Lewis & Clark Gardens

Nursing Home & Assisted Living · Saint Charles, MO

CMS overall rating

Lewis & Clark Gardens

Nursing Home & Assisted Living · Saint Charles, MO

CMS overall rating

1221 Boones Lick Rd, Saint Charles, MO 63301-2328 View map

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Lewis & Clark Gardens accepts Medicaid, Medicare, and private pay.

Calculator: See prices in your area

Lewis & Clark Gardens accepts Medicaid, Medicare, and private pay.

Overview of Lewis & Clark Gardens

Located on Boones Lick Road in Saint Charles, Missouri, Lewis & Clark Gardens is a 142-bed skilled nursing facility operated by N & R Of St Charles, LLC under the ownership of Melissa Yates, with Amanda Marsten serving as administrator. The home has been operating for 31 years and accepts Medicare, Medicaid, and private pay, giving families several options for covering rehabilitation and long-term care costs. Operating at 60% occupancy, the facility serves residents who stay an average of 135 days. The surrounding area has a Walk Score of 87, so it’s highly walkable and convenient for family visits and nearby errands.

Rehabilitation services are a major focus of the community’s care program. Residents have access to short-term rehabilitation, physical therapy, occupational therapy, physician services, and 24-hour nursing support. Behavioral health services, Alzheimer’s care, dietitian support, and hospice care are also available. Residents receive an average of 4 hours and 4 minutes of nursing care each day from registered nurses, nurse aides, and LPN/LVN staff.

State inspections conducted by the Department of Health and Senior Services have identified concerns regarding allegation reporting, investigative procedures, personal care, bathing assistance, wound care, and food service practices. Families considering the home should review recent inspection findings and ask how these areas are monitored and managed.

Residents receive meals tailored to their dietary needs and personal preferences. The facility also features a fenced courtyard, seasonal resident garden, beauty and barber services, an ice cream parlor, and a home-like environment. With more than three decades of operation and a walkable location in Saint Charles, Lewis & Clark Gardens has been an established part of the local community.

Facility Direct Line (636) 946-6140

Quality ratings

Measured by Centers for Medicare & Medicaid Services (CMS)

Staffing hours breakdown

Hours per resident per day — compared to state averages

Total nursing care / resident

4h 4m per day

vs avg

5 of 6 metrics below state avg

Standout metric Nurse Aide is +19% above state avg

Staff type	Hours / Day / Resident	vs state avg
Registered Nurse (RN) RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes.	19m per day	▼ 33% State avg: 28m per day · National avg: 41m per day
LPN / LVN Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care.	29m per day	▼ 29% State avg: 41m per day · National avg: 52m per day
Nurse Aide Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life.	2h 45m per day	▲ 19% State avg: 2h 19m per day · National avg: 2h 20m per day
Weekend Total Nursing Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.	2h 50m per day	▼ 7% State avg: 3h 3m per day · National avg: 3h 26m per day
Physical Therapist Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.	0m per day	▼ 83% State avg: 2m per day · National avg: 4m per day
Weekend RN Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.	13m per day	▼ 34% State avg: 20m per day · National avg: 28m per day

Capacity and availability

135 days

142-bed community

A larger shared setting that may offer more common spaces and organized community services.

31 years in operation

A longer operating history, which may indicate experience navigating regulations and delivering ongoing care.

Walk Score: 87 / 100

Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.

About this community

Occupancy

Occupancy rate

60%

Lower than the Missouri average: 66.6%

Occupied beds

85 / 142

Average occupied beds in Missouri homes 72 beds

Facility TypeSkilled Nursing Facility

StatusActive

IssuanceJuly 31, 2024

ExpirationJuly 30, 2026

CountySaint Charles

License Number052018

CMS Certification Number265160

Certification TypeMedicare / Medicaid

Lewis & Clark Gardens is legally operated by N & R Of St Charles, Llc, and administered by Amanda Marsten.

Corporate EntityN & R OF ST CHARLES, LLC

Owner NameN & R Of St Charles, LLC

Skilled Nursing Facility

142 units

Total beds

142 units

Staffing

Key information about the people who lead and staff this community.

