Best Assisted Living in Missouri

Surrey Place St. Luke’s Hospital Skilled Nursing is a 130-bed skilled nursing facility at 14701 Olive Blvd, Chesterfield, Missouri, in St. Louis County, operated by St. Luke’s Episcopal-Presbyterian Hospital and administered by Tracy Imhoff.

The facility accepts Medicare, Medicaid, and private-pay residents and holds CMS certification number 265414.

A serious medication error occurred during a September 11, 2024 complaint investigation. This deficiency was cited as a failure to ensure residents were free from significant medication errors and resulted in a moderate citation marked as corrected. Prior to this incident, an August 1, 2024 health inspection found deficiencies in infection control and in the absence of a water system management program to prevent Legionella growth. A December 2022 inspection documented failure to assist a resident with grooming and personal hygiene.

RNs provide 1 hour 50 minutes per resident daily (293% above Missouri’s 28-minute state average); LPNs deliver 1 hour 10 minutes daily (71% above state average); CNAs provide 2 hours 24 minutes daily (4% above state average). Weekend nursing totals 4 hours 29 minutes per resident per day, 47% above the Missouri state average. Physical therapy staffing is unusually comprehensive at 17 minutes per resident daily (751% above state average). RN weekend coverage specifically is 1 hour 6 minutes daily, 230% above state average.

Long-stay residents experienced zero falls with major injury (100% better than state baseline), zero urinary tract infections (100% better), and pneumococcal vaccination rates of 100% (17% better than state). Functional decline for long-stay residents is 1.7 (91% better than state). However, two quality metrics are concerning: long-stay residents with pressure ulcers stand at 9.1% (81% worse than Missouri’s 5% average), and weight loss in long-stay residents is documented at 25% (349% worse than Missouri’s 5.6% baseline). Short-stay re-hospitalization is 27.5% (9% worse than state average of 25.3%), and ability to care for self at discharge is 40.3% (25% worse than state’s 53.7%).

The CMS overall rating is 3 stars (14.1% above state average). Health Inspection rating is 2 stars (31% below state average). Staffing receives 5 stars (131.5% above state average). Quality Measures are rated 4 stars (43.4% above state average).

The facility received designation as Best Nursing Home 2026 by U.S. News and World Report and America’s Best Nursing Homes 2025 by Newsweek.

Inspection history since 2019 includes four health inspections with 16 total citations (4 citations per inspection, compared to Missouri average of 5.67). Zero citations are critical or serious severity. Of 16 citations, 15 are moderate and 1 is minor. No federal penalties have been imposed in the past three years.

Current occupancy is approximately 62% (80 residents in 130 beds). The facility is located less than 3 miles from St. Luke’s Hospital. Walk score is 39, indicating the neighborhood is somewhat walkable with most trips requiring transportation.

Families should ask about corrective measures implemented following the September 2024 medication allergy management failure, specifically regarding how the facility now documents allergy severity.

Ellisville Rehabilitation and Nursing is a 210-bed skilled nursing facility at 322 Old State Road, Ellisville, Saint Louis County, Missouri, operated by Ellisville Opco LLC under the administration of Mr Cory Sterling. The facility is Medicare and Medicaid certified, maintains 24-hour nursing care, and offers long-term care, short-term rehabilitation, and memory support. Industry recognitions include Top Senior Care provider by St. Louis Magazine and Best Nursing Home by Newsweek.

The walk score is 67, indicating moderate walkability.

Staffing composition reflects substantial strength in direct care and hands-on nursing, with notable support for rehabilitation services. Registered nurses provide 25 minutes per resident per day (11% below Missouri state average of 28 minutes), maintaining near-benchmark clinical oversight. Licensed practical nurses provide 56 minutes per day (37% above state average). Certified nursing aides provide 3 hours 8 minutes per day (35% above state average of 2h 19m), substantially exceeding typical direct care staffing and suggesting robust assistance with activities of daily living.

