Total health inspections
12
Missouri average 6.6
Last Health inspection on Sep 2025
Mostly long-term care residents
Most residents stay for extended periods and receive ongoing daily care.
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Nursing Home in Missouri
CMS overall rating
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.
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.
Lewis &Amp; Clark Gardens
Nursing Home in Missouri
CMS overall rating
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.
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.
Lewis &Amp; Clark Gardens
Lewis & Clark Gardens is a senior living community in St. Charles, MO. It offers a wide range of services including skilled nursing care, rehabilitation services, and various religious services. The facility provides a homelike environment with complete dining services and a commitment to resident well-being.
Quality ratings
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.
Nursing care per resident
This shows how many total hours of nursing staff time are available per resident each day. Higher numbers usually mean more staff support.
Capacity and availability
Medium-capacity home
Offers a balance of services and community atmosphere.
Total beds
142
This home usually has availability
Lower occupancy suggests more openings may be available.
Occupancy rate
52.8%
Residents per day (avg)
72
Occupancy rate
52.8%
Residents per day (avg)
72
Who this home usually serves
Show admissions and discharges
TYPE OF STAY
Might be optimal for
Long-term daily care
Ongoing support needs
Breakdown by payment type
Medicare
6% of new residents, usually for short-term rehab.
Typical stay
22 days
Private pay
33% of new residents, often for short stays.
Typical stay
2 - 3 months
Medicaid
60% of new residents, often for long-term daily care.
Typical stay
7 - 8 months
Finances and operations
Privately-owned community
Operated by a business corporation.
Home revenue
$5.8M
Operating loss
-$1.8M
Privately-owned community
Operated by a business corporation.
Home revenue
$5.8M
Operating loss
-$1.8M
Payroll costs
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
$2.9M
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Other operating costs
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
$4.7M
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Total costs
$7.6M
142-bed community
A larger shared setting that may offer more common spaces and organized community services.
31 years in operation
A longer operating history, which may indicate experience navigating regulations and delivering ongoing care.
BBB Rating: A+ (Not Accredited)
An independent rating from the Better Business Bureau based on factors such as complaint history, transparency, and business practices.
How BBB ratings work
How BBB ratings work
About this community
Facility TypeSnf
CountySAINT CHARLES
CMS Certification Number265160
Certification TypeMedicare/Medicaid
Lewis &Amp; Clark Gardens is administrated by Amanda Marsten.
Owner NameN & R OF ST CHARLES, LLC
Staffing
Key information about the people who lead and staff this community.
ContactLynette Klos
Accept Medicaid
Accept Medicare
Rehabilitation Services
Respite Care
Short-Term Rehab
Doctor on Staff
Skilled Nursing
24-Hour Staffing
Skilled Nursing Care
Physical And Occupational Therapies
Dietitians
Behavioral And Alzheimer’s Care
Activities
Hospice
24 Hour Professional Nursing Services
Beautifully Landscaped Surroundings
Fenced Courtyard
Professional Medical Care
Admissions 7 Days/Week
Various Religious Services
Ice Cream Parlor
Semi-Private Or Private Rooms
State Of The Art Rehabilitation Program
Podiatry & Optical Services
Homelike Environment
Soothing Aviary
Professional Beauty/Barber Shop
Cable Television
Unlimited Visiting Hours
Hospice Care
Respite Care
Iv Therapy
Seasonal Resident Garden
Pharmacy Services
Trach Care
Specific Programs24 Hour Professional Nursing Services, Professional Medical Care, Rehab Services, Complete Dining Services, Hospice Care, Respite Care, Community Involvement & Volunteer Program
Religious ServicesVarious Religious Services
Volunteer ProgramsYes
Semi-Private –$190.00/day
Private –$213.00/day
Food DescriptionComplete dining services with a variety of nutritious meals and snacks based on individual preferences.
Meals IncludedYes
Access & Eligibility
Ways to qualify for care at this community, including accepted programs and payment options.
Medicaid Accepted
This facility is certified for eligible Medicaid services.