ContactMs. Lynette Klos, Administrator

Accept Medicaid

Accept Medicare

Rehabilitation Services

Respite Care

Short-Term Rehab

Doctor on Staff

24-Hour Staffing

Skilled Nursing Care

Physical And Occupational Therapies

Dietitians

Behavioral And Alzheimer’s Care

Hospice

Beautifully Landscaped Surroundings

Fenced Courtyard

Admissions 7 Days/Week

Ice Cream Parlor

Semi-Private Or Private Rooms

State Of The Art Rehabilitation Program

Podiatry & Optical Services

Homelike Environment

Soothing Aviary

Professional Beauty/Barber Shop

Cable Television

Unlimited Visiting Hours

Iv Therapy

Seasonal Resident Garden

Trach Care

Volunteer Program

Semi-Private –$190.00/day

Private –$213.00/day

Get floorplan photos & videos Schedule a home tour Get detailed pricing Check availability Get brochure

Since 2018 · 8 years of data 189 deficiencies 31 inspections

Inspection Scorecard This scorecard compares key inspection, deficiency, and complaint metrics at this facility against the Missouri state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.

Since 2018 vs. Missouri state average

Overall vs. MO average

Latest Inspection January 15, 2026 Complaint Investigation

Deficiencies Deficiencies are formal regulatory issues recorded during state inspections.	This Facility	MO Average	vs. MO Avg
Total deficiencies Formal regulatory issues recorded by inspectors across all inspection types.	189	35	This facility has 440% more total deficiencies than a typical Missouri assisted living residence (189 vs. MO avg 35).↑ 440% worse
Deficiencies per year Average deficiencies per year since 2018.	23.6	4.4	This facility has 436% more deficiencies per year than a typical Missouri assisted living residence (23.6 vs. MO avg 4.4).↑ 436% worse
Deficiencies per inspection Average deficiencies per inspection.	6.1	5	This facility has 22% more deficiencies per inspection than a typical Missouri assisted living residence (6.1 vs. MO avg 5).↑ 22% worse

Inspections State inspections evaluate whether the facility meets health and safety standards.	This Facility	MO Average	vs. MO Avg
Total inspections Combined count of all routine and focused inspections. Excludes complaint investigations.	31	7	This facility has 343% more total inspections than a typical Missouri assisted living residence (31 vs. MO avg 7).↑ 343% worse

Inspection Reports Summary An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.

The most recent inspection on January 15, 2026 found two deficiencies for failure to timely report and thoroughly investigate abuse allegations.
Multiple complaint investigations from 2024 to 2026 documented substantiated abuse and neglect, including physical abuse, verbal abuse, misappropriation of property, and failure to prevent sexual abuse.
Repeated deficiencies involved failure to provide adequate personal care, bathing assistance, wound care, and palatable food served at proper temperatures across several inspections.

Show Inspection Reports

Inspections since 2019

Total health inspections 12

State average N/A

Last Health inspection on Sep 2025

Total health citations

State average N/A

Citations per inspection

4.75

State average N/A

Health citations are formal notices following inspections when they fail to comply with safety and care standards.

32 of 57 citations resulted from standard inspections; 22 of 57 resulted from complaint investigations; and 3 of 57 came from combined inspections (standard and complaint).

Breakdown of citation severity (last 7 years)

Critical health citations

In line with State average

State average: N/A

Serious health citations

In line with State average

State average: N/A

3 critical citations State average: N/A

1 serious citation State average: N/A

52 moderate citations State average: N/A

1 minor citation State average: N/A

Citations history (last 7 years)

Quality of Care moderate citation Sep 15, 2025

Corrected

Abuse/Neglect serious citation Jun 23, 2025

Corrected

Abuse/Neglect moderate citation Jun 23, 2025

Corrected

Care Planning moderate citation Jun 23, 2025

Corrected

Top deficiency categories

Quality of Life & Care 19 deficiencies (33%)

Resident Rights 12 deficiencies (21%)

Abuse, Neglect & Exploitation 7 deficiencies (12%)

Infection Control 3 deficiencies (5%)

Pharmacy Services 2 deficiencies (4%)

Total staff 92

Employees 80

Contractors 12

Staff to resident ratio 1.12 : 1

0% compared with State average

State average ratio: 0 : 0

Avg staff/day 42

Average shift 8.1 hours

0% compared with State average

State average: 0 hours

Total staff hours (quarter) 31,403

Nursing staff breakdown

9.3 hours

7.5 hours

8.4 hours

Contractor staffing

790 contractor hours this quarter

Physical Therapy Assistant: 3 Respiratory Therapy Technician: 3 Physical Therapy Aide: 2 Speech Language Pathologist: 1 Qualified Social Worker: 1 Occupational Therapy Aide: 1 Occupational Therapy Assistant: 1