Weekend nursing coverage is 3 hours 59 minutes per day (31% above state average), maintaining consistent staffing across the calendar week. Weekend RN presence at 16 minutes per day represents a modest 20% reduction from the state average. Physical therapist hours are 2 minutes per day, matching the state benchmark.

Quality outcomes for long-stay residents are aligned with state averages. Hospitalization rates are 2.06 per 1,000 days (in line with state average). Emergency department visit rates are 2.44 per 1,000 days (in line with state average). Short-stay rehabilitation outcomes are substantially weaker.

Readmission rates are 31.8% (26% worse than Missouri average of 25.3%). Falls with major injury occur in 1.4% of short-stay residents (84% worse than state average of 0.8%). Ability to care for self at discharge is 44.6% (17% worse than state average of 53.7%). Successful return to home or community is 39.5% (22% worse than Missouri average of 50.6%).

The facility’s regulatory record shows zero total inspections recorded, compared to a Missouri state average of seven inspections for comparable facilities. This absence of routine inspection oversight warrants explanation. Families must request and review the facility’s current licensing documentation and any available inspection records from the Missouri Department of Health and Senior Services.

The facility provides chef-prepared meals with dietary accommodation, beauty and barber services, transportation, recreational programming including music and pet therapy, gardening and baking clubs, and spiritual care services. The 210-bed capacity supports organized community activities and multiple common areas typical of large regional facilities.

Families should request explanations for the elevated short-stay readmission and fall rates, rehabilitation program outcomes and average length of stay, and licensing and inspection records.

Autumn Ridge Residences is an 81-bed residential care facility at 300 Autumn Ridge Drive, Herculaneum, Missouri, operated by HHCP OE, LP and administrated by Cynthia Sander. The facility provides independent living and residential care with emphasis on enhancing quality of life through amenities and social engagement.

Operational strengths include comprehensive amenities: three meals daily, scheduled medical appointment and shopping transportation, weekly housekeeping and linen service, on-site beauty and barber shop, fitness and wellness activities, and seven acres of grounds with a garden setting. Wheelchair accessibility accommodates residents with varying mobility needs. Respite care is available. A detailed activity calendar emphasizes resident interests and engagement.

The walk score of 30 reflects somewhat walkable surroundings; a few services are reachable on foot, though most daily trips require transportation. Herculaneum’s proximity to regional healthcare resources supports the residential care model.

The facility’s inspection profile shows zero routine inspections compared to the Missouri state average of seven. Missouri residents may access multiple payment assistance programs, including Medicaid A&D Waiver, Supplemental Nursing Care, Structured Family Caregiving Waiver, MO HealthNet Aged/Blind/Disabled, Medicare Savings Program, Caregiver Program, and Veterans Aid and Attendance.

Families should verify transportation availability and ask about staffing, occupancy, licensing, inspection records, quality metrics, and payment acceptance from Autumn Ridge Residences.

St. Agnes Home is a 150-bed intermediate care facility at 10341 Manchester Road, Kirkwood, Saint Louis County, Missouri, operated by the Carmelite Sisters of the Divine Heart of Jesus of Missouri under the administration of Angela Ruppel. The facility provides assisted living, enhanced care, and skilled nursing services with faith-based programming. It is nonprofit and has a walk score of 89, indicating very high walkability in an urban residential location.

A defining operational constraint merits immediate attention: St. Agnes Home does not accept Medicaid or Medicare. This policy restricts admission exclusively to private-pay residents; those funding care through personal resources or private long-term care insurance. For families dependent on government assistance programs, the facility is not accessible regardless of clinical suitability.

This payment restriction narrows the eligible population significantly and influences family decision-making from the outset.

The facility maintains a physician on staff, operates 24-hour nursing oversight with medication administration capabilities, and provides 24-hour security and emergency response systems.

Spiritual care is central to the facility’s mission. Daily Mass and Rosary, weekly Eucharistic Adoration, and other religious devotions are provided for residents. The continuum-of-care model encompasses assisted living, enhanced care, and skilled nursing within a single campus, allowing residents to remain at the facility as care needs progress. Meals are restaurant-style, served three times daily.

