Winchester Nursing Center, Inc
400 Winchester Dr, Bernie, MO 63822 · Stoddard County · (573) 293-6702
60 certified beds, about 53 residents a day · For profit - Corporation · Medicare and Medicaid since 2019
Certified for Medicaid Certified for Medicare
Overall
5 of 5
Health inspections
5 of 5
Staffing
2 of 5
Quality measures
3 of 5
CMS Care Compare ratings, data as of September 1, 2026 · CCN 265874 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on July 25, 2025, inspectors cited 1 health deficiency (the Missouri average is 11.4, the national average 9.2).
None of its 7 health citations since February 2023 was rated as actual harm or immediate jeopardy.
CMS lists no fines against this home in the last three years.
Nurses and nurse aides worked 3.41 hours per resident per day, against 3.43 across Missouri and 3.86 nationally. Registered nurses accounted for 0.60 of those hours.
55.6% of nursing staff left within the year CMS measured (Missouri average 56.0%).
CMS links it to Paradigm Senior Management, an affiliated group of 8 nursing homes.
Health inspections
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
002/23
605/24
107/25
Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit
Where its citations fall on CMS's grid
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 7 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
0K
0L
Actual harm
0G
0H
0I
Potential for more than minimal harm
7D
0E
0F
Potential for minimal harm
0A
0B
0C
July 25, 2025Standard inspection · 1 citation
- D Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Inspectors wroteBased on interview and record review, the facility failed to notify the resident and/or the resident's representative in writing of a transfer to a hospital which included the reason for the transfer for two residents (Residents #30 and #52) out of nine sampled residents. The facility census was 52. [...]
May 9, 2024Standard inspection · 6 citations
- D Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a safe, clean and comfortable homelike environment. This deficient practice had the potential to affect all residents in the facility. The facility census was 44. Review of the facility's policy titled, Homelike Environment, revised 2021, showed: - Residents are provided with a safe, clean, comfortable and homelike environment and encouraged to use their personal belongings to the extent possible; - Staff provides person-centered care that emphasizes the residents' comfort, independence and personal needs and preferences; - The facility staff and management maximizes, to the extent possible, the characteristics of the facility that reflect a personalized, homelike setting which include a clean, sanitary and orderly environment. Observations made on 05/06/24 at 10:07 A.M., 05/07/24 at 3:13 P.M. [...]
- D Ensure services provided by the nursing facility meet professional standards of quality.
Inspectors wroteBased on interview and record review the facility failed to follow physician's orders for daily weights for one resident (Resident #40) out of 12 sampled residents. The facility census was 44. The facility did not provide a policy. 1. Review of Resident #40's Physician Order Sheet, dated May 2024, showed: - An order to obtain daily weight, one time a day, dated 03/21/24; - Diagnosis of congestive heart failure (when the heart does not pump like it should and fluid can build up around the heart). Review of the resident's medical chart showed: - March 21, 2024 through March 31, 2024 three missed out of 11 opportunities; - April 2024 12 missed out of 30 opportunities; - May 1, 2024 through May 8, 2024 five missed out of eight opportunities. [...]
- D Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Inspectors wroteBased on observation, interview and record review, the facility failed to follow standards of practice to have a physician's order for an indwelling catheter (a tube inserted into the urinary bladder to drain urine), failed to obtain orders to change catheter every 30 days and failed to ensure documentation of the catheter changes were maintained for one resident (Resident #6) out of three sampled residents. The facility census was 44. The facility did not provide a policy. Record review of Resident #6's Physician Order Sheet (POS), dated May 2024, showed: - An admission date of 04/01/19; - No order for Foley catheter. Observation made on 05/06/24 at 9:23 A.M., showed the resident resting in bed and catheter bag visible from doorway. Observation made on 05/07/24 at 8:44 A.M., showed the resident resting in bed and catheter bag visible from doorway. [...]
- D Provide safe, appropriate dialysis care/services for a resident who requires such services.
Inspectors wroteBased on interview and record review, the facility failed to provide documentation of ongoing assessments, monitoring, and communication between the facility and the dialysis (a process for removing waste and excess water from the blood) center for two residents (Residents #40 and #42) out of two sampled residents. The facility census was 44. Review of the facility's policy titled, Hemodialysis Catheters-Access and Care Of, dated February 2023, showed: - Check patency (open/unobstructed) of the site at regular intervals. Palpate (examine by touch) the site to feel the thrill (a vibrating sensation) or use a stethoscope to hear the bruit (the sound of blood flowing through a narrowed blood vessel) through the dialysis access site; - The dressing change is done in the dialysis center after treatment; [...]
- D Ensure medication error rates are not 5 percent or greater.
