Best Nursing Homes in Missouri

Overview of Big Bend Retreat

Big Bend Retreat is a 10-bed intermediate care facility at 620 North Emmerson, Slater, Saline County, Missouri. Emily Hahn administers the facility, operated by Big Bend Retreat, Inc. The facility emphasizes personalized care in a small, intimate residential setting.

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 state records. This aligns with typical regulatory patterns for very small rural intermediate care facilities.

Big Bend Retreat provides 24-hour staffing with residential care, adult daycare, and respite care services. Home-style meals are prepared daily for residents. No state or federal operational data is available regarding staff-to-resident ratios, occupancy rates, or clinical outcomes. Administrative hours are listed as Monday through Friday 8:00 AM to 4:00 PM, though 24-hour staffing is claimed.

As an intermediate care facility, Big Bend Retreat operates under a different regulatory framework than skilled nursing facilities, providing personalized residential care with supporting services for a small census. Located at or near Slater city center, the facility is in a low-walkability area with Walk Score 33. Most errands require transportation.

The facility’s small 10-bed capacity may allow for intimate staff-resident relationships. Services emphasize respite care and adult daycare flexibility for temporary or part-time stays.

Families evaluating Big Bend Retreat should contact directly for details about staffing credentials, admission requirements, care scope, and current availability.

Maple Grove Wellness & Rehabilitation is a 144-bed skilled nursing and rehabilitation facility in Fenton, St. Louis County, Missouri, administrated by Jodie Pate and privately owned. The facility provides skilled nursing care, rehabilitation services, and respite care serving Medicare, Medicaid, and private-pay residents with an average length of stay of 643 days, indicating a primarily long-term care population.

Total nursing care averages 2 hours 46 minutes/resident/day, 27% below the average. Registered nurse coverage of 8 minutes/day is critically deficient at 71% below average. Certified Nursing Aide hours are 21% below benchmark. Weekend registered nurse presence of 7 minutes/day is 65% below average.

Staff-to-resident ratio of 1.45 to 1 is 15% worse than state norms. Contractor staffing comprises 8.7% of total hours, predominantly Licensed Practical Nurses.

Pressure ulcer prevention is effective at 3.5% of high-risk residents affected (31% better than state). Urinary tract infection rates of 0.6% are 77% better than state. However, long-stay hospitalization rates of 4.33/1,000 days are 108% worse than benchmark of 2.08. Low-risk residents with incontinence at 23.4% are 29% worse than state.

Antipsychotic use at 32.0% is 46% worse than average. Pneumococcal vaccination for long-stay residents reaches only 59.5% (30% worse than state), and influenza vaccination is 24% worse than state. Short-stay vaccination rates are critically deficient with pneumococcal at 7.0% and influenza at 11.4%.

The facility reported a $941,000 operating loss in fiscal 2023 (profit margin of negative 14.5%) against $6.5 million revenue. Payroll represents 69.2% of revenue, above sustainable levels. Occupancy is 61.2%, below average.

Six inspections since December 2022 identified 44 citations including one serious violation and 39 moderate citations. Citations/inspection average 7.33, exceeding Missouri’s average. No federal penalties were imposed.

June 2025 complaint investigation documented a serious pharmacy deficiency with actual patient harm. Multiple residents with diabetes did not receive ordered insulin injections. A Licensed Practical Nurse, running late on medication pass, withdrew morphine sulfate and lorazepam intended for one resident, entered another resident’s room, called out the wrong resident’s name, and when that resident aroused, administered both medications without confirming identity. The nurse was terminated the next day.

Complaint investigations in March 2025 and July 2024 documented additional infection control and quality of care deficiencies. The cumulative inspection record demonstrates systemic failures in pharmacy operations, medication administration safety, infection control, and vaccination administration.

The facility maintains physical therapy, occupational therapy, and speech pathology services. Walk Score of 54 reflects moderately walkable surroundings. CMS ratings are 1/5 overall, 2/5 for health inspection, 1/5 for staffing, and 2/5 for quality measures.