On-campus amenities include barber and beauty salon, fitness and physical therapy area, in-house medical services, housekeeping, linen service, utilities included, and concierge services. The community calendar includes physical, social, educational, and spiritual programming.

The facility’s regulatory record shows zero total inspections recorded, compared to a Missouri state average of seven for comparable facilities. This unusually sparse inspection history requires clarification from facility leadership. Current licensing status and any available regulatory documentation should be reviewed prior to placement. Request detailed staffing schedules and credentials, seek CMS ratings and quality outcome data, obtain current licensing documents and any inspection reports from the Missouri Department of Health and Senior Services.

Families should verify private-pay funding sources and confirm eligibility and ask about care protocols for residents with complex medical needs, fall prevention, and discharge planning.

Stonebridge DeSoto is an 80-bed skilled nursing facility at 1550 Villas Drive, De Soto, Missouri, operated by Eldercare Of Mid-Missouri IV, Inc. and administrated by Angela Moore. The facility provides assisted living, rehabilitation, skilled nursing care, short-term rehabilitation, and senior rehabilitation services with Medicare and Medicaid certification. The community received recognition as Missouri’s Best 2021.

It maintains 24-hour staffing with comprehensive clinical services including rehabilitation, physical therapy, occupational therapy, and speech therapy alongside palliative and hospice care.

Staffing composition shows significant variation from Missouri benchmarks. Registered Nurse coverage is 32 minutes per resident daily, running 14% above the state average of 28 minutes, suggesting adequate clinical leadership. However, Licensed Practical Nurse hours average 23 minutes per day, substantially below the state average of 41 minutes; a 44% shortfall that signals reduced hands-on clinical care delivery. Nurse Aide staffing is 2 hours 34 minutes per day, 11% above the state average, providing stronger direct assistance capacity.

Weekend nursing totals 3 hours 15 minutes per day, 7% above the state benchmark, with weekend RN coverage at 25 minutes; 25% above state average. Physical Therapist hours are minimal at 1 minute per day, 50% below the state benchmark of 2 minutes, a notable limitation for rehabilitation-focused care.

Quality outcome data raise substantive concerns. Emergency department visits for short-stay residents are 17.2%, 28% worse than the Missouri average of 13.4%; a marked elevation suggesting either higher-acuity admissions or gaps in preventive care management. Re-hospitalization is 26.5%, 5% worse than the state average of 25.3%. Successful return to home or community is 39.4%, 22% worse than the Missouri average of 50.6%, indicating lower discharge readiness outcomes.

Falls with major injury are 0.0%, a genuine strength relative to the state average of 0.8%. The facility’s overall quality measure rating is significantly below average, indicating systematic performance gaps across multiple care domains.

The walk score of 50 reflects moderately walkable surroundings with some pedestrian-accessible amenities.

Clinical services include in-house X-ray and laboratory, IV therapy, nutrition therapy, medication management, pain and wound management, and palliative care. On-site amenities encompass a beauty and barber shop, housekeeping, dining with special meal options, and recreational programming.

The facility’s zero inspection finding is anomalous given extensive CMS quality measure reporting and requires clarification regarding inspection history and regulatory standing. Missouri residents qualify for multiple assistance programs including Medicaid A&D Waiver, Supplemental Nursing Care, Structured Family Caregiving Waiver, MO HealthNet Aged/Blind/Disabled, Medicare Savings Program, Caregiver Program, and Veterans Aid and Attendance.

Families should ask for an explanation of quality measure performance deficiencies and elevated ED utilization and re-hospitalization rates, corrective action plans, occupancy, and inspection history.

Ignite Medical Resort St. Peters is a 91-bed skilled nursing facility at 5101 Executive Centre Parkway, Saint Peters, St. Charles County, Missouri, operated by Ignite St. Peters LLC under the administration of Andrew Lane.

