Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record
FRIENDSHIP VILLAGE CHESTERFIELD
CHESTERFIELD, MO · 98 certified beds · Last Life Safety survey September 12, 2024
CMS Certification Number 265121 · first certified October 1975
Ownership
Independently operated (no chain recorded by CMS) · Non profit - Corporation
No change of ownership on CMS record since January 1, 2016, when the records begin.
Position within MO
13 citations — more than 33% of the 487 certified nursing homes in MO. Compared within MO rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated
The latest survey found 5 citations; the earlier surveys in the window averaged 4. With 3 surveys on file this is a direction of travel, not a conclusion.
When is the next survey likely?
Well past the typical window (November 2025 to May 2026), and past the point by which nine in ten MO facilities have been surveyed. This facility’s last Life Safety survey was September 2024. Facilities in MO are typically surveyed 14–21 months after the last one (median 17), measured over 567 consecutive surveys in the last two years of CMS records.
A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured
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2 inspection-and-testing tags have been cited here at more than one survey. Nationally, that pattern is common: about three quarters of cited facilities have at least one repeated tag, and half of the facilities ever cited for sprinkler inspection and testing are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.
Emergency preparedness
3 of the 13 citations on file are Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index
Physical environment (health survey)
6 physical-environment citations on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 13 Life Safety citations above. The Physical Environment Index
- F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- F-0880 Provide and implement an infection prevention and control program.
- F-0921 Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
How that compares
Compared with the median facility in MO, and nationally. Surveyors differ markedly between states, so the MO figure is the meaningful one.
| Measure | Citations |
|---|---|
| This facility | 13 |
| Median facility in MO | 18 |
| Median facility nationally | 11 |
Survey history
| Survey date | Citations |
|---|---|
| October 11, 2019 | 3 |
| July 26, 2023 | 5 |
| September 12, 2024 | 5 |
Most-cited tags
| Tag | What the surveyor checks | Times cited | Last cited |
|---|---|---|---|
| K-0372 | Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | 2 | 2024-09-12 |
| K-0345 | Have approved installation, maintenance and testing program for fire alarm systems. | 2 | 2024-09-12 |
| K-0531 | Have elevators that firefighters can control in the event of a fire. | 1 | 2024-09-12 |
| K-0753 | Have restrictions on the use of highly flammable decorations. | 1 | 2019-10-11 |
| E-0041 | Implement emergency and standby power systems. | 1 | 2023-07-26 |
| E-0030 | List the names and contact information of those in the facility. | 1 | 2023-07-26 |
| K-0341 | Install a fire alarm system that can be heard throughout the facility. | 1 | 2024-09-12 |
| K-0711 | Provide a written emergency evacuation plan. | 1 | 2019-10-11 |
What the citations cover
- Smoke Deficiencies 6
- Emergency Preparedness Deficiencies 3
- Miscellaneous Deficiencies 2
- Services Deficiencies 1
- Other 1
| Category | Citations |
|---|---|
| Smoke Deficiencies | 6 |
| Emergency Preparedness Deficiencies | 3 |
| Miscellaneous Deficiencies | 2 |
| Services Deficiencies | 1 |
| Gas, Vacuum, and Electrical Systems Deficiencies | 1 |
Every citation on file
As published by CMS, newest survey first. Descriptions are CMS’s own wording.
September 12, 2024 — 5 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| K-0341 | Install a fire alarm system that can be heard throughout the facility. | Deficient, Provider has date of correction (October 23, 2024) |
| K-0345 | Have approved installation, maintenance and testing program for fire alarm systems. | Deficient, Provider has date of correction (October 23, 2024) |
| K-0353 | Inspect, test, and maintain automatic sprinkler systems. | Deficient, Provider has date of correction (October 23, 2024) |
| K-0372 | Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Deficient, Provider has date of correction (October 23, 2024) |
| K-0531 | Have elevators that firefighters can control in the event of a fire. | Deficient, Provider has date of correction (October 23, 2024) |
July 26, 2023 — 5 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| E-0004 | Develop and maintain an Emergency Preparedness Program (EP). | Deficient, Provider has date of correction (August 30, 2023) |
| E-0030 | List the names and contact information of those in the facility. | Deficient, Provider has date of correction (August 30, 2023) |
| E-0041 | Implement emergency and standby power systems. | Deficient, Provider has date of correction (August 30, 2023) |
| K-0345 | Have approved installation, maintenance and testing program for fire alarm systems. | Deficient, Provider has date of correction (August 30, 2023) |
| K-0372 | Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Deficient, Provider has date of correction (August 30, 2023) |
October 11, 2019 — 3 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| K-0711 | Provide a written emergency evacuation plan. | Deficient, Provider has date of correction (November 19, 2019) |
| K-0753 | Have restrictions on the use of highly flammable decorations. | Deficient, Provider has date of correction (November 19, 2019) |
| K-0920 | Ensure proper usage of power strips and extension cords. | Deficient, Provider has date of correction (November 19, 2019) |
Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.