Page 23 of Best Nursing Homes in Missouri

Overview of Alpine Breeze Health and Wellness

Alpine Breeze Health and Wellness is a 154-bed skilled nursing facility in Raytown, Jackson County, Missouri, operated by Raytown Road Healthcare LLC with Micah Davis as administrator. The facility specializes in memory care and provides rehabilitation services, accepting Medicare, Medicaid, and private pay residents.

Staffing presents critical deficiencies. Registered nurse coverage is 13 minutes/day, 54% below average. Licensed practical nurse hours are 25 minutes/day, 39% below average. Certified nurse aide staffing is 1 hour 51 minutes/day, 20% below average.

Total adjusted nursing care is 2 hours 9 minutes/day, 44% below average, ranking the facility 267th of 276 Missouri facilities. Weekend total nursing is 2 hours 4 minutes/day, 32% below average, with weekend RN coverage at 10 minutes/day, 50% below average. This staffing profile indicates substantially reduced clinical oversight, particularly on weekends.

Quality measures show contrasting patterns. Clinical outcome measures are strong: high-risk clinical events score is 2.9 (74% better than average), functional decline score is 8.1 (58% better), pressure ulcer rates are 2.1% (58% better), hospitalization rates are 1.55 per 1,000 days (25% better), and ED visits are 0.49 per 1,000 days (79% better). Vaccination rates exceed 99%. However, depressive symptoms affect 72.6% of long-stay residents, 465% worse than the average of 12.8%.

Occupancy is 90% (138 of 154 beds), above the Missouri average of 66.6%. Current resident payer mix is 12.1% Medicare, 85.7% Medicaid, and 2.2% private pay. Gross revenue is $4.9 million with an operating loss of $459.6 thousand; payroll represents 64.3% of revenue. Walk score is 73.

The Missouri Department of Health and Senior Services, Division of Regulation and Licensure, conducts inspections for all long-term care providers. Alpine Breeze received 10 inspections since 2019, with 48 total deficiencies (37% above average). The facility received two critical citations and two serious citations, rates 186% and 100% worse than average, respectively.

Recent inspections identify serious patterns. April 2025: resident-to-resident physical injury resulting in hospitalization. January 2025: water service shutdown due to failure to pay vendors, constituting immediate jeopardy affecting 138 residents. January 2025: substantiated financial exploitation by CNA involving unauthorized Cash App withdrawals of $617.89 from a resident’s account.

October 2024: failure to provide proper discharge notice and refusal to readmit a resident after hospitalization; state appeals unit ordered readmission.

October 2023 routine inspection identified 18 deficiencies including failure to ensure resident privacy, widespread environmental cleanliness failures with mouse droppings, failure to follow wound care orders, unsafe resident transfers, inadequate infection control practices, improper food temperature maintenance, and delayed vendor payments. June 2023 complaint investigation identified three deficiencies: failure to provide behavioral monitoring for dementia residents resulting in resident-to-resident altercation, missing safety signage and handrails.

The inspection record demonstrates recurring deficiencies across six years in environmental maintenance, vendor payment administration, infection control, wound care, safe resident handling, behavioral monitoring for dementia residents, and food safety. The facility received $19,000 in civil money penalties in 2025.

Families considering Alpine Breeze should request corrective action plans addressing the January 2025 water shutdown, financial exploitation incident, and April 2025 resident injury.

Carmel Hills Wellness & Rehabilitation operates 194 beds at 810 East Walnut Street in Independence, Jackson County, Missouri, under private ownership (810 Opco LLC) and the administration of Charmaine Coffman Williams.

The facility’s resident census skews heavily Medicaid-dependent; 81% of current residents rely on Medicaid funding, with another portion covered by Medicare or private payment. Average resident tenure spans 112 days, reflecting a mixed population of short-term post-acute and longer-term care admissions. Current occupancy of 74% exceeds the Missouri state average, yet utilization masks a facilities crisis.

The facility earned a 1-star health inspection rating, placing it 65.5% below Missouri state performance standards. Since 2018, inspectors documented 73 deficiencies; 109% worse than the state baseline. Over just the past three years, 84 health citations accumulated, nearly triple the frequency of typical Missouri facilities.

