eligibility and bed availability directly; certification alone does not guarantee either.
Understand who pays for care · How we handle price evidence · Report an incorrect price
Who owns this facility
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 →
Non profit - Other
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Adair County Nursing Home District | Organization | Operational/Managerial Control | NOT APPLICABLE | 11/15/2018 |
| Adair County Nursing Home District | Organization | ADP of the SNF | NOT APPLICABLE | 11/15/2018 |
| Bell, Aurora | Individual | Operational/Managerial Control | NOT APPLICABLE | 10/01/2023 |
| Bell, Aurora | Individual | ADP of the SNF | NOT APPLICABLE | 10/01/2023 |
| Besler, Wendy | Individual | Operational/Managerial Control | NOT APPLICABLE | 06/01/2008 |
| Besler, Wendy | Individual | ADP of the SNF | NOT APPLICABLE | 06/01/2008 |
| Richardson, James | Individual | Corporate Director | NOT APPLICABLE | 12/01/2012 |
| Richardson, James | Individual | Operational/Managerial Control | NOT APPLICABLE | 12/01/2012 |
| Richardson, James | Individual | ADP of the SNF | NOT APPLICABLE | 12/01/2012 |
All 9 owning or managing parties CMS has on file are shown — none excluded.
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "Can you give me examples of how your staff protect residents' dignity in everyday care, like bathing and dressing?"
- "Could I join residents for a meal to see the food quality and temperature for myself?"
- "If my family member falls or their condition changes, exactly when and how will I be notified?"
- "Walk me through what happens when a resident or family files a grievance — who responds and how fast?"
- "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
- "How do frontline staff report care problems, and how does your quality improvement program act on them?"
- "How do you screen job applicants for past findings of abuse, neglect, or theft before hiring?"
- "If you ever planned to discharge or transfer my family member, how much written notice would we receive and how could we appeal?"
Also worth asking anywhere
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the plan of correction for the findings in your most recent state inspection?"
- "CMS reports 44% total nursing staff turnover here — who on the care team has been with you longest?"
- "Can I visit again unannounced, at a mealtime or on a weekend?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Kirksville Manor Care Center | 0.4 mi | Kirksville, MO | ★☆☆☆☆ | 1/5 | |
| La Plata Nursing Home | 11.5 mi | La Plata, MO | ★★★☆☆ | 3/5 |
Facility data as of CMS processing date 2026-08-01. CCN 265198.