Aspire Senior Living Moberly

Inspectors wroteBased on observation, interview, and record review, the facility failed to administer medications per physician's order, manufacturer guidelines, and per professional standard of practice for four additional residents (Residents #80 #32, #59, and #54), and failed to provide proper care for a urinary catheter (tube inserted into the bladder to drain urine) for one resident (Resident #7). The facility census was 71. Review of the facility policy, Medication Administration, dated 10/01/25, showed the following:-Medications are administered by licensed nurses or other staff who are legally authorized to do so in this state, as ordered by the physician and in accordance with professional standards of practice, in a manner to prevent contamination or infection;-Administer medication as ordered in accordance with manufacturer specifications (provide appropriate amount of food and fluid). 1. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure seven residents (Residents #7, #11, #24, #13, #60, #5 and #15), who required assistance with activities of daily living (ADLs), in a review of 23 sampled residents, received necessary care and services to maintain grooming and personal hygiene. The facility census was 71. Review of the facility policy, Grooming a Resident's Facial Hair, dated 10/01/25, showed it was the facility's practice to assist residents with grooming facial hair to help maintain proper hygiene as per current standards of practice. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide sufficient staff to meet residents' needs for seven residents (Resident #6, #71, #7, #11, #24, #15 and #5), in a review of 23 sampled residents, and for one additional resident (Resident #43). Staff failed to provide restorative therapy when the restorative aide (RA) was pulled to work as a certified nurse assistant (CNA) and was unable to complete duties for the restorative therapy nursing program. The facility failed to ensure sufficient staff were available to provide routine showers to ensure good personal hygiene and failed to ensure there was sufficient staff to provide assistance with residents' activities of daily living and care needs. The facility census was 71. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a safe environment for all residents. On 8/22/25, the facility received information from a structural engineer the middle common area framing, in its current condition, was not structurally sound. The structural engineer advised that the area below this needed to be unoccupied until all the framing deficiencies were addressed. The facility continued to utilize the middle common area, which included the resident sitting area toward the front entrance, the central nurses station, and the access to six hallways and the dining room and did not prohibit access until repairs were made. The facility census was 70. The facility was notified of the Immediate Jeopardy (IJ) on 09/04/25 at 5:08 P.M. which began on 08/22/25. The IJ was removed on 09/04/25 as confirmed by the surveyor's onsite verification. [...]

Inspectors wroteBased on interview and record review, the facility failed to provide a Registered Nurse (RN) eight consecutive hours a day, seven days a week, for 15 of 32 days reviewed. The facility census was 70. Review of the facility policy, Registered Nurse, dated 01/30/24, showed the following: -Purpose: ensure that an RN is available for supervision in the facility;-Procedure: except when waived, the facility must use the services of an RN for at least eight consecutive hours a day, seven days a week. 1. Review of the facility assessment, revised 05/14/25, showed a staffing plan of eight RN hours per a resident day on the day shift. 2. Review of the facility posted staffing sheets, from 08/05/25 through 09/05/25, documenting staff who worked each day, showed the following: [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure medication was administered according to professional standards of practice for one resident (Resident #1), in a review of five sampled residents. Licensed Practical Nurse (LPN) A administered an antipsychotic medication prepared by another nurse, LPN D, was unaware of the contents of the medication cup when he/she administered the medication to the resident and failed to document administration of the medication. LPN D gave a certified nurse aide medication LPN D prepared and when the certified nurse aide was unsuccessful in administration, LPN A administered the medication. The facility census was 64. Review of the facility undated Medication Administration policy showed the following: [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide reasonable accommodation of needs for one resident (Resident #4), in a review of 24 sampled residents, when staff did not ensure the resident had a comfortable wheelchair that fit him/her properly and did not cause him/her discomfort and pain. The resident presented with an increase in depression symptoms and reported that due to not having a comfortable wheelchair, he/she stayed in bed and felt abandoned, thrown away and like nobody cared. The facility also failed to ensure call lights were within reach for three residents (Residents #3, #22 and #29), in a review of 24 sampled residents. The facility census was 64. Review of the facility policy, Accommodation of Needs, revised 03/2021, showed the following: [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to label, date and cover food items, failed to properly wear hair restraints, failed to utilize proper handwashing and glove use while handling ready to eat food items, failed to maintain the walk-in cooler fan shrouds to be free of a buildup of debris, and failed to ensure the ice machine had an appropriate air gap. The facility census was 64. Review of the facility policy, Labeling and Dating Foods (Date Marking), dated 2020, showed the following: -All foods stored will be properly labeled according to the following guidelines; -Date marking for refrigerated storage food items: Once opened, all ready to eat, potentially hazardous food will be re-dated with a use by date according to current safe food storage guidelines or by the manufacturer's expiration date; [...]