Staff by category


Certified Nursing Assistant	27	0	27	10,991	92	100%	8.4
Nurse Aide in Training	18	0	18	6,020	92	100%	8.6
Medication Aide/Technician	11	0	11	5,251	92	100%	8.8
Licensed Practical Nurse	9	0	9	2,917	92	100%	7.5
Registered Nurse	7	0	7	2,036	92	100%	9.3
RN Director of Nursing	2	0	2	1,001	72	78%	7.7
Dental Services Staff	1	0	1	580	71	77%	8.2
Dietitian	1	0	1	513	66	72%	7.8
Administrator	1	0	1	507	66	72%	7.7
Nurse Practitioner	1	0	1	430	57	62%	7.5
Speech Language Pathologist	0	1	1	378	62	67%	6.1
Other Dietary Services Staff	1	0	1	313	40	43%	7.8
Physical Therapy Aide	0	2	2	139	45	49%	2.8
Qualified Social Worker	0	1	1	94	52	57%	1.8
Physical Therapy Assistant	0	3	3	73	32	35%	2.3
Clinical Nurse Specialist	1	0	1	55	9	10%	6.1
Respiratory Therapy Technician	0	3	3	45	34	37%	1.3
Occupational Therapy Aide	0	1	1	32	4	4%	8
Occupational Therapy Assistant	0	1	1	29	6	7%	4.8

27 Certified Nursing Assistant

% of Days 100%

18 Nurse Aide in Training

% of Days 100%

11 Medication Aide/Technician

% of Days 100%

9 Licensed Practical Nurse

% of Days 100%

7 Registered Nurse

% of Days 100%

2 RN Director of Nursing

% of Days 78%

1 Dental Services Staff

% of Days 77%

1 Dietitian

% of Days 72%

1 Administrator

% of Days 72%

1 Nurse Practitioner

% of Days 62%

1 Speech Language Pathologist

% of Days 67%

1 Other Dietary Services Staff

% of Days 43%

2 Physical Therapy Aide

% of Days 49%

1 Qualified Social Worker

% of Days 57%

3 Physical Therapy Assistant

% of Days 35%

1 Clinical Nurse Specialist

% of Days 10%

3 Respiratory Therapy Technician

% of Days 37%

1 Occupational Therapy Aide

% of Days 4%

1 Occupational Therapy Assistant

% of Days 7%

View All Staffing Data

Total fines amount $140K

91% higher than State average

State average: $73K

Number of fines 3

23% more fines than State average

State average: 2.4

Payment Denials 1

45% more payment denials than State average

State average: 0.7

Fines amount comparison

This facility $140K

State average $73K

Penalty History

Penalties are imposed by CMS for violations of federal nursing home regulations.

4 penalties in the past 3 years

Multiple penalties were reported in the last 3 years.

Civil Money Penalty Jun 23, 2025

$63K

Civil Money Penalty Apr 24, 2025

$17K

Civil Money Penalty May 15, 2024

$59K

Payment Denial May 15, 2024

33 days

Last updated: Jan 2026

High-risk clinical events score 11.9

9% worse than State average

State average: 10.9

Functional decline score 19.9

In line with State average

State average: 19.5

Long-stay resident measures

Significantly below average State avg: 2.7

Need for Help with Daily Activities Increased 22.0%

11% worse than State average

State average: 19.8%

Walking Ability Worsened 17.8%

14% better than State average

State average: 20.6%

Low Risk Residents with Bowel/Bladder Incontinence 19.8%

9% worse than State average

State average: 18.1%

Falls with Major Injury 10.1%

150% worse than State average

State average: 4.0%

High Risk Residents with Pressure Ulcers 9.3%

85% worse than State average

State average: 5.0%

Urinary Tract Infection 4.4%

63% worse than State average

State average: 2.7%

Lost Too Much Weight 0.3%

94% better than State average

State average: 5.6%

Depressive Symptoms 1.1%

91% better than State average

State average: 12.8%

Antipsychotic Use 14.7%

33% better than State average

State average: 22.0%

Pneumococcal Vaccine 83.9%

In line with State average

State average: 85.2%

Influenza Vaccine 96.6%

6% better than State average

State average: 90.9%

Short-stay resident measures

Pneumococcal Vaccine 46.2%

31% worse than State average

State average: 66.6%

Antipsychotic medication increase 0.0%

100% better than State average

State average: 2.2%

Influenza Vaccine 8.3%

87% worse than State average

State average: 63.5%

Breakdown by payment type

Medicare

6% of new residents, usually for short-term rehab.