Most critically, May 2025 findings identified six deficiencies spanning resident notification failures (a family guardian learned of a death 14 days after it occurred), inadequate personal care (missed bathing assistance), and catastrophic safety breakdowns. One resident’s hair ignited during unsupervised smoking; burn treatment was delayed. Food temperatures ranged from dangerously cold (100-107°F) to unsafe extremes, with sanitation violations including grime under dishwashers and unrefrigerated items left exposed.

Earlier complaint investigations substantiated abuse allegations and documented a resident abandoned overnight in a hospital lobby after dialysis. In October 2024, 47 Oxycodone pills went missing under the watch of a nurse who later resigned. A February 2024 inspection identified immediate jeopardy: unsafe resident transfers resulted in fractures and bruising.

Deficiencies repeat across inspection cycles with no clear trajectory of sustained correction.

Daily direct care averages 2 hours 2 minutes per resident; nearly half the 3-hour 48-minute Missouri standard and far below the 3.0-hour threshold flagging minimal care adequacy. Registered nurses provide only 14 minutes daily per resident; weekends drop to 7 minutes. This facility ranks 272nd of 276 Missouri nursing homes in nurse hours.

Long-stay residents report depressive symptoms at 71.3%; an astounding 455% worse than the 12.8% state average, indicating systemic failure in behavioral health and emotional support. Short-stay vaccination rates collapse: pneumococcal vaccine at 22.3% (66% below average), influenza vaccine at 35.6% (44% below average).

Carmel Hills Wellness & Rehabilitation operates with dangerously inadequate staffing and a persistent pattern of safety violations unsuitable for vulnerable long-term care residents.

Overview of Ascend at Aurora

Ascend at Aurora is a 125-bed skilled nursing and rehabilitation facility at 1700 South Hudson Avenue in Aurora, Lawrence County, Missouri, administrated by Melanie Towers and privately owned. The facility provides skilled nursing, short-term rehabilitation, memory care in its Autumn Court unit, and subacute care serving Medicare, Medicaid, and private-pay residents. Current occupancy is 50.2% with an average length of stay of 109 days.

Total nursing care averages 3 hours 6 minutes/resident/day, 19% below Missouri’s 3 hours 48 minutes average. Registered nurse coverage of 27 minutes/day equals the state minimum. Licensed Practical Nurse hours are 34% below average at 27 minutes/day. Certified Nursing Aide time is 7% below benchmark.

Weekend nursing totals 2 hours 43 minutes per day, 11% below average. Staff-to-resident ratio of 1.28 to 1 indicates 25% fewer staff relative to residents compared to state norms. Physical therapist hours of 1 minute per resident per day are 50% below average.

Functional decline reaches 26.0 (34% worse than average). Walking ability decline affects 32.9% of residents (59% worse than average). Need for increased assistance with daily activities involves 28.1% of residents (42% worse than average). High-risk residents with pressure ulcers account for 8.2% (63% worse than average of 5.0%).

Urinary tract infection rates of 4.8% are 75% worse than Missouri’s average of 2.7%. Weight loss occurs in 8.5% of residents (53% worse than average). Long-stay hospitalization rates are 42% worse than benchmark. One notable strength: falls with major injury at 1.6% are 62% better than average.

Revenue totaled $5.7 million with net income of $1.1 million (profit margin of 18.9%), a significant turnaround from the prior-year deficit of $327,000. Payroll represents 58% of revenue.

Seven inspections since August 2019 identified 46 citations including two critical violations related to abuse or neglect (186% worse than Missouri average). Four complaint investigations between August 2023 and December 2025 documented the most serious findings. An August 2023 complaint investigation documented critical infection control failures during wound care for a resident with stage 3 and stage 4 pressure ulcers with bone infection.

April 2024 identified a critical citation for abuse or neglect. October 2024, July 2025, and December 2025 inspections documented continued deficiencies in resident rights, nursing services, and quality of care. Earlier inspections in May 2022 and August 2019 documented additional quality of care lapses. Citations per inspection average 6.57, exceeding Missouri’s average of 5.67.

Federal penalties totaled $57,000, including a $47,000 penalty issued in April 2024.

Ascend at Aurora offers skilled nursing, rehabilitation, memory care, and subacute care with on-site physical therapy, speech pathology, and occupational therapy. Restaurant-style dining with dietary customization is available. Residents participate in crafts, exercise, music, spiritual services, and social events.