Inspectors wroteBased on interview and record review, the facility failed to identify that one employee had a previous criminal offense as identified on a Criminal Background Check (CBC) through the Family Care Safety Registry (FCSR), that would have prohibited his/her employment, and allowed Housekeeper H continued resident contact through his/her employment at the facility. The facility census was 64. Review of the undated facility document, titled Department of Health and Senior Services, Can't Hire and Can Hire, showed the Can't Hire column included burglary, first degree, class B felony (§569.160). Review of the facility policy and procedure, Criminal Background Checks, revised 08/21/24, showed the following: -Purpose: Ensure compliance with state and federally required criminal background checks needed to provide a safe environment for residents, staff, and visitors; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to design a meaningful activity program to meet the needs and interests of six residents (Residents #3, #4, #21, #22, #30 and #50), in a review of 24 sampled residents. The facility failed to provide activities to the residents at a frequency consistent with their plan of care and activity assessment, and failed to provide a structured activities program to three residents (Residents #21, #22 and #50) on the memory care unit focused on the individualized needs of the residents to keep them engaged in meaningful activities. The facility census was 64. Review of the facility's policy, Activity Program, dated 01/30/24, showed the following: [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide adequate staffing to monitor residents, provide oversight, and to provide activities to the ten residents who resided on the memory care unit. The facility census was 64. Review of the Facility Assessment, updated 02/12/24, showed the following: -The facility was licensed for 120 total beds; 14 of these beds were located on the locked unit (dementia care); -The facility had an average daily census of 71 ranging from 65-72 residents at a time; -There was an average of 12 residents located on the locked dementia care unit; -Approach to Staffing: -Five certified nurse assistants (CNAs) on day shift 6:00 A.M.-2:00 P.M.; -Five CNAs on evening shift 2:00 P.M.-10:00 P.M.; -Three CNAs on night shift 10:00 P.M.-6:00 A.M. -Staffing plan for the memory care unit was 16 hours per resident day for days and for nights; [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure the right to privacy with communication when the facility opened two additional residents' (Resident #51 and #52) personal mail without permission. The facility census was 64. Review of the facility's policy, Mail and Electronic Communication, revised May 2017, showed the following: -Residents are allowed to communicate privately with individuals of their choice and may send and receive personal mail, email and other electronic forms of communication confidentially; -Mail will be delivered to the resident unopened; -Staff members of this facility will not open mail for the resident unless the resident requests them to do so (such request will be documented in the resident's plan of care). 1. [...]

Inspectors wroteBased on observation, interview, and record review, the facility facility failed to provide documentation of a medical diagnosis that warranted the use of a restraint prior to initiation, assessment and monitoring for the use of physical restraints, including a wheelchair locked when placed up to the dining room table, a pommel cushion (a cushion with an upward-projecting protuberance at its front part that prevents a wheelchair dependent resident from sliding down and possibly falling out of a wheelchair), to prevent rising from a wheelchair, and a recliner positioned with he legs elevated (Resident #50 and #22), in a review of 24 sampled residents, who were in chairs to prevent them from rising. The residents could not easily and intentionally rise from their wheelchairs or a recliner. [...]

Inspectors wroteBased on interview and record review, the facility failed to develop a person-centered comprehensive care plan specific to the resident, for two residents (Resident #42 and #36), in a review of 24 sampled residents. The facility census was 64. Review of the facility policy, Care Plans, Comprehensive Person-Centered, revised March 2022, showed the following: -The interdisciplinary team (IDT), in conjunction with the resident and his/her family or legal representative, develops and implements a comprehensive, person-centered care plan for each resident; -The care plan interventions are derived from a thorough analysis of the information gathered as part of the comprehensive assessment; -The comprehensive, person-centered care plan: a. Includes measurable objectives and timeframes; b. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure staff provided two residents (Resident #42 and #36), who required assistance to complete their own activities of daily living (ADL), in a review of 24 sampled residents, the necessary care and services to maintain good oral hygiene. The facility census was 64. Review of the facility policy, Dental/Oral Care of the Resident, dated 01/30/24, showed the following: -Purpose: to clean and freshen the resident's mouth, prevent infections of the mouth, maintain the teeth and gums in a healthy condition, stimulate the gums and remove food particles from between the teeth; -Assist the resident with brushing their teeth based on individual needs; -Teeth should be brushed every morning and evening; -Flossing of the teeth should be done at least once a day to promote healthy gums; [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure an approved indication for use of psychotropic medications for one resident (Resident #21), in a review of five residents sampled for unnecessary medications. Resident #21 had an order for risperidone (an antipsychotic medication) which is contraindicated for use in residents with dementia related psychosis. The resident's dosage of risperidone (an antipsychotic medication) was increased after the resident presented with one day of behaviors on 01/19/24 after the medication was decreased on 01/16/24. The resident's medical record did not contain documentation the facility assessed the root cause of the resident's behaviors or attempted non-pharmacological interventions to address the behaviors prior to increasing and adding medications to the resident's medication regimen. The facility census was 64. [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure all required components of an arbitration agreement were part of the facility policy. This failure affected all of the residents in the facility, as all residents had a signed arbitration agreement. The facility census was 64. Review of the undated facility admission Agreement Packet showed the following: -Alternative Dispute Resolution Addendum: This Alternative Dispute Resolution Addendum is attached to and made a part of the admission Agreement between the facility and the resident. All claims, disputes, and controversies arising out of or in any manner relating, directly or indirectly, to the resident's care or stay at the facility (in each case, a dispute) shall be subject to certain alternative dispute resolution procedures that must be exhausted prior to pursuing any other remedy that may be available. [...]

