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The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.
This home is ranked 75th out of 276 homes in Missouri. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
| Staff type | Hours / Day / Resident | vs state avg |
|---|---|---|
|
Weekend Total Nursing
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
| 3h 4m per day | ■ Avg State avg: 3h 3m per day · National avg: 3h 26m per day |
Lower than the Missouri average: 66.6%Avenir at Mark Twain is administrated by Emmanuel Jackson.
In Missouri, the Department of Health and Senior Services, Division of Regulation and Licensure performs the inspections and unannounced surveys required for all long-term care providers.
This scorecard compares key inspection, citation, and complaint metrics at this facility against the Missouri state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.
Deficiencies
| This Facility | MO Average | vs. MO Avg |
|---|---|---|---|
|
Total deficiencies
Formal regulatory issues recorded by inspectors across all inspection types.
| 72 | 35 | This facility has 106% more total deficiencies than a typical Missouri nursing home (72 vs. MO avg 35).↑ 106% worse |
|
Deficiencies per year
Average deficiencies per year since 2019.
| 10.3 | 5 | This facility has 106% more deficiencies per year than a typical Missouri nursing home (10.3 vs. MO avg 5).↑ 106% worse |
|
Deficiencies per inspection
Average deficiencies per inspection.
| 7.2 | 5 | This facility has 44% more deficiencies per inspection than a typical Missouri nursing home (7.2 vs. MO avg 5).↑ 44% worse |
Inspections
| This Facility | MO Average | vs. MO Avg |
|---|---|---|---|
|
Total inspections
Combined count of all routine and focused inspections. Excludes complaint investigations.
| 10 | 7 | This facility has 43% more total inspections than a typical Missouri nursing home (10 vs. MO avg 7).↑ 43% worse |
Read the full inspection reports for this facility, including detailed findings and corrective actions.
Show Inspection ReportsMissouri average 6.6
Last Health inspection on Oct 2025
Missouri average 36.5
Missouri average 5.67
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
24 of 43 citations resulted from standard inspections; 16 of 43 resulted from complaint investigations; and 3 of 43 came from combined inspections (standard and complaint).
186% worse than Missouri averageMissouri average: 0.7
100% better than Missouri averageMissouri average: 1
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
137% better than Missouri average
0% compared with Missouri average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.5 hoursThis role is partially covered by contractors.
Assists with medical care and medications.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.8 hoursThis role is partially covered by contractors.
Helps with daily care and mobility.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.7 hoursThis role is partially covered by contractors.
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
5,259 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 53 | 99 | 152 | 14,217 | 92 | 100% | 7.7 |
| Medication Aide/Technician | 17 | 14 | 31 | 4,162 | 92 | 100% | 8 |
| Licensed Practical Nurse | 11 | 39 | 50 | 3,319 | 92 | 100% | 8.8 |
| Registered Nurse | 7 | 2 | 9 | 1,962 | 84 | 91% | 9.5 |
| Physical Therapist | 11 | 0 | 11 | 1,345 | 33 | 36% | 6.8 |
| Respiratory Therapy Technician | 3 | 0 | 3 | 868 | 65 | 71% | 6.6 |
| Dietitian | 2 | 0 | 2 | 697 | 72 | 78% | 8.2 |
| Physical Therapy Aide | 4 | 0 | 4 | 629 | 66 | 72% | 6.6 |
| RN Director of Nursing | 1 | 0 | 1 | 512 | 54 | 59% | 9.5 |
| Clinical Nurse Specialist | 2 | 0 | 2 | 449 | 57 | 62% | 7.6 |
| Nurse Practitioner | 2 | 0 | 2 | 297 | 38 | 41% | 7.8 |
| Administrator | 2 | 0 | 2 | 264 | 33 | 36% | 8 |
| Mental Health Service Worker | 2 | 0 | 2 | 178 | 22 | 24% | 8.1 |
| Qualified Social Worker | 2 | 0 | 2 | 177 | 41 | 45% | 4.3 |
| Physical Therapy Assistant | 2 | 0 | 2 | 149 | 45 | 49% | 3.2 |
| Speech Language Pathologist | 2 | 0 | 2 | 41 | 10 | 11% | 4.1 |
Includes penalties issued in 2023-2025
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database (Data as of Jan 2026)
167% higher than Missouri averageMissouri average: $73K
228% more fines than Missouri averageMissouri average: 2.4
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
2
191% more payment denials than Missouri averageMissouri average: 0.7
Penalties are imposed by CMS for violations of federal nursing home regulations.