Medicare Accepted
This facility is certified for eligible Medicare services.
Health Inspection History
Inspections
Total health citations
57
Missouri average 36.5
Citations per inspection
4.75
Missouri average 5.67
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
32 of 57 citations resulted from standard inspections; 22 of 57 resulted from complaint investigations; and 3 of 57 came from combined inspections (standard and complaint).
Breakdown of citation severity (last 3 years)
Critical Health citations
3
3
329% worse than Missouri averageMissouri average: 0.7
Serious Health citations
1
1
In line with Missouri averageMissouri average: 1
3 critical citations
1 serious citation
52 moderate citations
1 minor citation
Citations history (last 3 years)
Quality of Care moderate citation
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Sep 15, 2025
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Sep 15, 2025
Corrected
Abuse/Neglect serious citation
Issues related to protecting resident's from harm, including abuse, neglect, or mistreatment.
Jun 23, 2025
Issues related to protecting resident's from harm, including abuse, neglect, or mistreatment.
Jun 23, 2025
Corrected
Abuse/Neglect moderate citation
Issues related to protecting resident's from harm, including abuse, neglect, or mistreatment.
Jun 23, 2025
Issues related to protecting resident's from harm, including abuse, neglect, or mistreatment.
Jun 23, 2025
Corrected
Care Planning moderate citation
Issues related to creating and updating personalized care plans for residents based on their needs and conditions.
Jun 23, 2025
Issues related to creating and updating personalized care plans for residents based on their needs and conditions.
Jun 23, 2025
Corrected
Data sourced from CMS Health Deficiencies reports. Citation severity codes range from A (least serious) to L (most serious). Immediate Jeopardy (J-L) citations indicate situations where the facility's noncompliance has placed residents at risk of death or serious harm.
Compare Nursing Homes around Missouri The information below is reported by the Missouri Department of Health and Senior Services, Division of Regulation and Licensure.
Filter by care type
Aberdeen Heights
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.
Kirkwood
38
92.6%
+39%
5.18
+39%
0
9
2.3
0
34
-
-
Ashfield Active Living And Wellness Communities, Inc.
$27.3M
$7.2M
26.3%
265841
Bertrand Nursing And Rehab Center
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.
Bertrand
60
78.8%
+18%
3.65
-2%
0
10
3.3
0
54
-
5
Chance, Don
$5.1M
$2.3M
44.1%
265678
Lewis &Amp; Clark Gardens
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.
Saint Charles
142
52.8%
-21%
4.07
+9%
4
57
4.8
4
72
A+
-
Yates, Melissa
$5.8M
$2.9M
50.5%
265160
Good Shepherd Care Community
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.
HC
Home Care Professional care delivered in the person's own home — from companionship and errands to skilled nursing and therapy. Allows seniors to age in place. Medicare covers skilled home health when medically necessary.
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.
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).
RC
Respite Care Short-term temporary care — days to weeks — to give family caregivers a break. Full care provided during the stay. Often used after hospitalization or to trial a facility before a permanent placement decision.
Concordia
-
-
-
-
-
0
0
0.0
0
-
-
38
-
-
-
-
-
Abbey Senior Health
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.
O'fallon
55
-
-
-
-
0
0
0.0
0
-
-
-
-
-
-
-
-
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Staffing Data (Q2 2025)
This data corresponds to Q2 2025 and is based on CMS Payroll-Based Journal.
Total staff
104
Employees
87
Contractors
17
Staff to resident ratio
1.27:1
26% worse than Missouri averageMissouri average ratio: 1.71:1
Avg staff/day
35
Average shift
8.1 hours
0% compared with Missouri averageMissouri average: 8.1 hours
Total staff hours (quarter)
25,895
Nursing staff breakdown
Registered Nurse
Manages medical care and health needs.
Total count
6
Average shift length
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.4 hours
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.4 hoursNo contractors work on this role.
Licensed Practical Nurse
Assists with medical care and medications.
Total count
12
Average shift length
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.9 hours
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.9 hoursNo contractors work on this role.
Certified Nursing Assistant
Helps with daily care and mobility.