Inspectors wroteBased on observation and interview, the facility failed to implement sanitary practices and conditions within the dietary department to prevent the potential for contamination of food during storage, preparation, and distribution. The facility census was 69. 1. Observation on 03/13/23 between 9:32 A.M. and 12:27 P.M., of the preparation and service of the noon meal, showed the following: -At 9:32 A.M., Dietary [NAME] P prepared the noon meal in the kitchen. He/She did not have the front of his/her hair covered with a hair net. Dietary Aide A washed dishes and did not have the front of his/her hair covered with a hairnet; -At 10:25 A.M., Dietary Aide B rolled silverware into napkins for the residents' meal and did not wear a beard restraint to cover his/her beard; -At 11:05 A.M., Dietary Aide A stacked three wet skillets and put them away on a shelf; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure staff spoke to one resident (Resident #4), in a review of 18 sampled residents, and one additional resident (Resident #45), in a dignified manner. The facility census was 69. Review of the facility policy Dignity, revised February 2021, showed the following: -Each resident shall be cared for in a manner that promotes and enhances his/her sense of well-being, level of satisfaction with life, and feelings of self-worth and self-esteem; -Residents are treated with dignity and respect at all times; -Staff speak respectfully to residents at all times, including addressing the resident by his/her name of choice and not labeling or referring to the resident by his/her room number, diagnosis or care needs; -Demeaning practices and standards of care that compromise dignity are prohibited. 1. [...]

Inspectors wroteBased on interview and record review, the facility failed to review the Certified Nurse Aide (CNA) Registry for a Federal Indicator (which would disquality an individual from working in the facility) for eight employees in a review of ten newly hired employees. The facility also failed to develop a policy and procedure to address reviewing the CNA Registry for a Federal indicator for all potential new hires. The facility census was 69. Review of the undated facility policy titled CNA Registry Check for Skilled Nursing Facilities, showed the following: Purpose: -The purpose of this policy is to ensure resident safety by requiring all skilled nursing facilities to conduct a CNA Registry Check before hiring CNAs. This policy aims to ensure that all CNAs employed by the facility are properly trained, qualified, and have no history of abuse or neglect in the provision of care for residents; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure staff provided the necessary care and services to maintain good personal hygiene and prevent body odor for seven residents (Residents #4, #35, #37, #41, #50, #116, and #317), who required assistance to perform their activities of daily living (ADLs), in a review of 18 sampled residents. The facility census was 69. Review of the facility's undated Shower/Tub Bath policy shower no evidence of how frequently residents should receive a shower/bath. Review of the facility's undated policy, Dental/Oral Care of the Resident, showed the following: -Assist the resident with brushing his/her teeth based on individual needs; -Teeth should be brushed every morning and evening. 1. Review of Resident #41's quarterly Minimum Data Set (MDS), a federally mandated assessment instrument, dated 1/28/23, showed the following: [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure safety during transfers and/or repositioning for four residents (Residents #6, #20, #22 and #27), in a review of 18 sampled residents. Staff failed to properly transfer three residents (Residents #20, #22, and #27) with a gait belt (a device put around a resident's waist prior to a transfer or position change to aid in the safe movement from one surface to another), and failed to safely reposition one resident (Resident #6) while in bed. The facility census was 69. Review of the undated facility policy, Gait Belt Use, Mechanical Lift, and Manual Transfer, showed the following: -Purpose: The purpose of this policy and procedure is to ensure the safe and proper use of gait belts, mechanical lifts, and manual transfer in our skilled nursing facility; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure staff prepared and served food at a safe and appetizing temperature. The facility census was 69. During interview on 3/13/23 at 9:54 A.M., Resident #33 said the food served at the facility was mediocre in taste and temperature. During an interview on 3/13/23 at 10:18 A.M., Resident #10 said the following: -Sometimes the food was not hot; -The food was bland; -Sometimes the meat was not tender. Record review of the menu for the noon meal on 03/13/23 showed the menu items included fried chicken and creamed corn. During interview on 3/13/23 at 12:14 P.M., Resident #20 said the following: -The fried chicken for lunch was cold, hard, and he/she couldn't chew it. (Observation showed the resident consumed less than 10% of the fried chicken on his/her plate); [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to use appropriate infection control practices when staff rinsed out a graduated cylinder that contained urine in the sink in one resident's (Resident #37) shared room, in a review of 18 sampled residents, and rinsed a fecal soiled incontinence pad in the sink in one additional resident's (Resident #29's) shared room. The facility also failed to ensure all procedures were implemented to address prevention, development, and transmission of Tuberculosis (TB) as directed by facility policy. The facility failed to ensure Tuberculin Skin Tests (TST; an injection into the top layer of skin in the forearm that contains purified protein derivative, PPD) were completed and documented as directed by facility policy for eight of ten sampled employees reviewed. The facility census was 69. 1. [...]