Inspectors wroteBased on observation, interview and record review, the facility failed to maintain a medication error rate of less than five percent (%). There were 25 opportunities with three errors made, resulting in an error rate of 12% for five residents (Residents #9, #25, #28, #34 and #42) out of five sampled residents. The facility's census was 44. Review of the facility's policy titled, Administering Medications, dated April 2019, showed: - Medications are administered in accordance with prescriber orders, including any required time frame; - The policy did not address insulin pen administration technique. Review of the Humalog/lispro (a rapid insulin injected just below the skin that helps lower mealtime blood sugar spikes) Kwik Pen (Insulin in a pen-type device) instructions, revised, July 2023, showed: - Pull the Kwik Pen cap straight off; - Wipe the rubber seal with an alcohol swab; [...]
- D Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a safe and sanitary environment by failing to perform hand hygiene during medication administration for five residents (Resident #9, #25, #28, #34, and #42) and to disinfect the glucometer (a device used to measure blood sugar) per the manufacturer's instructions for three residents (Resident #9, #25, and #34) out of five sampled residents. The facility's census was 44. Review of the facility's policy titled, Blood Sampling-Capillary (fine-branching blood vessels) (Finger Sticks), revised 09/2014, showed: - Always ensure blood glucose meters intended for reuse are cleaned and disinfected between resident uses; - The steps in the this procedure include: wash hands; put on gloves; follow the manufacturer's instructions to clean and disinfect the reusable equipment, parts and/or devices after each use; [...]
February 23, 2023Standard inspection · 0 citations
Fire safety inspections
4 fire safety citations on file: 2 on July 25, 2025, 1 on May 9, 2024, 1 on February 23, 2023.
Every fire safety citation4 citations
- F Ensure proper usage of power strips and extension cords.
- F Have proper medical gas storage and administration areas.
- F Provide properly protected cooking facilities.
- F Inspect, test, and maintain automatic sprinkler systems.
Fines and payment denials
CMS lists no fines or payment denials against this home in the last three years. The national average is 0.9 fines per home.
Staffing
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Missouri | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 3.41 | 3.43 | 3.86 |
| Registered nurses | 0.60 | 0.46 | 0.69 |
| All nursing staff on weekends | 2.86 | 3.01 | 3.42 |
| Nurse aides | 2.28 | ||
| Licensed practical nurses | 0.53 | ||
| Nursing staff turnover (share who left in a year) | 55.6% | 56.0% | 45.8% |
| Registered nurse turnover | 50.0% | 47.8% | 42.9% |
| Administrators who left | not reported |
CMS expects 3.83 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Staffing by quarter, from daily payroll records
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 3.63 on weekdays and 2.86 on weekends, 21% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 0.0% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.36 in April to June 2025 to 3.41 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 3.41 | 0.60 | 3.63 | 2.86 | 0.0% | 0 of 90 | 53 |
| Oct to Dec 2025 | 3.33 | 0.66 | 3.58 | 2.70 | 0.0% | 0 of 92 | 53 |
| Jul to Sep 2025 | 3.41 | 0.63 | 3.66 | 2.76 | 0.0% | 0 of 92 | 52 |
| Apr to Jun 2025 | 3.36 | 0.54 | 3.60 | 2.76 | 0.0% | 0 of 91 | 50 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Missouri, Jan to Mar 2026 | 3.34 | 0.40 | 3.50 | 2.93 | 3.9% | 1.1% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Quality measures
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Missouri | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 13.9 | 18.1 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.9 | 1.1 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 6.3 | 2.3 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 15.4 | 4.1 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 1.8 | 2.2 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 14.6 | 17.4 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 5.9 | 4.5 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 15.9 | 23.5 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 42.2 | 26.1 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 19.8 | 13.7 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 2.9 | 2.1 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 3.9 | 2.3 | 1.8 |
Owners and operators
Legal business name: WINCHESTER NURSING CENTER, INC. CMS links this home to Paradigm Senior Management, a group of 8 nursing homes averaging 3.6 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| First Midwest Bank of Dexter | 5% or greater mortgage interest | Organization | 02/05/2021 | |
| Jones, Angela | Corporate officer | Individual | 08/23/2022 | |
| Sells, Benjamin | Corporate officer | Individual | 08/23/2022 | |
| Forvis Mazars LLP | Operational/managerial control | Organization | 01/01/2025 | |
| Paradigm Rehab Services LLC | Operational/managerial control | Organization | 09/01/2024 | |
| Paradigm Senior Management LLC | Operational/managerial control | Organization | 03/22/2019 | |
| Aters, Kelli | Operational/managerial control | Individual | 04/24/2023 | |
| Caldwell, Fred | Operational/managerial control | Individual | 10/01/2024 | |
| Diebold, Colby | Operational/managerial control | Individual | 01/01/2025 | |
| Hutchinson, Dalen | Operational/managerial control | Individual | 11/01/2022 | |
| Sells, Benjamin | Operational/managerial control | Individual | 08/23/2022 | |
| First Midwest Bank of Dexter | Adp of the SNF | Organization | 04/02/2025 | |
| Forvis Mazars LLP | Adp of the SNF | Organization | 04/02/2025 | |
| Paradigm Rehab Services LLC | Adp of the SNF | Organization | 04/02/2025 | |
| Paradigm Senior Management LLC | Adp of the SNF | Organization | 04/02/2025 | |
| Winchester Place Retirement Community, LLC | Adp of the SNF | Organization | 04/02/2025 | |
| Aters, Kelli | Adp of the SNF | Individual | 04/24/2023 | |
| Caldwell, Fred | Adp of the SNF | Individual | 10/01/2024 | |
| Diebold, Colby | Adp of the SNF | Individual | 01/01/2025 | |
| Hutchinson, Dalen | Adp of the SNF | Individual | 11/01/2022 | |
| Sells, Benjamin | Adp of the SNF | Individual | 08/23/2022 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Questions to ask on a visit
Chosen from this home's own inspection record.
