James River Nursing and Rehabilitation
Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.
based on 80 Google reviews

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Quality Concerns Identified
Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.
- Low staffing rating (2/5 stars)
- Above-median deficiencies (17 vs median 10)
- High staff turnover (58%)
Above average in MO · Critically understaffed (RN) · Below chain average · No penalties on record
What this means for your family
While some families report excellent end-of-life care, the recurring reports of severe understaffing and neglect are deeply concerning. If you consider this facility, perform unannounced visits during weekends and evenings to verify if staff response times meet your loved one's needs.
Google Reviews
Google Reviews
80 reviews on Google“James River Nursing and Rehabilitation presents a stark contrast between its well-maintained physical appearance and the quality of care reported by families. While many reviewers praise the compassionate staff and supportive environment during end-of-life care, a significant number of families report severe neglect, including delayed response times, poor hygiene, and medication management failures. The facility appears to struggle heavily with staffing levels, which directly impacts the consistency and safety of resident care.”
Quality Themes
Tap a score for detailsStrengths
- Compassionate end-of-life and hospice care
- Clean and aesthetically pleasing facility
- Friendly and dedicated individual staff members
- Effective rehab therapy department
Concerns
- Severe understaffing leading to neglect (mentioned by 9 reviewers)
- Slow or non-existent response to call lights (mentioned by 4 reviewers)
- Poor hygiene and lack of assistance with basic needs (mentioned by 5 reviewers)
- Medication errors or late administration (mentioned by 3 reviewers)
- Poor communication from management and billing (mentioned by 3 reviewers)
Rating Trends
Tap a year to see what changed
Distribution · 86 analyzed
How They Respond to Reviews
This facility rarely responds to reviews.
Questions for Your Tour
- 1Given the current staffing levels, what specific protocols are in place to ensure that call lights are answered promptly and basic hygiene needs are met consistently?
- 2I noticed the facility has had a high number of recent state violations; what concrete steps is management taking to address these findings and improve the overall quality of care?
- 3How does your nursing team coordinate with the pharmacy and clinical staff to ensure that medications are administered accurately and on time?
- 4Since the rehab department is highly regarded, how do you integrate those therapeutic services into the daily routine for residents who are not in active recovery?
- 5What is your standard process for communicating updates regarding a resident's health or billing changes to family members, and who is our primary point of contact for these concerns?
- 6Could you walk me through how your staff handles medical emergencies or sudden changes in a resident's condition during evening or weekend shifts?
Personalized based on this facility's data
Key Review Excerpts
“The condition of this facility is Not what you see in the reception area. The room was often very dirty and smelled awful.”
“I walked into the building tonight and could hear my mother from down the hall crying/yelling for help. When I entered her room she was hanging off her bed with her head on the floor.”
“The staff was absolutely amazing to us the whole time. So caring and compassionate.”
Staffing
Staffing Hours
per resident/day · Medicare 2026Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.
Quality Measures
Quality Measures
Resident outcomes compared with national, state, and local averages · 17 measures
12
measures
2
measures
3
measures
Residents on antipsychotic medication
Residents vaccinated for pneumonia
Residents with depression symptoms
Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.
Residents whose walking got worse
Residents vaccinated for the flu
Residents on anti-anxiety or sleep medication
Short-stay residents vaccinated for pneumonia
Short-stay residents vaccinated for the flu
Short-stay residents newly given antipsychotics
US average from Medicare published data
Inspection History
Medicare Inspection History
3-year lookback · Medicare 2026
Families have filed multiple complaints against this facility, triggering investigations that revealed concerning issues with resident rights, medication management, and patient care quality. The facility shows recurring problems with medication errors and food safety across multiple surveys from 2019 to 2024, suggesting persistent operational challenges. While all deficiencies have correction dates, the pattern of repeated violations in critical care areas warrants careful consideration before placement.
Nov 4, 2025Complaint1
Resident Rights Deficiencies
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Jul 30, 2024Routine18
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Egress Deficiencies
Have properly located and lighted "Exit" signs.
Resident Rights Deficiencies
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.
Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Construction Deficiencies
Use approved construction type or materials.
Smoke Deficiencies
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Resident Rights Deficiencies
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Resident Rights Deficiencies
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Jul 30, 2024Complaint1
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Feb 9, 2024Complaint3
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from the wrongful use of the resident's belongings or money.
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Quality of Life and Care Deficiencies
Provide safe, appropriate pain management for a resident who requires such services.
Sep 23, 2022Routine3
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
Oct 9, 2019Routine5
Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Ownership & Operations
Who Operates This Facility
James River Nursing and Rehabilitation
for profit
Chain Affiliation
Anthony & Bryan Adams
38 facilities nationwide
Chain avg rating: 3.8/5 · Rank 25 of 37
Ownership & Management
Key personnel
Contact
Get in Touch
Contact this facility directly and verify the details that matter most to your family.
References & Resources
Medicare Care Compare
Official Medicare quality ratings, inspections & staffing data
Google Maps
Photos, directions & neighborhood info
Google Reviews
80 reviews from families & visitors
Official Website
Visit jamesrivernursingandrehabilitation.com
Medicare data downloads
Original nursing home datasets
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