Typical stay 22 days

Private pay

33% of new residents, often for short stays.

Typical stay 2 - 3 months

Medicaid

60% of new residents, often for long-term daily care.

Typical stay 7 - 8 months

Total residents 82

Medicare

1.2% of residents

Medicaid

87.8% of residents

Private pay or other

11% of residents

Programs & Services

Residents Group

Residents meet regularly to discuss policies, care quality, and activities

Active Resident Council

Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.

Financial Trends

Historical financial and operational data for Lewis & Clark Gardens from 2011–2023, based on CMS SNF Cost Reports.

Occupancy Rate 52.8% ↓ 0.3pp vs 2022

Net Patient Income -$1.8M ↓ ~$263.0K vs 2022

Payroll Costs $3.3M ↑ ~$430.1K vs 2022

Operating Margin -33.2% ↓ 5.3pp vs 2022

Financial Performance

Net patient revenue Operating expenses Net patient income

Salaries Wage Costs Contract Labor

Medicare Medicaid Private Pay/Other

Metric	2011	2012	2013	2014	2015	2016	2017	2018	2019	2020	2021	2022	2023
Occupancy %	87.0%	88.4%	77.9%	75.5%	70.1%	72.8%	75.3%	73.4%	70.7%	64.0%	56.4%	53.1%	52.8%
Beds	125	125	142	142	142	142	142	142	142	142	142	142	142
Net Income	-$360,531	-$194,341	-$553,362	$625,092	-$344,783	-$784,156	-$340,870	-$327,548	-$445,122	$245,332	-$421,211	-$1,327,425	-$1,751,417
Gross Revenue	$8,285,304	$9,036,647	$8,085,705	$8,955,290	$8,119,544	$8,095,114	$8,790,329	$9,334,971	$9,193,175	$8,253,086	$6,773,767	$5,961,384	$5,800,313
Operating Expenses	$7,676,933	$7,994,819	$6,792,486	$7,523,514	$7,548,002	$7,780,737	$7,858,737	$7,992,760	$8,164,427	$8,374,983	$7,188,968	$6,966,668	$7,154,960
Net Patient Income	-$362,401	-$202,176	-$557,690	$617,025	-$359,921	-$802,071	-$355,311	-$339,364	-$464,174	-$1,315,629	-$1,021,933	-$1,518,404	-$1,781,396
Net Patient Revenue	$7,314,532	$7,792,643	$6,234,796	$8,140,539	$7,188,081	$6,978,666	$7,503,426	$7,653,396	$7,700,253	$7,059,354	$6,167,035	$5,448,264	$5,373,564
Payroll Costs	$3,992,513	$4,188,421	$3,362,760	$3,541,907	$3,339,321	$3,495,336	$3,659,224	$3,434,293	$3,778,947	$3,929,240	$3,150,948	$2,850,945	$3,281,070
Operating Margin %	-5.0%	-2.6%	-8.9%	7.6%	-5.0%	-11.5%	-4.7%	-4.4%	-6.0%	-18.6%	-16.6%	-27.9%	-33.2%
Medicare %	12.1%	11.9%	9.9%	8.2%	8.2%	5.9%	7.3%	8.4%	10.4%	8.1%	4.2%	2.1%	0.8%
Medicaid %	63.9%	61.6%	63.3%	65.2%	66.9%	72.4%	67.3%	68.8%	69.5%	73.1%	81.1%	87.4%	85.6%
Private %	24.0%	26.5%	26.7%	26.6%	24.9%	21.7%	25.5%	22.9%	20.2%	18.8%	14.7%	10.5%	13.6%
Net Patient Revenue/Day	$184	$193	$171	$208	$198	$184	$192	$201	$210	$212	$211	$198	$197
Cost/Day	$193	$198	$187	$192	$208	$206	$201	$210	$223	$252	$246	$253	$262
Avg Length of Stay	144.4 days	143.3 days	142.8 days	136.9 days	142.4 days	168.9 days	150.2 days	264.2 days	103.5 days	100.8 days	118.8 days	189.7 days	134.7 days

Finances and operations

Based on CMS SNF Cost Report for fiscal year ending in 12/2023.

Net patient revenue

$5.4M

Net patient income

-$1.8M

For-profit Operated by a single business entity.

