Nathan Richard Health Care Center
A nursing home in Nevada, Missouri 64772
700 East Highland Avenue, Nevada, Missouri 64772. (417) 667-8889.
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The short answer
Record last released by CMS on Oct 28, 2026.
- 1of 5 CMS’s overall rating
- 17 health citations at the latest inspection cycle Missouri average: 11.4
- 1.70 nurse hours per resident per day Missouri average: 3.40
- 1 fine in the last three years (needs attention)
Each figure’s source sits beside it, in its section below.
What these words mean7
- Star ratings
- CMS rates some kinds of place from 1 to 5 stars, more stars meaning better on CMS’s own measures for that kind: for a nursing home, its health inspections, staffing and quality measures. A rating is CMS’s summary of those measures; it doesn’t promise good care. Source: CMS, Care Compare and the Five-Star Quality Rating System.
- Inspection (survey)
- A visit by state inspectors, often unannounced, who check a place against the rules it must meet. For nursing homes and other places Medicare pays, CMS calls these visits surveys: a standard survey of a nursing home comes at least every 15 months, and a complaint survey whenever a complaint calls for one. Source: CMS; 42 CFR 488.308.
- Deficiency, citation, violation
- What inspectors write up when a place didn’t meet a rule: the rule, what they saw, and when. CMS calls it a deficiency; states may say citation or violation. It is the inspectors’ finding, not a court’s, and the place is usually asked for a plan to correct it. Source: CMS, statement of deficiencies (Form CMS-2567); each state’s licensing agency.
- Scope and severity (A to L)
- CMS grades each nursing home deficiency with a letter. A to C: no actual harm, with potential for minimal harm. D to F: no actual harm, but potential for more. G to I: actual harm. J to L: immediate jeopardy. Within each band, the letter rises as more residents were affected or could be: one or a few, a pattern, or widespread. Source: CMS, nursing home scope and severity grid (State Operations Manual, chapter 7).
- Nurse staffing hours
- The hours registered nurses, licensed practical nurses and nurse aides worked, per resident per day, from the payroll records each home sends CMS. Source: CMS, Payroll-Based Journal.
- Fines and payment denials
- A fine (civil money penalty) is money CMS makes a nursing home pay when it falls short of federal rules. A payment denial means Medicare and Medicaid stop paying for new admissions until the home meets the rules again. Source: CMS; 42 CFR 488.430 and 488.417.
- Capacity
- The most people the licence or certification lets the place care for at once: residents, children, beds or apartments, as the state counts them. It isn’t how many are there now. Source: Each state’s licensing agency.
What did inspectors find?
17 health citations at the latest inspection cycle
The Missouri average is 11.4.
Last standard inspection Feb 28, 2025.
Most serious in three years: actual harm (G), at a standard and complaint inspection on Feb 28, 2025
CMS, Provider Information, State and US Averages and Health Deficiencies. Released Oct 28, 2026. Updated monthly.
When those citations happened
17 citations in 3 months of the last 36. Last cited Mar 2026. Most serious: actual harm (G). The last 3 years, to Nov 5, 2026.
| Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2023 | Dec | |||||||||||
| 2024 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2025 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2026 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov |
Hover or focus a month to read it.
Hearth Record drew this from the dates and levels in the source’s own records.
All 17 citations in the last three years
Grouped by inspection, newest first. Each carries CMS grades each nursing home deficiency with a letter. A to C: no actual harm, with potential for minimal harm. D to F: no actual harm, but potential for more. G to I: actual harm. J to L: immediate jeopardy. Within each band, the letter rises as more residents were affected or could be: one or a few, a pattern, or widespread. Source: CMS, nursing home scope and severity grid (State Operations Manual, chapter 7)., from A, the least serious, to L, the most. 4 came from complaint inspections.
CMS, Health Deficiencies. Released Oct 28, 2026. Updated monthly.
Mar 19, 2026: complaint inspection1 citation
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Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
Dec 30, 2025: complaint inspection1 citation
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Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Feb 28, 2025: standard inspection13 citations
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Provide appropriate pressure ulcer care and prevent new ulcers from developing.
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Develop and implement policies and procedures to prevent abuse, neglect, and theft.
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Ensure services provided by the nursing facility meet professional standards of quality.
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Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident’s well being.
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Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
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Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
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Ensure medication error rates are not 5 percent or greater.
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Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
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Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
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Have an agreement with at least one or more hospitals certified by Medicare or Medicaid to make sure residents can be moved quickly to the hospital when they need medical care.
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Provide and implement an infection prevention and control program.
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Develop and implement policies and procedures for flu and pneumonia vaccinations.
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Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
Feb 28, 2025: standard and complaint inspection2 citations
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Provide appropriate treatment and care according to orders, resident’s preferences and goals.
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Implement a program that monitors antibiotic use.
Is it certified, and in good standing?
- Certified for Medicare and Medicaid since Oct 12, 1993.
- Not on CMS’s special focus list.
- No abuse icon from CMS.
- No change of ownership in the last 12 months.
- CMS lists its ownership as for profit, corporation.
- 68 certified beds.
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
Has it been fined or penalized?
- 1 fine in the last three years, $69,178 in all.
- No Medicare payment denials in the last three years.
- 4 citations in the last three years came from complaint inspections.