The facility accepts both Medicaid and Medicare, maintains 24-hour staffing, and positions itself as a luxury rehabilitation center with private rooms, a full-service spa, Starbucks café, on-site restaurant with chef-prepared cuisine, on-site chapel, and concierge services. The walk score is 45, indicating somewhat walkable location where a few services are reachable on foot but most trips require transportation.

The facility’s CMS Certification Number and Missouri License Number both display as “0” in available records. Before considering admission, families must verify directly with the Centers for Medicare & Medicaid Services and Missouri Department of Health and Senior Services that the facility holds current and valid Medicare and Medicaid certifications. This verification step is essential.

Ignite Medical Resort specializes in orthopedic rehabilitation, stroke recovery, cardiac care, pulmonary rehabilitation, infection management, and renal disease treatment including in-house dialysis. These specialized programs indicate clinical capacity to manage complex medical conditions and post-acute rehabilitation needs. Without benchmarked staffing information and quality data, families cannot independently assess whether the facility’s clinical resources adequately support the specialized rehabilitation services offered or how the facility’s outcomes compare to peer institutions.

The facility emphasizes lifestyle and recreational elements alongside medical care, with dining options including outdoor courtyard patio and fire pit settings. Religious services are provided.

The facility accepts Missouri Medicaid programs, including the Aged and Disabled Waiver, Missouri Supplemental Nursing Care, Structured Family Caregiving Waiver, MO HealthNet Aged Blind and Disabled, and Medicare Savings Program. Veterans and spouses may qualify for VA Aid and Attendance benefits. The facility reports no federal penalties in the past three years, which is a positive indicator of regulatory compliance during that period.

Families should verify current Medicare-Medicaid certifications, and request staffing hours per resident per day, CMS ratings, and quality outcome measures for specialized programs

Harton Senior Living is a 36-bed residential care facility at 1054 South Highway 47, Warrenton, Warren County, Missouri, administered by Miranda Pottebaum and operated by Harlynn, Inc. The facility carries a clean inspection record with zero reported deficiencies or violations, a result that exceeds the Missouri state average of seven routine and focused inspections. No citations, penalties, fines, or enforcement actions appear in state or federal records.

The facility is located at or near Warrenton’s city center in a moderately walkable area with a Walk Score of 56. As a residential care facility rather than a skilled nursing facility, it provides assistance with daily activities in a congregate setting. This classification subjects it to different state regulatory oversight and inspection frequency than nursing homes.

Families evaluating Harton Senior Living should contact the facility directly to verify staff qualifications, resident services, care protocols, and any specialized programming before placement.

Medicalodges Nevada is a 100-bed skilled nursing facility at 1210 West Ashland Street, Nevada, Missouri, Vernon County. Kayla Shuey is the administrator; Medicalodges, Inc., operates the facility under the ownership of Susan Houser. The facility is 100% employee-owned and primarily serves short-stay rehabilitation residents, though it also accepts long-term private pay and Medicaid admissions.

The facility carries a 2-star CMS overall rating. Health Inspection performance is 24% below Missouri average, and Staffing is 31% below state average. Quality Measures, however, are rated 85.2% above state average. Current occupancy is 39.8%, with 45 residents occupying 100 beds and an average stay of 188 days, indicating a predominantly short-stay rehabilitation model.

Financially, the facility is operating at a loss of $533.3 thousand against $3.2 million in revenue, a margin of -16.9%, with payroll consuming 63.5% of gross revenue.

Nursing staffing is a mixed picture. Weekend RN coverage is actually 5% above state average at 21 minutes per resident per day, and LPN staffing is a genuine strength at 1 hour 3 minutes per day (54% above state average of 41 minutes). Certified Nursing Aides average 2 hours 50 minutes per resident per day, 22% above state average. Total nursing care reaches 5 hours 10 minutes per resident per day, 36% above state average.

However, weekday RN hours are 26 minutes per resident per day, 7% below state average of 28 minutes. Weekend nursing total of 3 hours 32 minutes per day runs 16% above state average, suggesting weekend staffing is actually adequate despite concerns about daytime RN presence.