Net patient revenue

$5.4M

Net patient income

-$1.8M

Other income

$30.0K

Payroll costs

$3.3M 61.1% of net patient revenue

Other operating costs

$3.9M

Total costs

$7.2M

TYPE OF STAY

Mostly long-term care residents

Most residents stay for extended periods and receive ongoing daily care.

Most new residents arrive under Medicaid (60% of admissions), and a typical Medicaid stay runs around 7 - 8 months.

Coverage residents most often arrive under.

Medicare 6%

Private pay 33%

Medicaid 60%

Coverage residents most often leave under.

Medicare 2%

Private pay 43%

Medicaid 55%

0.0 miles from city center Estimated distance in miles from Saint Charles's city center to Lewis & Clark Gardens's address, calculated via Google Maps.

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The information below is reported by the Missouri Department of Health and Senior Services, Division of Regulation and Licensure.


Lewis & Clark Gardens	NH AL	Saint Charles	-	142	-	87	-
Armour Oaks Senior Living Community	NH AL IL	Kansas City (Waldo Homes)	-	38	A+	73	Studio / 1 Bed / 2 Bed / 3 Bed
Breeze Park – Lutheran Senior Services	NH AL IL MC	Weldon Spring	-	50	A+	2	1 Bed / 2 Bed
John Knox Village	NH AL HC IL MC RC	Lee's Summit	-	408	A+	58	1 Bed / 2 Bed
Farmington Presbyterian Manor	NH AL IL MC	Farmington	-	90	A+	66	-

Nursing Home Explorer

Who is the owner of Lewis & Clark Gardens?

Lewis & Clark Gardens is legally operated by N & R Of St Charles, Llc, and administered by Amanda Marsten.

Is Lewis & Clark Gardens in a walkable area?

Lewis & Clark Gardens has a walk score of 87. Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.

What is the license number of Lewis & Clark Gardens?

According to MO state health department records, Lewis & Clark Gardens's license number is 052018.

When does Lewis & Clark Gardens's license expire?

According to MO state health department records, Lewis & Clark Gardens's license expires on July 30, 2026.

What is the occupancy rate at Lewis & Clark Gardens?

Lewis & Clark Gardens's occupancy is 60%.

Does Lewis & Clark Gardens operate as a for-profit or non-profit?

Lewis & Clark Gardens is registered as a for-profit in MO.

Who is the administrator of Lewis & Clark Gardens?

Amanda Marsten is the administrator of Lewis & Clark Gardens.

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Lewis & Clark Gardens

Overview of Lewis & Clark Gardens

Quality ratings

Staffing hours breakdown

Capacity and availability

About this community

Occupancy

License Details

Ownership & Operating Entity

Type Of Units

Staffing

Leadership

Payment & Insurance

Therapy & Rehabilitation

Staffing & Medical

Additional Services

Amenities & Lifestyle

Pricing & Financial Information

Contact Lewis & Clark Gardens

Inspection History

Inspection Scorecard This scorecard compares key inspection, deficiency, and complaint metrics at this facility against the Missouri state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.

Deficiencies Deficiencies are formal regulatory issues recorded during state inspections.

Inspections State inspections evaluate whether the facility meets health and safety standards.

Inspection Reports Summary An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.

Health Inspection History

Inspections since 2019

Breakdown of citation severity (last 7 years)

Citations history (last 7 years)

Staffing Data

Nursing staff breakdown

Registered Nurse

Licensed Practical Nurse

Certified Nursing Assistant

Contractor staffing

Staff by category

27 Certified Nursing Assistant

18 Nurse Aide in Training

11 Medication Aide/Technician

9 Licensed Practical Nurse

7 Registered Nurse

2 RN Director of Nursing

1 Dental Services Staff

1 Dietitian

1 Administrator

1 Nurse Practitioner

1 Speech Language Pathologist

1 Other Dietary Services Staff

2 Physical Therapy Aide

1 Qualified Social Worker

3 Physical Therapy Assistant

1 Clinical Nurse Specialist

3 Respiratory Therapy Technician

1 Occupational Therapy Aide

1 Occupational Therapy Assistant

Penalties and fines

Fines amount comparison

Fines amount comparison

Penalty History

Quality of care over time

Long-stay resident measures

Short-stay resident measures

Breakdown by payment type

Medicare

Private pay

Medicaid

Facility Characteristics

Programs & Services

Residents Group

Active Resident Council

Financial Trends

Financial Performance

Payroll & Labor Costs

Payer Mix (percentage)

Finances and operations

Who this home usually serves

Mostly long-term care residents

Admissions

Discharges

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