Best Assisted Living in Missouri

Overview of Nazareth Living Center

Nazareth Living Center is a 235-bed skilled nursing and assisted living community in Saint Louis, Missouri, offering skilled nursing, assisted living, memory care, respite care, and short-term rehabilitation, with 24-hour staffing across all units. It is operated by the Sisters of St. Joseph of Carondelet St. Louis Province, a nonprofit that has run the facility since 1987.

The facility carries a 2-star overall CMS rating, driven by Health Inspection and Quality Measures scores that are both roughly 30% below the Missouri average. Across 10 inspections since 2020, the facility recorded 51 deficiencies — 46% above the state average. The March 2025 routine survey identified 17 deficiencies, including a 38.71% medication error rate and infection control failures. The July 2025 complaint investigation was substantiated for financial exploitation of a resident, wound-care failures that led to a hospital transfer, and controlled-substance record discrepancies. CMS imposed a $12,000 civil money penalty in October 2023 and a four-day payment denial in March 2025.

Total nursing hours average 4 hours per resident per day, roughly 5% above the Missouri average, though RN-specific hours are 43% below state benchmarks. The facility’s occupancy rate is 40%, compared with Missouri’s average of 66.6%, reflecting current availability across most care levels. The community is part of a continuing care retirement community campus and maintains active resident and family councils; religious services and a full calendar of social and spiritual activities are available on-site.

With a 46-day average length of stay and a payer mix that is 72% private pay, the facility is structured primarily for short-term post-acute and rehabilitative stays in Saint Louis County. However, families considering Nazareth Living Center should also carefully review its recent inspection findings, medication error history, and substantiated complaint investigations before making a placement decision.

Located at 1050 Dawson Rd in New Madrid, Missouri, New Madrid Living Center is a skilled nursing community with 112 beds. It offers long-term care, rehabilitation services, memory care, and 24-hour professional staffing on site, under private ownership. Kimberly Ivie operates the facility, and it accepts Medicare, Medicaid, and private pay.

CMS gives the community a 5-star overall rating, about 90.1% above the Missouri average. Health Inspection performance is about 72.4% above state peers. Total nurse staffing averages 4 hours and 10 minutes per resident per day, roughly 10% above Missouri’s average of 3 hours and 48 minutes. Nurse aide staffing exceeds averages, while RN and LPN staffing lag behind state averages, which is worth noting for residents with complex clinical needs.

The facility has averaged 4 deficiencies per year over the review period, about 27% below Missouri’s average of 5.5. Two substantiated complaints stand out in the record: an investigation in April 2024 confirmed that a resident sustained a fractured tibia/fibula when staff bypassed the required mechanical lift and delayed reporting the injury; another complaint in September 2023 was substantiated after staff failed to notify a guardian of a critical lab value, resulting in hospital admission for severe hypernatremia. There were no fines or Immediate Jeopardy findings in the available record.

The community’s occupancy rate is 48%, well below Missouri’s average of 66.6%, indicating current availability. Rehabilitation services, memory care, and secured living amenities are also available on site.

With an average resident stay of 152 days and capacity across skilled nursing and memory care, New Madrid Living Center suits residents seeking long-term placements in New Madrid County, including those transitioning from acute care who require ongoing skilled nursing support.

Overview of New Haven Care Center

New Haven Care Center is a nonprofit nursing home in New Haven, Missouri, with 106 beds. It is operated by New Haven Care Center, Inc., under administrator Charles Tritch. Community-owned and operating for more than 40 years, the facility provides long-term care, short-term rehabilitation, and outpatient rehabilitation to residents in Franklin County. It accepts Medicare, Medicaid, and private pay.

CMS gives the facility a 3-star overall rating. Nursing staffing averages 4 hours and 0 minutes per resident per day, modestly above Missouri’s average of 3 hours and 48 minutes, a meaningful margin for residents with daily care needs. Four of the facility’s six quality measures fall below state averages, a signal worth weighing for long-stay placements.

Since 2022, New Haven Care Center has undergone three inspections, averaging 5 deficiencies per year, close to Missouri’s average of 5.5, roughly in line with peers. The annual inspection in 2023 cited personal hygiene care, mechanical lift safety, and infection control. A March 2025 focused inspection later identified deficiencies in medication administration, including insulin handling and oxygen orders. Neither inspection resulted in fines or enforcement actions.

The facility’s programs include therapy services, pain management, podiatry, optometry, and dental services. It also operates its own hospice program, New Haven Hospice, and provides memory care and respite care, with 24-hour staffing.