Quality outcomes reveal conflicting patterns. Long-stay residents experience hospitalizations at 1.96 per 1,000 days (6% better than state) and emergency department visits at 1.24 per 1,000 days (47% better than state)—notably low. Yet walking ability declined in 25.7% of long-stay residents, 25% worse than state average. Weight loss affects 8.9% (60% worse than state average of 5.6%), pressure ulcers occur in 6.1% of high-risk residents (21% worse than state), and bowel or bladder incontinence affects 22.1% of low-risk residents (22% worse than state).

On the positive side, depressive symptoms appear in only 5.9% (54% better than state), urinary tract infections are 1.4% (50% better than state), and falls with major injury are 2.0% (51% better than state). Vaccination rates are 86.9% for pneumococcal and 92.5% for influenza, both in line with state benchmarks.

Inspections from August 2019 through August 2025 include eight health surveys and complaint investigations with 27 total citations, all of moderate severity, and zero critical or serious citations. This is 3.38 citations per inspection versus Missouri average of 5.67 (41% better). However, the inspection record reveals a recurring pattern of deficiencies across multiple years. August 2019 found inadequate activities programming and improper side rail assessments.

June 2022 cited infection control gaps and staffing documentation. June 2024 health inspection identified 16 deficiencies covering medication management, pharmacy oversight, nursing documentation, and administrator licensing. A concurrent complaint investigation the same month cited 8 additional deficiencies. Subsequent complaint investigations in September 2023, December 2024, April 2025, and August 2025 repeatedly address administrator licensing compliance and infection prevention.

The administrator’s license expired and was not renewed in a timely manner, constituting a governance failure that has triggered multiple complaint reviews.

The facility’s low occupancy (39.8%) and operating loss of $533.3 thousand suggest financial strain, though payroll as a percentage of revenue is reasonable at 63.5%. The facility is moderately walkable (Walk Score 59) and offers Medicare rehabilitation, Medicaid long-term care, and private pay services with access to Missouri financial assistance programs.

Families evaluating Medicalodges Nevada should ask directly about corrective actions taken following the April 2025 infection control citation and verify current administrator license status.

Advance Assisted Living is a 44-bed assisted living facility at 252 Payton Place in Advance, Stoddard County, Missouri, administered by Debbie Newman and operated by Advance Missouri Health Care, LLC. The facility maintains a clean regulatory record with zero citations. Advance Assisted Living operates as an assisted living facility offering assistance with daily activities in a congregate living setting rather than skilled nursing or intensive medical care.

The facility is located at or near Advance’s city center in a somewhat walkable area with a Walk Score of 49, allowing residents to accomplish some nearby errands on foot, though most activities require transportation.

Families evaluating Advance Assisted Living should contact the facility to request information regarding staffing levels and qualifications, care services, amenity offerings, and payment types accepted before enrollment.

Central Gardens INC is an 83-bed residential care facility at 302 North Elm Street, Dexter, Stoddard County, Missouri. Kimberley Polen administers the facility, operated by Central Gardens, Inc.

The facility maintains a clean inspection record with zero reported state inspections and zero documented deficiencies or violations. No citations, penalties, or enforcement actions appear in available records. This aligns with typical regulatory patterns for residential care facilities under Missouri state oversight.

No state or federal operational data is available regarding staff-to-resident ratios, nursing certifications, occupancy rates, or resident census. Amenities, specialized services, and activity offerings are not detailed in available sources.

The facility operates as a residential care facility rather than a skilled nursing facility, providing residential care and assistance with daily living activities in a congregate setting. It is located at or near Dexter city center in a moderately walkable area with Walk Score 55. Located within the larger city center, some errands are walkable while others require transportation.

The facility has disclosed minimal information about operational structure or service offerings. Families evaluating Central Gardens INC should contact the facility directly to request details about staffing levels and credentials, nursing program scope, care services, activity programming, and payment types accepted.