The serious pharmacy deficiency and medication error resulting in patient hospitalization, combined with the facility-wide failure to administer ordered medications and critical nursing staffing shortages, represent substantial patient safety concerns.

Families should carefully review pharmacy procedures and medication oversight protocols before considering placement.

Overview of Friendship Village Assisted Living & Memory Care

Friendship Village Assisted Living & Memory Care is an 84-bed community at 12777 Pointe Drive, Saint Louis County, Missouri, operated by Friendship Village of South County under the administration of Ms. Nicole Summers.

The facility provides assisted living, memory care, skilled nursing, and rehabilitation services in a continuum-of-care model, allowing residents to remain on campus as care needs evolve. The facility maintains 24-hour staffing, offers hospice services, and has a walk score of 0, reflecting extreme car-dependence with virtually no nearby walkable options.

The facility offers assisted living support for residents with activities-of-daily-living assistance, memory care programming for residents with dementia and cognitive decline, skilled nursing for post-acute care, and short-term rehabilitation services. Respite care is available.

Amenities include fitness areas, a private library, movie theater, secure community environment, spiritual activities, adventure opportunities, and religious services. The continuum-of-care model within a single campus facilitates level-of-care transitions without relocating residents.

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, making the facility accessible to residents with government assistance.

The facility’s regulatory record shows zero total inspections recorded, compared to a Missouri state average of seven for comparable communities. This unusually sparse inspection history requires explanation. Current licensing status and any available regulatory documentation should be reviewed before placement.

Families should verify staffing credentials, CMS ratings, licenses and inspection reports from the Missouri Department of Health and Senior Services, and emergency response protocols.

Overview of Mcknight Place Assisted Living and Memory Care

Mcknight Place Assisted Living and Memory Care is a 55-bed skilled nursing facility offering assisted living, memory care, and skilled nursing at Three McKnight Place, Saint Louis, Saint Louis County, Missouri. Ms Elizabeth Stotser administers the facility, operated by Mpal Real Estate, LLC. The community is organized to serve multiple care levels from independent assisted living through skilled nursing within integrated residential spaces.

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.

An important operational constraint: McKnight Place accepts Medicare only and does not accept Medicaid, limiting access to residents with Medicare coverage or independent financial resources. The facility maintains a physician on staff and provides 24-hour staffing with short-term rehabilitation, respite care, and long-term care services. Staffing composition, staff-to-resident ratios, and nursing hours per resident are not publicly disclosed. No CMS ratings or clinical outcome data are publicly available.

The facility emphasizes quality of life through amenities and dining. Meals are prepared by an award-winning Executive Chef with attention to nutritional requirements. Gardens, beauty and barber salons, exercise and fitness programs, and transportation services support resident engagement and independence.

Starting price of $10,650 per month is disclosed.

Walk Score of 34 indicates somewhat walkable area where a few nearby services are reachable on foot, though most trips require transportation.

Families evaluating McKnight Place should request details regarding Medicare coverage scope, physician availability and medical protocols, staff-to-resident ratios, nursing hours per resident, specific care programming for memory care versus assisted living versus skilled nursing levels, and financial terms before enrollment.

Lawrence County Residential Care Center is a 30-bed residential care facility at 915 Carl Allen Street, Mt Vernon, Missouri, operated by Lawrence County Nursing Home District and administrated by Russell Newby. The facility operates as a 24-hour skilled nursing and rehabilitation center with designated memory care units, offering nursing care, physical therapy, and specialized services for residents with cognitive decline.

Operational strengths are evident but limited in disclosed detail. The facility maintains a doctor on staff and 24-hour staffing with skilled nursing capability. Rehabilitation services, a beauty salon, housekeeping, maintenance, and dietary services are programmed components. Dietary services are managed by a specialized team preparing individualized meals tailored to resident needs and preferences.