New Haven Care Center suits residents seeking long-term skilled nursing or short-term post-acute rehabilitation in a community-based, nonprofit setting in Franklin County, particularly those who may need in-house hospice access and end-of-life care in the same facility.

Overview of Truman Lake Manor, INC

Located in Lowry City, Missouri, Truman Lake Manor is a nursing home with 120 beds. It is operated by Truman Lake Manor, INC, owned by Wayne Morton, and administered by Timothy Corbin. The community accepts Medicare, Medicaid, and private pay, offering multiple options for residents and families to manage care costs.

The home is at 59% occupancy. Residents stay an average of 149 days, including those in short-term recovery and ongoing nursing care. Daily nurse staffing averages 3 hours and 14 minutes per resident, with registered nurses providing about 30 minutes of direct care per day, alongside nurse aides. Licensed practical nurses also contribute to the balance of hands-on attention.

The facility’s location on East 7th Street in Lowry City is a car-dependent neighborhood so most daily errands require transportation. State inspections reviewed the home’s adherence to protocols and safety practices and identified issues with resident reporting procedures, medication management and security, infection control measures, and physician notification protocols. Families should ask about these operational details during a tour with the management team.

Located at 415 Sidney St in Saint James, Missouri, St James Living Center is a nursing home with 90 beds. The facility is operated by N & R Of St James, LLC, under the administration of Anita Carroll. It accepts Medicare, Medicaid, and private pay, giving families multiple ways to cover short-term rehabilitation and longer-term nursing care.

Residents stay for an average of 102 days, including post-acute rehabilitation stays alongside longer-term placements. The facility’s current occupancy rate is 48%. Clinically, St James focuses on rehabilitation services. There’s 24-hour staffing and a doctor on-site, as it is an active rehabilitation setting for patients recovering from surgery, an acute illness, or a hospital stay.

Total nurse staffing averages 4 hours per resident each day. They are supported by registered nurses, nurse aides, and licensed practical nurses working across the schedule.

The neighborhood has a Walkability Score of 65 out of 100, which means some errands can be done on foot while most trips require a short drive. This may suit families who want easier access when visiting or running nearby errands.

The Department of Health and Senior Services regularly examines care processes at St James. It has focused on areas such as care documentation, physician communication and incident response, resident supervision and safety measures, medication handling and security, and related clinical protocols. These examinations help ensure the home maintains standards in resident care and administrative operations.

Residents can choose meals through a complete dining program made from their individual preferences. Transportation, housekeeping, laundry services, 24-hour medical care, and a dedicated special care unit are also available. Together, these services make it easier for residents and families by reducing some of the daily tasks they might otherwise need to do on their own.

Located in Steele, Missouri, River Oaks Care Center is a nursing facility operated by Steele #1, Inc., owned by David Pierce and administered by Lisa Kelley. At 90 beds, the facility supports both short-term rehabilitation and ongoing nursing care. It accepts Medicaid, Medicare, and private pay residents. The facility’s current occupancy rate is 74%. Residents stay for an average of 216 days, placing it between short-term post-acute recovery stays and longer-term care placements.

Residents have access to comprehensive nursing services, with a total of 3 hours of nursing care per resident each day. They are supported by registered nurses, nurse aides, and licensed practical nurses on a 24-hour basis. There are also rehabilitation services and short-term rehab programs alongside routine skilled nursing care.

Nutritious meals are also provided as part of daily life at the facility. The surrounding area in Steele has a walkability score of 47 out of 100, so most daily activities and services require transportation; however, some nearby services can be reached on foot.

River Oaks is a relatively new facility now in its second year of operation. The inspection by the Missouri Department of Health and Senior Services identified areas of focus, including environmental safety, medication management practices, and care planning. The facility maintains review and oversight processes to address these findings and support residents’ safety and quality of care.

Shady Oaks Healthcare Center is a skilled nursing facility located on Business Route 63 in Thayer, Missouri. The home is operated by Thayer No 1, Inc and owned by The Thayer Exempt Trust. Medicare, Medicaid, and private pay are accepted, giving families different ways to cover nursing and rehabilitation services.

Residents stay an average of 128 days, including short-term recovery patients and those receiving longer-term care. With 120 beds, the community currently operates at 54% occupancy. This lower occupancy can provide a quieter environment for residents who prefer a less crowded setting. Daily nurse staffing averages 3 hours per resident.

Registered nurses, nurse aides, licensed practical nurses, and certified nursing assistants work together to provide hands-on care throughout the day. This staffing structure supports rehabilitation services and ongoing skilled nursing care.

