Twin Pines Adult Care Center

Name: Twin Pines Adult Care Center
Address: 1900 S JAMISON, Kirksville, MO, 63501, US
Telephone: 6606652887

1900 S Jamison, Kirksville, MO 63501 · Adair County · 120 certified beds · avg 71 residents/day · certified since Sep 1, 1983

2/5

Health inspection rating (on-site)

Serious findings on record

Fines, last 3 years

4.79

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 (35)

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
Feb 24, 2026	E · Potential for harm, repeated	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
Feb 24, 2026	E · Potential for harm, repeated	The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature. · from a complaint
Feb 24, 2026	D · Potential for harm, one-off	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
Oct 11, 2024	F · Potential for harm, facility-wide	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.
Oct 11, 2024	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.
Oct 11, 2024	F · Potential for harm, facility-wide	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.
Oct 11, 2024	E · Potential for harm, repeated	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.
Oct 11, 2024	E · Potential for harm, repeated	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.
Oct 11, 2024	E · Potential for harm, repeated	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.
Oct 11, 2024	E · Potential for harm, repeated	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.
Oct 11, 2024	E · Potential for harm, repeated	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.
Oct 11, 2024	D · Potential for harm, one-off	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.
Oct 11, 2024	D · Potential for harm, one-off	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
Oct 11, 2024	D · Potential for harm, one-off	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.
Jan 30, 2023	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.
Jan 30, 2023	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.
Jan 30, 2023	E · Potential for harm, repeated	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.
Jan 30, 2023	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.
Jan 30, 2023	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.
Jan 30, 2023	D · Potential for harm, one-off	The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow.
Jan 30, 2023	D · Potential for harm, one-off	The facility did not provide safe and appropriate pain management for a resident who needed it.
Jan 30, 2023	D · Potential for harm, one-off	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.
Jan 30, 2023	D · Potential for harm, one-off	The facility did not develop and follow policies and procedures for offering residents flu and pneumonia vaccinations.
Jan 30, 2023	B · Minimal risk, repeated	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.
Jun 7, 2019	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.
Jun 7, 2019	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.
Jun 7, 2019	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.
Jun 7, 2019	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.
Jun 7, 2019	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.
Jun 7, 2019	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.
Jun 7, 2019	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.
Jun 7, 2019	E · Potential for harm, repeated	The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature.
Jun 7, 2019	E · Potential for harm, repeated	The facility did not develop and follow policies and procedures for offering residents flu and pneumonia vaccinations.
Jun 7, 2019	D · Potential for harm, one-off	The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow.
Jun 7, 2019	D · Potential for harm, one-off	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.

Inspection trend by year

Citations from standard inspections stayed about the same across the last two inspection cycles (10 → 11).

Year	Citations	Worst severity that year
2019	11	F
2023	10	F
2024	11	F
2026	3	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)

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)	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, 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. Staffing rating: 4/5.

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: 2/5 · short-stay residents: 1/5

Who owns this facility

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

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?"
"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
Kirksville Manor Care Center	0.4 mi	Kirksville, MO	★☆☆☆☆	1/5
La Plata Nursing Home	11.5 mi	La Plata, MO	★★★☆☆	3/5

Compare this facility with the 2 closest →

All facilities in Kirksville →

Facility data as of CMS processing date 2026-08-01. CCN 265198.

The Care File

Visit checklist — Twin Pines Adult Care Center

1900 S Jamison, Kirksville, MO 63501 · 6606652887

Health inspection rating 2/5 · CMS overall 2/5· Fines (3y): $0

Questions for the administrator:

☐ "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?"
☐ "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?"

While you're there, notice:

☐ Smell and cleanliness in hallways, not just the lobby
☐ How staff speak to residents; call lights answered promptly
☐ Residents up, dressed, and engaged (visit mealtimes and a weekend if you can)

Data: CMS Provider Data Catalog, version 2026-08-01 · CCN 265198 · Verify at medicare.gov/care-compare · Printed from The Care File (thecarefile.com)