Memory care units are designated for residents with dementia or cognitive decline. The facility accepts both Medicaid and Medicare, providing payment flexibility for qualifying residents. Operating hours are 24/7.

The facility’s inspection profile shows zero routine inspections from the Missouri Department of Health and Senior Services, Division of Regulation and Licensure compared to the Missouri state average of seven, which could indicate a recent opening or limited survey activity relative to comparable Missouri residential care facilities. Without access to the complete inspection record and detailed staffing breakdown, families cannot assess regulatory history or identify any substantive compliance issues. The zero-inspection finding requires clarification regarding the facility’s age, licensure status, and operational standing before consideration for placement.

The walk score of 53 reflects moderately walkable surroundings; some services are reachable on foot, though most daily needs will require transportation. Mt Vernon’s proximity to regional healthcare resources and available accessibility are relevant considerations for families evaluating placement.

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. The facility accepts Medicaid and Medicare.

Families should ask about memory care programming and staffing details, occupancy, licensing, inspections, quality metrics from Lawrence County Residential Care Center.

Overview of Abbey Senior Health

Abbey Senior Health is a 10-bed continuing care retirement community at 206 North Main Street, O’Fallon, Saint Charles County, Missouri, operated by Mount Carmel Communities-O’Fallon, LLC under the administration of C Christopher Brown. The facility provides independent living, assisted living, skilled nursing, and short-term rehabilitation services with a minimum age requirement of 55 for residents. The facility received U.S. News and World Report recognition as a Best Nursing Home in 2026.

The walk score is 65, indicating moderate walkability where some errands do not require a car.

Registered nurses provide 48 minutes per resident per day, representing a 71% increase above Missouri’s state average of 28 minutes. Licensed practical nurses provide 1 hour 1 minute per day, 49% above state average. Certified nursing aides provide 2 hours 45 minutes per day, 19% above state average. Weekend nursing totals 3 hours 49 minutes per day, 25% above state average, with weekend RN presence at 28 minutes per day, which is 40% above the state average.

Physical therapists provide 6 minutes per day, representing a 200% increase above the state average of 2 minutes.

Quality outcomes for long-stay residents demonstrate considerable strength. Long-stay hospitalizations average 1.48 per 1,000 days, representing a 29% improvement over Missouri’s state average of 2.08. Emergency department visits for long-stay residents average 0.33 per 1,000 days, 86% better than state average of 2.35.

Short-stay rehabilitation outcomes are mixed. Successful return to home or community is 56.9%, 12% better than the state average. Re-hospitalization rates are 27.2%, 8% worse than state average. Falls with major injury occur at 2.9% of short-stay residents, representing a concerning 271% increase over Missouri’s average of 0.8%.

Ability to care for self at discharge is 48.6%, 9% worse than state average.

Abbey Senior Health emphasizes faith-based programming with Catholic Mass, Communion, Chapel access, Reconciliation, Prayer, and Bible Study. Social and recreational amenities include food and drink tastings, happy hours, guest events, movie nights, birthday parties, sports watch parties, spa treatments, walking club, exercise classes, library, and art classes. Meals are offered on an optional purchase basis.

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’s regulatory record shows zero total inspections recorded, compared to a Missouri state average of seven. This unusually sparse inspection history requires explanation. Current licensing status and any available regulatory documentation should be reviewed.

Families should request fall prevention protocols and admission assessment procedures, and licenses and inspection reports from Missouri Department of Health and Senior Services.

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.

St. Peters Rehab and Healthcare Center is a 96-bed skilled nursing facility at 230 Spencer Road, Saint Peters, Saint Charles County, Missouri, providing memory care, skilled nursing, rehabilitation therapy, and post-acute services. Operated by St Peters Operator LLC under administrator Ms Beverly Rector, the facility holds a one-star CMS overall rating, representing performance 62% below Missouri average across health inspections, staffing, and quality measures. The walk score is 45, indicating most trips require transportation.