Total count
33
Average shift length
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.2 hours
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.2 hoursNo contractors work on this role.
Contractor staffing
Total hours from contractors
2.1%
542 contractor hours this quarter
Physical Therapy Aide: 5
Qualified Social Worker: 4
Physical Therapy Assistant: 3
Respiratory Therapy Technician: 2
Speech Language Pathologist: 1
Occupational Therapy Assistant: 1
Occupational Therapy Aide: 1
Staff by category
| Certified Nursing Assistant | 33 | 0 | 33 | 9,726 | 91 | 100% | 8.2 |
| Medication Aide/Technician | 15 | 0 | 15 | 5,581 | 91 | 100% | 9.1 |
| Licensed Practical Nurse | 12 | 0 | 12 | 3,845 | 91 | 100% | 7.9 |
| Nurse Aide in Training | 10 | 0 | 10 | 2,064 | 90 | 99% | 7.6 |
| Clinical Nurse Specialist | 2 | 0 | 2 | 974 | 76 | 84% | 8.3 |
| Registered Nurse | 6 | 0 | 6 | 913 | 74 | 81% | 8.4 |
| Dental Services Staff | 2 | 0 | 2 | 764 | 73 | 80% | 7.7 |
| Administrator | 2 | 0 | 2 | 451 | 56 | 62% | 8.1 |
| Dietitian | 2 | 0 | 2 | 397 | 55 | 60% | 7.2 |
| Speech Language Pathologist | 0 | 1 | 1 | 306 | 51 | 56% | 6 |
| RN Director of Nursing | 1 | 0 | 1 | 277 | 31 | 34% | 8.9 |
| Other Dietary Services Staff | 1 | 0 | 1 | 238 | 40 | 44% | 6 |
| Nurse Practitioner | 1 | 0 | 1 | 123 | 15 | 16% | 8.2 |
| Physical Therapy Aide | 0 | 5 | 5 | 87 | 22 | 24% | 3.9 |
| Physical Therapy Assistant | 0 | 3 | 3 | 42 | 14 | 15% | 3 |
| Qualified Social Worker | 0 | 4 | 4 | 38 | 39 | 43% | 1 |
| Occupational Therapy Aide | 0 | 1 | 1 | 35 | 6 | 7% | 5.9 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 29 | 7 | 8% | 4.1 |
| Respiratory Therapy Technician | 0 | 2 | 2 | 5 | 3 | 3% | 1.8 |
33 Certified Nursing Assistant
% of Days
100%
15 Medication Aide/Technician
% of Days
100%
12 Licensed Practical Nurse
% of Days
100%
10 Nurse Aide in Training
% of Days
99%
2 Clinical Nurse Specialist
% of Days
84%
6 Registered Nurse
% of Days
81%
2 Dental Services Staff
% of Days
80%
2 Administrator
% of Days
62%
2 Dietitian
% of Days
60%
1 Speech Language Pathologist
% of Days
56%
1 RN Director of Nursing
% of Days
34%
1 Other Dietary Services Staff
% of Days
44%
1 Nurse Practitioner
% of Days
16%
5 Physical Therapy Aide
% of Days
24%
3 Physical Therapy Assistant
% of Days
15%
4 Qualified Social Worker
% of Days
43%
1 Occupational Therapy Aide
% of Days
7%
1 Occupational Therapy Assistant
% of Days
8%
2 Respiratory Therapy Technician
% of Days
3%
Facility Characteristics
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total census
82 residents
Residents by payment source
Medicare
1 resident (1.2%)
Medicaid
72 residents (87.8%)
Private pay or other
9 residents (11%)
Programs & Services
Residents' Group
Residents meet regularly to discuss policies, care quality, and activities
Active Resident Council
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.