- How do residents and families raise a complaint or grievance, and how fast is it answered?Inspectors cited 2 problems in this area, most recently on July 25, 2025: "Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies."
- How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 2 problems in this area, most recently on May 9, 2024: "Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections."
- When is the care plan meeting, and can family attend it?Inspectors cited 1 problem in this area, most recently on May 9, 2024: "Ensure services provided by the nursing facility meet professional standards of quality."
- How are medications reviewed, and how often are antipsychotic or sedating drugs used?Inspectors cited 1 problem in this area, most recently on May 9, 2024: "Ensure medication error rates are not 5 percent or greater."
- Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 2.86 hours per resident per day, below the Missouri average of 3.01.
Other nursing homes nearby
- Aspire Senior Living Malden Malden, 6.5 mi · 3 of 5 stars · 29 citations
- Memory Lane of Dexter Dexter, 8.4 mi · 4 of 5 stars · 12 citations
- Cypress Point-Skilled Nursing by Americare Dexter, 8.9 mi · 4 of 5 stars · 16 citations
- Crowley Ridge Care Center Dexter, 10 mi · 4 of 5 stars · 11 citations
- Campbell Healthcare & Senior Living Campbell, 13.8 mi · 3 of 5 stars · 27 citations
- Gideon Care Center Gideon, 15.1 mi · 4 of 5 stars · 19 citations
- Prairie View Skilled Nursing Bloomfield, 15.3 mi · 2 of 5 stars · 16 citations
- Puxico Nursing and Rehabilitation Center Puxico, 22.2 mi · 4 of 5 stars · 16 citations
Missouri contacts for a concern about a nursing home
These are the official offices in Missouri. NursingHomeClear cannot take or act on complaints.
- Inspections and complaints: Missouri Department of Health and Senior Services, Section for Long-Term Care Regulation, the state agency that inspects nursing homes for CMS and takes complaints about care.
- Resident advocate: Missouri Long-Term Care Ombudsman Program, 800-309-3282. The long-term care ombudsman is a free, confidential advocate for residents and families, set up under the federal Older Americans Act.
- State inspection reports: Show Me Long Term Care in Missouri, where Missouri publishes its own records on licensed homes.
Common questions
- What is Winchester Nursing Center, Inc's Medicare star rating?
- CMS rates Winchester Nursing Center, Inc 5 out of 5 stars overall, with 5 for health inspections, 2 for staffing and 3 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did Winchester Nursing Center, Inc get at its last inspection?
- 1 health deficiency at the standard inspection on July 25, 2025. The Missouri average is 11.4.
- Has Winchester Nursing Center, Inc been fined?
- CMS lists no fines in the last three years.
- Does Winchester Nursing Center, Inc accept Medicaid?
- It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
- Who owns Winchester Nursing Center, Inc?
- CMS lists 21 owners and managers, and links the home to Paradigm Senior Management. Legal business name: WINCHESTER NURSING CENTER, INC.
Sources
- Ratings, staffing and fines: CMS Provider Information, released September 30, 2026, data as of September 1, 2026.
- Citations: CMS Health Deficiencies and Fire Safety Deficiencies.
- Owners: CMS Ownership. Penalties: CMS Penalties.
- Staffing by quarter: CMS Payroll Based Journal Daily Nurse Staffing, April 2025 to March 2026, summed by NursingHomeClear.
- Inspector summaries: CMS Full Statement of Deficiencies (CMS-2567 text), data as of September 1, 2026. Each quote is the part of the statement before the detailed findings.
- Inspection reports with the inspectors' full notes are on this home's Medicare.gov page.
- Something wrong on this page? Ask for a correction. We fix errors in our copy of the data; findings themselves can only be changed by CMS and the state.
- NursingHomeClear is independent and not affiliated with CMS, Medicare or any state agency. This page reports federal records; it does not rate, recommend or endorse any home, and it is not medical or legal advice.