Located along a business route outside the town center, the facility is in a somewhat walkable area. Some nearby services can be reached on foot, but most errands and appointments require transportation. Families who prefer a quieter rural setting may appreciate the location. The smaller resident population means they can get more individualized attention from staff.

Located on South Main in Granby, Missouri, Granby House is a skilled nursing home operated by Granby #1, Inc., owned by Rebecca Massey, with Tara Spencer serving as administrator. The 60-bed home has been operating for 39 years. It accepts Medicare, Medicaid, and private pay, giving families several ways to arrange coverage for short-term rehabilitation and longer-term nursing care.

Residents stay for an average of 153 days. The facility has a current occupancy rate of 87%, with steady demand for its services. With its number of beds, Granby House offers a mid-sized community setting. The neighborhood is somewhat walkable, with a Walk Score of 45. Some errands are within walking distance, but most trips require a car.

Rehabilitation services are available within a 24-hour nursing care environment. Daily nurse staffing averages 3 hours and 15 minutes per resident. Registered nurses, nurse aides, and licensed practical nurses work together to provide hands-on care, supervision, and support throughout the day. This staffing structure helps residents recovering from surgery, illness, or a hospital stay, as well as those who need longer-term skilled nursing care.

State inspections identified themes involving resident safety systems, facility maintenance and sanitation, and staff training readiness. Families should take a tour of the home and ask staff about these areas. Granby House’s long tenure in the community and stable occupancy suggest a facility with established ties and consistent operations.

For families considering Granby House, visiting the facility is a good way to assess the setting, see the rooms available, and get a clear sense of the daily care routines and environment. Its location in the heart of Granby and decades of operation make it a great option for local and regional families seeking skilled nursing care.

Overview of Medicalodges Neosho

Located on Lyon Drive in Neosho, Missouri, Medicalodges Neosho is a skilled nursing home operated by Medicalodges, Inc, and owned by Mecca Belty. The 114-bed facility accepts Medicare and private pay, providing multiple options for families navigating payment during short-term rehabilitation and longer-term care stays. Most residents stay for an average of 127 days, reflecting its focus on post-acute and transitional care rather than permanent residence.

The facility focuses on rehabilitation services. Respite care and short-term rehab programs support residents recovering from surgery, hospitalization, or illness. Daily nurse staffing averages 3 hours and 28 minutes per resident, which is composed of registered nurses, nurse aides, and licensed practical nurses. They provide consistent hands-on care throughout the day.

Documented concerns focused on procedures related to physician notification following falls, infection control practices during wound care, and medication administration accuracy. Families evaluating the facility should ask how these areas are managed in daily operations and what safeguards are in place.

Residents have access to social areas and family spaces where they can gather and receive visits. The home offers dining with a wide selection of menu choices and special diet preparations. There are also barbershop and salon services, spiritual services including weekly Bible studies and church services, and transportation.

With a Walk Score of 55, the neighborhood is moderately walkable. Some errands can be accomplished on foot, but most trips require a vehicle.

Located on West Rolla Street in Hartville, Missouri, Hartville Care Center is a skilled nursing home with 60 beds. It is operated by N & R Of Hartville, LLC, and administered by Matthew Allman. The home serves residents who need nursing care and rehabilitation following hospitalization or surgery, as well as those with longer-term care needs. It accepts Medicaid, Medicare, and private pay, so families have several coverage options.

The facility has been operating for 33 years and currently has 67% occupancy, with residents staying an average of 152 days. Daily nurse staffing takes approximately 3 hours and 23 minutes per resident, with registered nurses, licensed practical nurses, and nursing aides on staff 24 hours a day. This level of hands-on care supports a robust rehabilitation focus, and skilled nursing is available for those with ongoing medical needs.

Clinically, the home offers short-term rehabilitation, along with physical and occupational therapies to help residents regain strength and function. On-site medical services include a doctor on staff, regular physician visits, portable X-ray, and laboratory capabilities. Consultations from a dietitian, pharmacist, and specialists in eye care and podiatry are also available. There are behavioral health support and specialized care for residents with Alzheimer’s disease, and it offers hospice services for end-of-life care.

Residents can choose their meals from prepared dining options. The home also offers housekeeping and on-site laundry services, religious services, and a daily activities program. Amenities include individual room heating and cooling controls, access to satellite television, and on-site beauty and barber services. Transportation is arranged as needed. Hartville is in a car-dependent area, but the home provides arrangement services for residents and families who need local transportation.

State inspections focused on environmental sanitation, food safety procedures, documentation accuracy, and reporting protocols. These are common areas examined during nursing home inspections. The facility addresses all findings through its regulatory compliance and quality assurance processes.