Licensed practical nurse hours are 29 minutes per resident per day, 29% below state average of 41 minutes. Registered nurse hours are 30 minutes per day, 7% above state average. Weekend RN coverage is 16 minutes per day, 20% below state average of 20 minutes. Payroll represents 25.9% of revenue, ranking 260th out of 263 Missouri SNFs, significantly below industry benchmarks of 60 to 71%.

Walking ability worsened in 36.1% of residents, 75% worse than state average of 20.6%. Falls with major injury occurred in 5.6%, 39% worse than state average. Depressive symptoms were present in 37.9%, 195% worse than state average of 12.8%, indicating critical mental health management concerns. Need for ADL help increased in 25.9%, 31% worse than state average.

Functional decline score was 29.2, 50% worse than state average.

Falls with major injury reached 4.6%, 500% worse than state average of 0.8%. Ability to care for self at discharge was 35.0%, 35% worse than state average. Re-hospitalization was 15.7% (38% better than state average of 25.3%).

Since 2023, the facility received 14 health inspections versus state average of 6.6.

Total citations reached 114 versus state average of 36.5. Critical citations numbered 2 (186% worse than state average). Serious citations numbered 8 (700% worse than state average). Moderate citations numbered 100 (three times state average).

The facility incurred 195,000 dollars in fines (167% higher than state average) and received 3 payment denials (336% more than state average), resulting in temporary suspension of Medicare and Medicaid reimbursement for new admissions. Operating loss reached 546,800 dollars in 2024 versus negative 78,024 dollars in 2023.

Occupancy declined from 80.9% (2021) to 76.1% (2024).

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 may qualify for VA Aid and Attendance benefits.

Families should request detailed fall prevention protocols for short-stay residents and corrective measures for the 500% elevated fall rate before placement.

Overview of Aspen Point Health and Rehabilitation

Aspen Point Health and Rehabilitation is a 180-bed skilled nursing facility at 2840 West Clay Street, Saint Charles, Saint Charles County, Missouri, operated by Clay Street Healthcare LLC and administered by Lindsey Keener. The privately owned facility accepts Medicare, Medicaid, and private pay. Currently operating at 39.1% occupancy with 56 residents; well below Missouri’s 66.6% average. The facility serves primarily long-term Medicaid residents, with smaller cohorts in short-term rehabilitation and private pay.

The December 9, 2024 complaint investigation is the critical placement consideration. State surveyors documented substantiated verbal abuse with findings of “Actual Harm.” Residents reported staff used profanity and disrespectful language when responding to care needs, with one resident describing being called a “fucking bitch” and ordered to “shut the fuck up” while speaking to family on the phone. Four residents independently reported similar experiences on evening and night shifts, describing how staff language made them feel worthless, less than human, and upset. Both the facility’s Director of Nursing and Administrator conceded this constituted a dignity and verbal abuse violation.

This is the single most recent and most serious finding in the facility’s record.

Certified nursing aides provide 1 hour 43 minutes per resident daily, 26% below Missouri’s 2 hour 19 minute standard. Registered nurses average 33 minutes daily (18% above state), and licensed practical nurses 52 minutes daily (27% above state). Weekend nursing totals 2 hours 38 minutes per resident daily, 13% below state average. Overall staff-to-resident ratio is 1.41 to 1, performing 18% worse than Missouri’s 1.71 to 1 benchmark.

Payroll consumes 71% of revenue.

Quality outcomes for short-stay rehabilitation residents are dramatically below standard. Short-stay falls resulting in major injury occur at 5.9%; nearly seven times Missouri’s 0.8% average. Only 19.1% of short-stay residents achieve expected functional ability at discharge, compared to 53.7% statewide. Short-stay re-hospitalization rates reach 33.3%, 32% worse than state average.

Long-stay residents show elevated depressive symptoms at 77%, nearly five times the 12.8% state rate.