The facility maintains an active resident council.

CMS ratings reflect the regulatory and clinical challenges: 1/5 overall, 1/5 for health inspection, 1/5 for staffing, and 1/5 for quality measures.

Families should review the facility’s corrective action documentation and seek detailed explanation of the April 2024 abuse or neglect finding before considering placement.

Overview of Livingston Manor Care Center

Livingston Manor, Inc., and administrator Sara Hoover-Shaw coordinate care at Livingston Manor Care Center, a 94-bed skilled nursing community located on East Birch Drive in Chillicothe, Missouri. The business office organizes patient billing through typical setups like Medicare, Medicaid, and private payments. Guests visiting the building can navigate the surrounding area easily on foot, as the neighborhood carries a walkability score of 71 out of 100, letting people handle multiple errands without a car.

On average, residents live in the community for 295 days, a timeframe that highlights a routine balancing continuous residential care with shorter post-hospital recovery schedules. To manage day-to-day medical treatments and physical support, the 24-hour staffing framework provides an average of 3 hours and 25 minutes of total nursing care per resident each day. The building splits this clinical focus across a dedicated Private Medicare Hall and a Special Care Unit designed for individualized rehabilitation.

Inspection reports show that recent surveys cited specific procedural corrections regarding resident banking funds, employee background tracking, nurse staffing adjustments, respiratory care, basic environmental sanitation, and resident safety rules, keeping the overall citation rate above zero.

Older adults can look into the community’s monthly activity setups, social calendars, and tailored rehabilitation programs. The indoor layout is configured to support physical recovery and memory care needs under continuous medical supervision. Families can call the main office directly to look over insurance requirements, ask about specific safety safeguards, or schedule an in-person walkthrough of the residential halls.

Overview of Atrium Place Health and Rehabilitation

Atrium Place Health and Rehabilitation is a 120-bed skilled nursing facility at 2600 Redman Road, Saint Louis, Missouri, in St. Louis County. The privately owned facility, operated by Redman Rd Consulting LLC and administered by Jessica Peebles, serves primarily long-term Medicaid-eligible residents alongside short-term Medicare rehabilitation admissions.

Between October 2019 and January 2026, Atrium Place received three standard health inspections and twelve separate complaint investigations, resulting in 54 deficiencies and 54 citations. In February 2025, a critical Quality of Care citation was issued. Four serious violations have been documented. The facility has incurred nine federal penalties totaling $190,000 in civil fines during the past three years; 160% higher than the Missouri state average of $73,000.

A 14-day payment denial was imposed in April 2024. The top deficiency categories reflect systemic patterns spanning multiple inspections and complaint investigations, indicating persistent rather than isolated problems.

Staffing is substantially below state benchmarks across bedside care roles. Total nursing care averages 1 hour 53 minutes per resident per day versus the Missouri average of 3 hours 48 minutes; a 51% reduction in overall clinical support. Registered Nurse hours are 14 minutes per resident per day, 50% below state (28 minutes). Certified Nursing Assistant hours average 1 hour 19 minutes, 43% below state (2 hours 19 minutes).

Weekend nursing totals 1 hour 52 minutes per resident per day, 39% below state (3 hours 3 minutes). Licensed Practical Nurses average 45 minutes per resident daily, 10% above state, representing the only staffing category above state average. Physical Therapist hours are 3 minutes per resident per day, 50% above state average, indicating stronger rehabilitation-focused therapy.

Quality measure performance is mixed. Long-stay hospitalizations are 1.33 per 1,000 days, 36% better than the state average of 2.08. Emergency department visits are 2.08 per 1,000 days, 11% better than state (2.35). However, pressure ulcer rates among high-risk long-stay residents are 6.9%, 38% worse than Missouri average (5.0%), indicating skin care and positioning gaps.

Depressive symptom prevalence stands at 76.6% of long-stay residents, 496% worse than the state average of 12.8%.

Occupancy is 71.4%, generating above-average revenue relative to capacity. Resident payer mix reflects 60% Medicaid, 35.3% private pay, and 4.7% Medicare, with average length of stay of 797 days indicating primarily long-term rather than short-stay census. CMS star ratings are 2-star overall, 1-star for Health Inspection, 1-star for Staffing, and 2-star for Quality Measures.