Quality of care over time
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
High-risk clinical events score
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
11.9
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
11.9
9% worse than Missouri averageMissouri average: 10.9
Functional decline score
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
19.9
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
19.9
In line with Missouri averageMissouri average: 19.5
Long-stay resident measures
Need for Help with Daily Activities Increased
Percent of long-stay residents whose need for help with daily activities has increased
22.0%
Percent of long-stay residents whose need for help with daily activities has increased
22.0%
11% worse than Missouri averageMissouri average: 19.8%
Walking Ability Worsened
Percent of long-stay residents whose ability to move independently worsened
17.8%
Percent of long-stay residents whose ability to move independently worsened
17.8%
14% better than Missouri averageMissouri average: 20.6%
Low Risk Residents with Bowel/Bladder Incontinence
Percent of low risk long-stay residents who lose control of their bowels or bladder
19.8%
Percent of low risk long-stay residents who lose control of their bowels or bladder
19.8%
9% worse than Missouri averageMissouri average: 18.1%
Falls with Major Injury
Percent of long-stay residents experiencing one or more falls with major injury
10.1%
Percent of long-stay residents experiencing one or more falls with major injury
10.1%
150% worse than Missouri averageMissouri average: 4.0%
High Risk Residents with Pressure Ulcers
Percent of long-stay high risk residents with pressure ulcers
9.3%
Percent of long-stay high risk residents with pressure ulcers
9.3%
85% worse than Missouri averageMissouri average: 5.0%
Urinary Tract Infection
Percent of long-stay residents with a urinary tract infection
4.4%
Percent of long-stay residents with a urinary tract infection
4.4%
63% worse than Missouri averageMissouri average: 2.7%
Lost Too Much Weight
Percent of long-stay residents who lose too much weight
0.3%
Percent of long-stay residents who lose too much weight
0.3%
94% better than Missouri averageMissouri average: 5.6%
Depressive Symptoms
Percent of long-stay residents who have depressive symptoms
1.1%
Percent of long-stay residents who have depressive symptoms
1.1%
91% better than Missouri averageMissouri average: 12.8%
Antipsychotic Use
Percent of long-stay residents who received an antipsychotic medication
14.7%
Percent of long-stay residents who received an antipsychotic medication
14.7%
33% better than Missouri averageMissouri average: 22.0%
Pneumococcal Vaccine
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
83.9%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
83.9%
In line with Missouri averageMissouri average: 85.2%
Influenza Vaccine
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
96.6%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
96.6%
6% better than Missouri averageMissouri average: 90.9%
Short-stay resident measures
Pneumococcal Vaccine
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
46.2%
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
46.2%
31% worse than Missouri averageMissouri average: 66.6%
Antipsychotic medication increase
Percent of short-stay residents who newly received an antipsychotic medication
0.0%
Percent of short-stay residents who newly received an antipsychotic medication
0.0%
100% better than Missouri averageMissouri average: 2.2%
Influenza Vaccine
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
8.3%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
8.3%
87% 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.
Penalties and fines
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)
Total fines amount
$140K
91% higher than Missouri averageMissouri average: $73K
Number of fines
3
23% more fines than Missouri averageMissouri average: 2.4
Payment Denials
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
1
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
1
45% more payment denials than Missouri averageMissouri average: 0.7
Fines amount comparison
Fines amount comparison
This facility
$140K
Missouri average
$73K
Penalty History
Penalties are imposed by CMS for violations of federal nursing home regulations.
Civil Money Penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Jun 23, 2025
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Jun 23, 2025
$63K
Civil Money Penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Apr 24, 2025
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Apr 24, 2025
$17K
Civil Money Penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
May 15, 2024
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
May 15, 2024
$59K
Payment Denial
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
May 15, 2024
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
May 15, 2024
33 days
Last updated: Jan 2026
Financial Trends
Historical financial and operational data for Lewis &Amp; Clark Gardens based on CMS SNF Cost Reports.
Occupancy Rate
52.8%
↓ 0.3pp vs 2022
Net Income
-$1.8M
↓ ~$424.0K vs 2022
Total Payroll
$4.4M
↑ ~$342.7K vs 2022
Profit Margin
-30.2%
↓ 7.9pp vs 2022
Loading trend charts...
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Understanding Senior Living Costs: Pricing Models, Discounts & Financial Assistance
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