Regulatory violations cluster heavily in 2023 and 2024. Since March 2023, the facility has received 18 inspections (all complaint investigations or health inspections, with no routine survey conducted).

The April 17, 2024 complaint investigation cited six deficiencies covering housekeeping inadequacy, medication administration failures, insufficient ADL care, pressure ulcer management gaps, understaffing, and improper director of nursing deployment. June 5, 2024 revisits the same ADL deficiency as uncorrected.

Total citations since 2024 reach 127; critical (11), serious (17), moderate (96), minor (3), ranking the facility 261st of 261 Missouri SNFs. Federal penalties total $497,000 across 12 fines (the highest in Missouri), with two payment denials (134 days in August 2023, 73 days in February 2024).

The progression from operational deficiencies (housekeeping, medication, staffing, assessments) in early and mid-2024 to substantiated resident abuse in December 2024 reflects a deteriorating operational environment.

Families should verify corrective measures and staff training protocols following the December 2024 verbal abuse finding before any placement decision.

Overview of Avenir at Maple Grove

Avenir at Maple Grove is a 90-bed skilled nursing and rehabilitation facility at 2407 Kentucky Street in Louisiana, Pike County, Missouri. Administrator Dakota Yowell operates this privately-owned community, which accepts Medicare, Medicaid, and private pay. The facility provides long-term care, short-term rehabilitation, wound care, and adult day services in a mixed-stay setting.

In August 2023, residents complained through Resident Council that meals arrived cold; inspection confirmed that food temperatures fell dangerously below safe standards. By October 2023, a follow-up complaint investigation found that corrective measures had not been implemented. In November 2025, after nearly two years of promises and continued failures, a third complaint investigation discovered the deficiency persists.

Registered nurses provide 19 minutes per resident per day, 32% below state average; licensed practical nurses deliver 48 minutes (modestly above the 41-minute state average); and certified nursing aides supply 1 hour 50 minutes daily, 21% below state average. Weekend nursing coverage measures 2 hours 32 minutes per resident per day, 17% below state average. Total nursing care averages 3 hours 12 minutes per resident per day, 16% below Missouri’s 3-hour-48-minute benchmark. Physical therapy is an outlier, at 4 minutes per resident per day (100% above state average).

Long-stay emergency department visits reach 2.97 per 1,000 resident days, 26% worse than Missouri’s average of 2.35. Long-stay hospitalizations are recorded at 2.29 per 1,000 days, 10% above state average. The high-risk clinical events score (measuring falls, pressure ulcers, weight loss, and functional decline) is 34.2, 76% worse than Missouri’s 19.5 benchmark. Functional decline in activities of daily living affects long-stay residents at higher-than-average rates: 31.6% of long-stay residents show increased need for ADL help (60% worse than state average), and 33.6% experience worsening walking ability (63% worse than state average).

Only 25.1% of short-stay residents successfully return to home or community, 50% below Missouri’s average of 50.6%.

Occupancy stands at 54%, lower than Missouri’s average of 66.6% and below the 85% threshold that typically signals full capacity. Current census is 49 residents. Payer mix is 67.3% Medicaid, 26.5% private pay, and 6.1% Medicare.

The facility recorded 5.2 million in gross revenue with a $200,700 operating loss in 2023; payroll represents 52.3% of revenue at 2.7 million dollars annually.

The facility’s CMS ratings reflect mixed performance: 1 star overall (62% below state average), 1 star for health inspection (31% below state average), 1 star for staffing (53.7% below state average), and 2 stars for quality measures (43.4% above state average).

Across seven years of inspections, the facility received zero critical citations and one serious citation, with 30 moderate and 1 minor citation.

No immediate jeopardy findings, fines, or license suspensions have been imposed.

Families considering Avenir at Maple Grove should request verification of corrective measures for persistent food temperature deficiencies and clarify staffing model given RN shortage.