Families should request corrective action plans addressing the February 2025 critical citation and substantiated complaint investigations, and protocols for infection control and medication management.

Overview of Big Bend Woods Healthcare Center

Big Bend Woods Healthcare Center is a 135-bed skilled nursing home on Highland Avenue in Valley Park, Missouri, managed by operator Bbw Management Group, LLC, administrator Melissa Levvintre, and owner Irving Brecher. The finance department channels billing through standard options, accepting Medicare, Medicaid, and private pay. For visitors, the facility is located in a car-dependent neighborhood with a walkability score of 42 out of 100, which means family members will typically need a vehicle for trips to the campus.

Operational records show a 67 percent occupancy rate with an average length of stay of 127 days. This operational timeline points to an everyday schedule balanced between short-term post-hospital therapy and extended residential care. To supervise regular medical tasks and daily personal assistance, the 24-hour staffing schedule organizes an average of roughly 3 hours of total nursing care per resident each day, combining the efforts of registered nurses, licensed practical nurses, and nurse aides. State regulatory records from public health departments document how the facility manages its ongoing licensing evaluations.

Documents verify that recent inspections identified standard compliance deficiencies involving palatable food temperature standards and basic life support protocol timing, which means the property’s total cumulative citations-per-inspection rate is not zero, and these items remain part of ongoing regional quality tracking.

Prospective residents have access to on-site dental, eye, and laboratory options, alongside localized physician visits and creative art therapies. The everyday routine coordinates physical rehabilitation and recovery loops with chef-prepared meals, crafts group sessions, a game room, and pet visitation privileges.

Overview of Manchester Rehab and Healthcare Center

The 137-bed nursing community at Manchester Rehab and Healthcare Center operates under the direction of administrator Yakov Appelbaum, owner of Manchester Holdco LLC, and operator of Manchester Operator LLC in Ballwin, Missouri. Financial billing paths accommodate multiple standard insurance structures, accepting Medicare, Medicaid, and private pay. For visitors, the surrounding area carries a moderate walkability score of 52 out of 100, indicating a layout where family members can walk to a few nearby amenities, though a vehicle remains practical for most local trips.

Operational metrics show that residents stay at the facility for an average of roughly 82 days, a timeline that reflects a daily caseload mixing short-term post-hospital therapy with extended skilled nursing placements. To manage routine physical care and medical needs, the 24-hour staffing framework relies on registered nurses, licensed practical nurses, and certified nurse aides. Within this clinical rotation, nurse aides supply the primary share of daily hands-on personal support, averaging 2 hours and 27 minutes of direct care per resident each day.

Public health safety data tracks the facility’s historical compliance through recurring licensing reviews overseen by state regulators. Documented inspection files show that administrative teams have logged specific compliance deficiencies concerning timely laboratory service delivery, resident fund management, registered nurse shift coverage, and grievance documentation protocols, meaning the property’s total cumulative citations-per-inspection rate is not zero, and these items remain part of ongoing quality tracking.

Prospective residents have access to multi-specialty clinical programs, including physical rehabilitation, professional wound care, and on-site dental, podiatry, optometry, audiology, and counseling services.

Grand River Health Care is a skilled nursing home in Chillicothe, Missouri, operated by N & R Of Chillicothe, Inc. The 60-bed facility is at 118 Trenton Rd, which scores 71 out of 100 for walkability. Most residents and visiting family can handle everyday errands on foot. Medicaid, Medicare, and private pay are accepted, providing families multiple options to cover short-term rehabilitation or longer-term nursing care.

The facility has a wide range of clinical services, including rehabilitation, respite care, skilled nursing care, and physical and occupational therapy. There are also specialized programs in behavioral health and Alzheimer’s care. A doctor is on staff, and the facility provides 24-hour nursing coverage.

Residents with more complex medical needs can access infusion therapy and hospice services. Total nurse staffing averages approximately 4 hours and 43 minutes per resident each day. The care team is composed of registered nursing, licensed practical nursing, and nurse aide support.

The facility’s current occupancy rate is 52%, and residents stay an average of 257 days. The home serves both short-term rehabilitation patients and those needing ongoing skilled care. Residents have access to comprehensive dining services, including nutritious meals tailored to individual preferences. These help support resident recovery and well-being.

