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CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
The 120-bed skilled nursing facility at Avenir at Mark Twain is located on Mark Twain Lane in Bridgeton, Missouri, under administrator Cory Sterling and operator Nbh1 Mtopcollc. Financial billing processes accommodate multiple coverage plans, accepting Medicare, Medicaid, and private pay options. If you are planning a visit, the local surroundings carry a walkability score of 4 out of 100, which indicates a heavily car-dependent setup where family members will require a personal vehicle for all errands and trips to the campus.
Operational logs show that the property maintains a 63 percent occupancy rate, with an average length of stay around 104 days. This operational timeline confirms a focus on temporary post-hospital therapy and subacute recovery tracks rather than multi-year residential placements. To oversee routine medical schedules and daily personal care tasks, the 24-hour staffing framework provides an average of 4 hours and 11 minutes of total nursing care per resident each day, with nurse aides supplying 3 hours and 4 minutes of direct, hands-on assistance.
State databases from public health departments maintain documented logs of the facility’s compliance history. Recent standard health and safety reviews indicate that inspectors identified specific compliance deficiencies concerning standard infection control protocols, staff training routines for nurse aides, and meal service temperatures, which means the property’s total cumulative citations-per-inspection rate is not zero, and these items remain part of ongoing regional tracking.
Older adults have access to an on-site therapy gym, indoor lounges, and designated outdoor relaxation areas. The everyday calendar coordinates physical recovery tracks and structured activities, such as exercise loops, musical sessions, and crafts, with restaurant-style dining options adapted to standard therapeutic parameters. Daily operations combine these services with full room cleaning, laundry assistance, and flexible family visiting windows.
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 for nurse hours. 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 legally operated by Nbh1 Mtopcollc, and administrated by Cory Sterling.
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 |
An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.
Missouri 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% more staff per resident 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.
9 total: 7 full-time employees and 2 contractors.
9
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.5 hoursAssists with medical care and medications.
50 total: 11 full-time employees and 39 contractors.
50
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.8 hoursHelps with daily care and mobility.
152 total: 53 full-time employees and 99 contractors.
152
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.7 hours
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.
| Breeze Park – Lutheran Senior Services |
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.
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 | 50
Facility
50
MO AVG
97
Rank
#390 / 454 | - | - | 5.01
Facility
5.01
MO AVG
3.74
Rank
#31 / 276 | -16% | +34% | $41.3k
Facility
$41.3k
MO AVG
$76.9k
Rank
#222 / 283 | 16
Facility
16
MO AVG
36.5
Rank
#55 / 281 | 4.0
Facility
4.0
MO AVG
5.7
Rank
#75 / 281 | 2 | 46 | A+ |
2
Facility
2
MO AVG
45
Rank
#545 / 563 | Holly Stevens | $20.9M
Facility
$20.9M
MO AVG
$8.4M
Rank
#17 / 286 | $12.2M
Facility
$12.2M
MO AVG
$3.3M
Rank
#6 / 286 | 58.6%
Facility
58.6%
MO AVG
45.6%
Rank
#105 / 286 | 265767 | ||||
| Farmington Presbyterian Manor |
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.
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. | Farmington | 90
Facility
90
MO AVG
97
Rank
#227 / 454 |
74.4%
Facility
74.4%
MO AVG
66.6%
Rank
#150 / 428 | +12% | 4.58
Facility
4.58
MO AVG
3.74
Rank
#43 / 276 | +49% | +23% | $12.6k
Facility
$12.6k
MO AVG
$76.9k
Rank
#167 / 283 | 9
Facility
9
MO AVG
36.5
Rank
#11 / 281 | 2.3
Facility
2.3
MO AVG
5.7
Rank
#11 / 281 | 1 | 70 | A+ |
66
Facility
66
MO AVG
45
Rank
#113 / 563 | Jane Hull | $9.9M
Facility
$9.9M
MO AVG
$8.4M
Rank
#73 / 286 | $6.3M
Facility
$6.3M
MO AVG
$3.3M
Rank
#52 / 286 | 63%
Facility
63%
MO AVG
45.6%
Rank
#74 / 286 | 265583 | ||||
| Armour Oaks Senior Living Community |
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.
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. | Kansas City (Waldo Homes) | 38
Facility
38
MO AVG
97
Rank
#424 / 454 |
100.0%
Facility
100.0%
MO AVG
66.6%
Rank
#1 / 428 | +50% | 3.03
Facility
3.03
MO AVG
3.74
Rank
#230 / 276 | -27% | -19% | $0
Facility
$0
MO AVG
$76.9k
Rank
#1 / 283 | 39
Facility
39
MO AVG
36.5
Rank
#183 / 281 | 6.5
Facility
6.5
MO AVG
5.7
Rank
#200 / 281 | - | 100 | A+ |
73
Facility
73
MO AVG
45
Rank
#70 / 563 | Womens Christian Association Of Kansas City Missouri | $2.9M
Facility
$2.9M
MO AVG
$8.4M
Rank
#264 / 286 | $2.4M
Facility
$2.4M
MO AVG
$3.3M
Rank
#221 / 286 | 81.6%
Facility
81.6%
MO AVG
45.6%
Rank
#13 / 286 | 265802 | ||||
| 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.
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. | Des Peres | 102
Facility
102
MO AVG
97
Rank
#169 / 454 |
72.5%
Facility
72.5%
MO AVG
66.6%
Rank
#166 / 428 | +9% | 3.50
Facility
3.50
MO AVG
3.74
Rank
#168 / 276 | +4% | -6% | $334.9k
Facility
$334.9k
MO AVG
$76.9k
Rank
#277 / 283 | 87
Facility
87
MO AVG
36.5
Rank
#272 / 281 | 7.9
Facility
7.9
MO AVG
5.7
Rank
#243 / 281 | 13 | 74 | A+ |
50
Facility
50
MO AVG
45
Rank
#244 / 563 | Mary Grodeon | $15.6M
Facility
$15.6M
MO AVG
$8.4M
Rank
#32 / 286 | $7.7M
Facility
$7.7M
MO AVG
$3.3M
Rank
#31 / 286 | 49.2%
Facility
49.2%
MO AVG
45.6%
Rank
#186 / 286 | 265834 | ||||
| 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
Facility
120
MO AVG
97
Rank
#89 / 454 |
62.5%
Facility
62.5%
MO AVG
66.6%
Rank
#245 / 428 | -6% | 4.18
Facility
4.18
MO AVG
3.74
Rank
#75 / 276 | -58% | +12% | $195.3k
Facility
$195.3k
MO AVG
$76.9k
Rank
#269 / 283 | 43
Facility
43
MO AVG
36.5
Rank
#196 / 281 | 3.9
Facility
3.9
MO AVG
5.7
Rank
#72 / 281 | 2 | 76 | - |
4
Facility
4
MO AVG
45
Rank
#530 / 563 | - | $7.6M
Facility
$7.6M
MO AVG
$8.4M
Rank
#111 / 286 | $4.4M
Facility
$4.4M
MO AVG
$3.3M
Rank
#102 / 286 | 57.9%
Facility
57.9%
MO AVG
45.6%
Rank
#112 / 286 | 265236 |
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.
According to MO state health department records, Avenir at Mark Twain's license number is 053265.
According to MO state health department records, Avenir at Mark Twain's license expires on February 24, 2027.
Avenir at Mark Twain's occupancy is 63%.
Cory Sterling is the administrator of Avenir at Mark Twain.
Avenir at Mark Twain has 120 beds.
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