10 penalties in the past 3 years
Multiple penalties were reported in the last 3 years.
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Jan 21, 2025
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
Jan 21, 2025
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Jan 19, 2024
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
Jan 19, 2024Last updated: Jan 2026
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
14.4
32% worse than Missouri averageMissouri average: 10.9
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
22.3
15% worse than Missouri averageMissouri average: 19.5
CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Percent of long-stay residents whose need for help with daily activities has increased
19.9%
In line with Missouri averageMissouri average: 19.8%
Percent of long-stay residents whose ability to move independently worsened
30.5%
48% worse than Missouri averageMissouri average: 20.6%
Percent of low risk long-stay residents who lose control of their bowels or bladder
16.6%
8% better than Missouri averageMissouri average: 18.1%
Percent of long-stay residents experiencing one or more falls with major injury
3.9%
In line with Missouri averageMissouri average: 4.0%
Percent of long-stay high risk residents with pressure ulcers
10.0%
100% worse than Missouri averageMissouri average: 5.0%
Percent of long-stay residents with a urinary tract infection
0.7%
74% better than Missouri averageMissouri average: 2.7%
Percent of long-stay residents who lose too much weight
7.9%
41% worse than Missouri averageMissouri average: 5.6%
Percent of long-stay residents who have depressive symptoms
0.0%
100% better than Missouri averageMissouri average: 12.8%
Percent of long-stay residents who received an antipsychotic medication
15.3%
30% better than Missouri averageMissouri average: 22.0%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
59.9%
30% worse than Missouri averageMissouri average: 85.2%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
93.2%
In line with Missouri averageMissouri average: 90.9%
Number of hospitalizations per 1,000 long-stay resident days.
1.82
13% better than Missouri averageMissouri average: 2.08
Number of outpatient emergency department visits per 1,000 long-stay resident days.
1.79
24% better than Missouri averageMissouri average: 2.35
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
23.4%
65% worse than Missouri averageMissouri average: 66.6%
Percent of short-stay residents who newly received an antipsychotic medication
2.1%
6% better than Missouri averageMissouri average: 2.2%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
56.7%
11% worse than Missouri averageMissouri average: 63.5%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
15% of new residents, usually for short-term rehab.
38% of new residents, often for short stays.
48% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
69Residents meet regularly to discuss policies, care quality, and activities
Part of a Continuing Care Retirement Community offering multiple care levels
Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.
Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
Historical financial and operational data for Avenir at Mark Twain based on CMS SNF Cost Reports.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #102 / 286Payroll — State benchmarkedThis home is ranked 102nd out of 286 homes in Missouri. Shows total annual staff payroll benchmarked to the Missouri average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Most residents stay for extended periods and receive ongoing daily care.
0.0 miles from city center
Estimated distance in miles from Bridgeton's city center to Avenir at Mark Twain's address, calculated via Google Maps.
Add your location
Avenir at Mark Twain is located in BRIDGETON, Missouri.
Here are the financial assistance programs available to residents in Missouri.
The information below is reported by the Missouri Department of Health and Senior Services, Division of Regulation and Licensure.
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AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk. | Weldon Spring | 81 | 74.9% | +12% | 5.01 | -16% | +34% | $41.3k | 16 | 4.0 | 2 | 46 | A+ | 2 | Holly Stevens | $20.9M | $12.2M | 58.6% | 265767 | ||||
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AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
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| Avenir at Mark Twain |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Bridgeton | 120 | 62.5% | -6% | 4.18 | -58% | +12% | $195.3k | 43 | 3.9 | 2 | 75 | - | 4 | - | $7.6M | $4.4M | 57.9% | 265236 | ||||
| Sunrise of Des Peres |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
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The legal owner and operator of Avenir at Mark Twain is Nbh1 Mtopcollc.
Avenir at Mark Twain has a walk score of 4. Car-dependent. Most errands require a car, with limited nearby walkable options.
Avenir at Mark Twain's occupancy is 63%.
Emmanuel Jackson is the administrator of Avenir at Mark Twain.
Avenir at Mark Twain has 120 beds.
Yes — there are 2 photos of Avenir at Mark Twain in the photo gallery on this page.
Avenir at Mark Twain is located at 11988 MARK TWAIN LN.
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