Inspectors wroteBased on interview and record review, the facility failed to notify the physician timely after a change in condition for one additional resident (Resident #117) and one discharged resident (Resident #64). The facility census was 69. Review of the facility's Notification of Changes policy, undated, showed the following: -The facility must immediately inform the resident, consult with the resident's physician, and notify, consistent with his/her authority, the resident representative(s) when there is: a. A significant change in the resident's physical, mental or psychosocial status (that is, a deterioration in health, mental, or psychosocial status in either life-threatening conditions or clinical complications); b. A need to alter treatment significantly (that is, a need to discontinue an existing from a treatment due to adverse consequences, or to commence a new form of treatment). 1. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide proper care to a suprapubic urinary catheter (a tube inserted into the bladder through a small cut in the low abdomen) for one resident (Resident #37), in a review of 18 sampled residents. Four residents had a urinary catheter. The facility census was 69. Review of the facility's undated policy, Catheter Care, showed catheter bags must be kept below the level of the bladder to prevent backflow of urine. Review of Resident #37's significant change Minimum Data Set (MDS), a federally mandated assessment instrument completed by facility staff, dated 1/4/23, showed the following: -The resident had moderate cognitive impairment; -He/She required extensive assistance from two staff for toilet use and personal hygiene; -He/She was dependent on two staff for transfers; [...]

Inspectors wroteBased on observation and interview, the facility failed to follow proper sanitation and food handling practices in the kitchen. The facility census was 47. 1. Review of the Dietary Personnel Guidelines policy dated May 2015 showed hairnets should be worn at all times and should cover the entire head of hair. Hands should be washed any time deemed necessary. 2. Review of the dietitian consultation report dated 08/07/19 showed the dietitian did a complete walk through of the kitchen area with the dietary manager. They discussed employee behaviors including food handling and the standards for food protection. 3. Observation on 08/12/19 between 9:36 A.M. and 12:31 A.M. showed the following: -Kitchen staff in the kitchen preparing the noon meal; -A male employee walked through the kitchen with no hair net or beard net (employee had facial hair); [...]

Inspectors wroteBased on observation, interview, and record review, the facility staff failed to design and provide an activity program to meet the needs, interests, physical, mental, and psychosocial well-being for six residents (Residents #9, #12, #17, #20, #39, and #45) in a review of 12 sampled residents. The facility census was 47. 1. Review of the Long-Term Care Facility Resident Assessment Instrument User's Manual, dated October 2013, showed the following: -Most residents capable of communicating can answer questions about what they like; -Obtaining information about preferences directly from the resident, sometimes called hearing the resident's voice, is the most reliable and accurate way of identifying preferences; -If a resident cannot communicate, then family or significant other who knows the resident well may be able to provide useful information about preferences; [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure staff served bread as directed by the spreadsheet to residents on regular, mechanical soft and pureed diets. The facility census was 47. Review of the facility's spreadsheet menu for 8/12/19 showed staff were to serve meatballs with gravy, mashed potatoes, seasoned carrots, dinner roll, and chilled pears to residents at the noon meal. The meal was to be served to all residents on regular, mechanical soft and pureed diets. The modified diets were to be of appropriate consistency for the resident's diet. Observation on 08/12/19 between 11:53 A.M. and 12:31 P.M. of the noon meal, showed staff did not serve a dinner roll or bread to the residents as directed by the spreadsheet menu. During an interview on 8/12/19 at 2:27 P.M., Resident #20 said he/she did not get a dinner roll for the lunch meal. [...]