State inspections documented concerns in areas related to resident safety and abuse prevention, medication management, infection control, food safety, and the timeliness of protective actions. Families evaluating the facility should carefully review the inspection history and ask how it addresses ongoing matters.

Bluebird Wellness and Rehabilitation is a 188-bed skilled nursing facility at 9350 Green Park Road, Saint Louis, Saint Louis County, Missouri, operated by Blooming Oaks Wellness & Rehabilitation LLC under the administration of Anita Tillery. The facility is Medicare and Medicaid certified with a physician on staff and maintains 24-hour nursing coverage for residents requiring skilled care and post-acute rehabilitation services.

Staffing composition reveals significant clinical limitations. Registered nurse hours average 14 minutes per resident per day, representing a 50% reduction compared to Missouri’s state average of 28 minutes. This marked RN shortfall constrains clinical assessment capacity and responsiveness to acute changes in resident condition. Weekend RN presence deteriorates further to just 5 minutes per day; 75% below the state average of 20 minutes, creating substantial gaps in clinical oversight during evenings and weekends when administrative support is minimal.

Licensed practical nurses provide 45 minutes per day (10% above state average), delivering consistent hands-on nursing care. Certified nursing aides provide 2 hours 13 minutes per day (4% below state average). Physical therapist hours are 1 minute per day (50% below state average), severely limiting rehabilitation capacity for a facility marketed as a rehabilitation center.

Quality measures for long-stay residents show mixed outcomes. Hospitalization rates are 2.22 per 1,000 days (7% worse than Missouri average). Emergency department visits are 1.85 per 1,000 days (21% better than state average), indicating some strength in managing chronic conditions. Short-stay rehabilitation outcomes are substantially weaker.

Falls with major injury occur at 2.0% of residents; 155% worse than Missouri’s average of 0.8%, reflecting either inadequate fall prevention protocols or a higher-risk admission population. Successful return to home or community is 32.3% (36% worse than state average of 50.6%). Ability to care for self at discharge is 46.7% (13% worse than state average of 53.7%). These discharge metrics suggest residents exit the facility with lower functional capacity than patients at comparable facilities, pointing to either more acute admissions, extended institutional placement, or limited rehabilitation effectiveness.

Short-stay readmission rates are 15.9% (37% better than state average of 25.3%), a positive signal that discharged residents generally remain stable after leaving the facility. Short-stay emergency department visit rates are 14.5% (8% worse than state average of 13.4%).

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 explanation. Families must request and review the facility’s current licensing status, actual inspection records from the Missouri Department of Health and Senior Services, and documentation of the reason for the absence of routine regulatory oversight.

Families should request information on weekend RN staffing, emergency response, fall prevention, incident tracking, rehabilitation program outcomes, and below average discharge outcome metrics.

Located in Florissant, Missouri, Willowcreek Wellness & Rehabilitation is a skilled nursing facility operated by Willowcreek Wellness LLC and administered by John McBryant. The home is on New Florissant Road South. It is in a moderately walkable neighborhood with a Walk Score of 63, so some everyday errands can be handled on foot. The facility accepts Medicare and private pay, providing families multiple ways to cover short-term rehabilitation and longer-term skilled nursing care.

The 158-bed facility is currently running at 66% occupancy. Residents stay an average of 115 days, including those in post-acute rehabilitation and those requiring ongoing skilled care. The home focuses on rehabilitation services and respite care. There’s a doctor on staff and 24-hour nursing support. Total nursing care averages roughly 2 hours and 54 minutes per resident each day, providing daily hands-on support.

Residents receive nutritionally balanced meals prepared to meet their medical and faith-based dietary needs, accommodating diverse dietary preferences. The facility also has structured programs in health care management. It supports residents’ dietary and nutritional needs, including those with complex medical conditions.

Like other nursing homes, Willowcreek undergoes regular inspections by the Missouri Department of Health and Senior Services. Inspections identified concerns in clinical care areas, including diabetes management, pain control, medication administration accuracy, and documentation practices, as well as environmental and facility maintenance matters. Families considering the home should ask about how the facility has addressed these clinical and operational areas and what steps were taken to address past findings.