CMS, Penalties and Health Deficiencies. Released Oct 28, 2026. Updated monthly.
| Date | Kind | Amount |
|---|---|---|
| Feb 28, 2025 | Fine | $69,178 |
Who does the caring?
1.70 nurse hours per resident per day
The Missouri average is 3.40.
CMS publishes staffing about four months after the fact.
CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.
| Measure | This home | Missouri average |
|---|---|---|
| Nurse hours per resident per day | 1.70 | 3.40 |
| Of which registered nurses | 0.23 | 0.46 |
| At weekends | 1.55 | 2.96 |
| Nursing staff turnover | 81.4% | 56.9% |
| Registered nurse turnover | 83.3% | 50% |
| Administrators who left | 1 | Not given |
Who owns it?
- Reliant CARE Group LLC owns 100% directly since Aug 1, 2020.
- Reliant Care Management Company LLC runs it.
- 8 owners or officers are people: Richard J Destefane (corporate officer, 100%); Richard J Destefane (owns a share through other companies, 100%); Richard J Destefane (runs it (operational or managerial control)); Richard J Destefane (additional disclosable party (controls, leases property to, or provides services to the home)); Abdullah Arshad (runs it (operational or managerial control)); Abdullah Arshad (additional disclosable party (controls, leases property to, or provides services to the home)); Lawrence Willis (runs it (operational or managerial control)); Lawrence Willis (additional disclosable party (controls, leases property to, or provides services to the home)).
- Part of Reliant Care Management (35 homes in CMS’s data).
- No private-equity firm among the owners CMS lists.
- No real-estate investment trust among the owners CMS lists.
CMS, All Owners. Checked Nov 5, 2026. Updated monthly.
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
| Organisation | Role | Share | Since |
|---|---|---|---|
| Richard J Destefane Revocable Living Trust | Owns a share through other companies | 100% | Aug 1, 2020 |
| Reliant CARE Group LLC | Owns a share directly | 100% | Aug 1, 2020 |
| Rcg Inc. | Owns a share through other companies | 0.01% | Aug 1, 2020 |
| Richard J Destefane Revocable Living Trust | Additional disclosable party (controls, leases property to, or provides services to the home) | Aug 1, 2020 | |
| Nevada Associates, L.L.C. | Additional disclosable party (controls, leases property to, or provides services to the home) | Aug 1, 2020 | |
| Tlg II LLP | Additional disclosable party (controls, leases property to, or provides services to the home) | Aug 1, 2020 | |
| Reliant Care Management Company LLC | Runs it (operational or managerial control) | 0% | Aug 1, 2020 |
| Reliant Care Management Company LLC | Additional disclosable party (controls, leases property to, or provides services to the home) | Jun 27, 2025 |
How do residents fare?
- CMS rates its quality measures 4 of 5 (Missouri average 2.9).
CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.
| Measure | Rating |
|---|---|
| Overall rating | 1 of 5 |
| Health inspections | 2 of 5 |
| Staffing | 1 of 5 |
| Quality measures | 4 of 5 |
How does it compare nearby?
- Among the 12 nearest homes, within 34.0 miles, this one had the 2nd most health citations at the latest inspection cycle (17; the middle value was 7.5).
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
| Place | Miles away | Citations, latest cycle |
|---|---|---|
| Nathan Richard Health Care Center This nursing home | 17 | |
| Medicalodges Nevada | 1.6 | 8 |
| Moore Few Care Center | 2.1 | 5 |
| Community Springs Healthcare Facility | 18.1 | 7 |
| Medicalodges Fort Scott | 20.1 | 8 |
| Truman Healthcare & Rehabilitation Center | 24.5 | 24 |
| Ml Op Butler LLC | 27.1 | 7 |
| Butler Rehab and Healthcare Center | 27.2 | 15 |
| Arma Operator, LLC | 29.0 | 5 |
| Appleton City Manor | 29.2 | 6 |
| Lake Stockton Healthcare Facility | 32.1 | 5 |
| Medicalodges Frontenac | 34.0 | 10 |
What the record doesn’t say
- Complaints that didn’t lead to a citation aren’t published.
- Inspections reach CMS’s data about six weeks after they happen, and staffing about four months after.
- CMS publishes the inspectors’ full written findings in a separate monthly file, which isn’t loaded yet.
- Fines and Medicare payment denials are the only enforcement CMS publishes; state licence actions aren’t included.
Sources
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Centers for Medicare & Medicaid Services, Provider Information (4pq5-n9py).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Health Deficiencies (r5ix-sfxw).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Penalties (g6vv-u9sr).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, All Owners (afe44b85-cc6d-40d7-b5df-00ae8910d1d2).
Checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, State and US Averages (xcdc-v8bm).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
If you believe something here is wrong, a correction starts with the agency whose record this copies: CMS. CMS’s own record is on Care Compare. If Hearth Record copied something wrongly, it will fix it and log the correction publicly, with its date: how corrections work.
This copy of the record was made on Nov 5, 2026.
From the home
The public record above comes first. Anything the home adds will appear here, below it, and say who wrote it.
Replies
None. Replies aren’t open yet. When they open, the home will be able to answer any finding for free, and the reply will show beside that finding, unedited and dated.
Paid listing
None. Paid listings aren’t open yet. When they open, anything paid for will say “Paid by the home”, and paying will never change a finding, a rating or the order of results.