Inspectors wroteBased on observation and interview, the facility failed to serve food that was palatable and at a safe and appetizing temperature. The facility census was 47. 1. Review of the facility's policy, Food Temperatures, dated May 2015, showed hot food should be at least 120 degrees Fahrenheit when served to the resident. 2. Record review of the facility menu for 08/12/19 showed the lunch meal included meatballs with gravy, mashed potatoes, and seasoned carrots. During observation and interview on 8/12/19 at 12:30 P.M. Resident #42 sat on the bed in his/her room. The resident was eating his/her lunch tray of meatballs, mashed potatoes and gravy, carrots, and pears. The resident said the food was barely warm. The food didn't taste too bad but it would be much better if it was warm. The resident would prefer the food to be warmer. [...]

Inspectors wroteBased on interview and record review, the facility failed to report allegations of resident-to-resident abuse to the state agency within two hours. The facility census was 47. 1. Review of the facility's Abuse Policy, undated, showed the following: -The facility will adhere to reporting time frames as outlined for the reporting to the State Survey agency for reporting to law enforcement. When there is a reasonable suspicion that a crime has occurred, to include but not limited to: abuse or the crime results in serious bodily injury, the crime must be reported within two hours. If the crime is not abuse or result in serious bodily injury, the report must be made within 24 hours; -The nursing home administrator or designee will report abuse to the state agency per State and Federal requirements. 2. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide appropriate treatment and services consistent with professional standards of practice to increase range of motion and/or prevent further decrease in range of motion for two residents (Residents #12, and #45), in a review of 12 sampled residents. The facility census was 47. 1. Review of the facility's policy on Range of Motion, dated May 2006, showed the following: -Range of motion (ROM) may be defined as the extent of movement within a given joint which is normally achieved through the action of a muscle or group of muscles; -Objectives of ROM are to prevent contractures (fibrotic changes which begin to occur in the muscles and other joint tissues within three to four days if immobility); -To maintain normal range of motion (different normal ranges of motion may be fund in different individuals); [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to evaluate and implement interventions to prevent further choking episodes after one additional resident (Resident #39), who had a history of dysphagia (difficulty swallowing), choked and required the Heimlich maneuver (a first-aid procedure for dislodging an obstruction from a person's windpipe in which a sudden strong pressure is applied on the abdomen) to dislodge the food. The facility also failed to ensure an electric range in the activity area, accessible to residents, was inoperable when not in use. The facility census was 47. 1. Review Resident #39's care plan, dated 10/18/18, showed the following: -History of dysphagia (difficulty swallowing) and at risk for aspiration (breathe foreign objects into the airway); -Monitor for signs and symptoms of aspiration, coughing, wheezing, fever, etc. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide appropriate services to attain the highest practical well-being for one resident (Resident #34), with a diagnosis of dementia, in a review of 12 sampled residents. Facility staff identified the resident had behaviors affecting the resident and other residents, however, did not evaluate and implement further approaches to address the resident's care needs related to his/her diagnosis of dementia. The facility census was 47. 1. Review of the facility's policy on the philosophy and mission statement of the Special Care Unit (SCU), dated April 2006, showed the following: -The overall objective of the SCU was to provide a therapeutic, homelike, environment that maximizes the resident's independent functioning for as long as possible; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to administer insulin according to the manufacturer's recommendations for two different types of insulin pens, for one resident (Resident #45), in a review of 12 sampled residents and one additional resident (Resident #6). Facility staff also failed to ensure an insulin vial had not exceeded its recommended storage date prior to administration for one sampled resident (Resident #45). The failure had the potential to result in residents not receiving their full dose of ordered insulin. The facility census was 47. 1. Review of the manufacturer's instructions for use for the Novolog (insulin) FlexPen (injection cartridge device) showed the following: -Before each injection, small amounts of air may collect in the cartridge during normal use; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure staff washed their hands when indicated by professional standards of practice during personal care for one resident (Resident #17), in a review of 12 sampled residents and failed to ensure infection control measures were appropriately followed when staff failed to promptly disinfect surfaces that came into contact with body substances for one sampled resident and one additional resident (Residents #17 and #19). The facility census was 47. 1. Review of the Infection Control Guidelines for Long Term Care Facilities, January 2005 edition, Section 3.0, Body Substance Precautions, Subsection 3.2 Implementing the Body Substance Precautions System, provided by the facility, showed the following regarding gloves and handwashing: [...]