Mostly long-term care residents
Most residents stay for extended periods and receive ongoing daily care.
Most new residents arrive under Medicaid (60% of admissions), and a typical Medicaid stay runs around 7 - 8 months.
Located on Boones Lick Road in Saint Charles, Missouri, Lewis & Clark Gardens is a 142-bed skilled nursing facility operated by N & R Of St Charles, LLC under the ownership of Melissa Yates, with Amanda Marsten serving as administrator. The home has been operating for 31 years and accepts Medicare, Medicaid, and private pay, giving families several options for covering rehabilitation and long-term care costs. Operating at 60% occupancy, the facility serves residents who stay an average of 135 days. The surrounding area has a Walk Score of 87, so it’s highly walkable and convenient for family visits and nearby errands.
Rehabilitation services are a major focus of the community’s care program. Residents have access to short-term rehabilitation, physical therapy, occupational therapy, physician services, and 24-hour nursing support. Behavioral health services, Alzheimer’s care, dietitian support, and hospice care are also available. Residents receive an average of 4 hours and 4 minutes of nursing care each day from registered nurses, nurse aides, and LPN/LVN staff.
State inspections conducted by the Department of Health and Senior Services have identified concerns regarding allegation reporting, investigative procedures, personal care, bathing assistance, wound care, and food service practices. Families considering the home should review recent inspection findings and ask how these areas are monitored and managed.
Residents receive meals tailored to their dietary needs and personal preferences. The facility also features a fenced courtyard, seasonal resident garden, beauty and barber services, an ice cream parlor, and a home-like environment. With more than three decades of operation and a walkable location in Saint Charles, Lewis & Clark Gardens has been an established part of the local community.
Lewis & Clark Gardens is legally operated by N & R Of St Charles, LLC, and administered by Amanda Marsten.
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.
Deficiencies
| This Facility | MO Average | vs. MO Avg |
|---|---|---|---|
|
Total deficiencies
| 189 | 64 | This facility has 195% more total deficiencies than a typical Missouri nursing home (189 vs. MO avg 64).↑ 195% worse |
|
Deficiencies per inspection
| 6.1 | 5.3 | This facility has 15% more deficiencies per inspection than a typical Missouri nursing home (6.1 vs. MO avg 5.3).↑ 15% worse |
Inspections
| This Facility | MO Average | vs. MO Avg |
|---|---|---|---|
|
Total inspections
| 31 | 12 | This facility has had 158% more total inspections than the Missouri average (31 vs. MO avg 12). More inspections can mean more regulatory scrutiny rather than worse care.↑ 158% more |
Federal inspection data published by CMS, covering this home's Medicare and/or Medicaid-certified skilled-nursing/nursing beds only.
State average 6.6
Last Health inspection on Sep 2025
State average 36.5
State 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).
State average: 0.7
State average: 1
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
Manages medical care and health needs.
Assists with medical care and medications.
Helps with daily care and mobility.
Total hours from contractors
790 contractor hours this quarter
| Certified Nursing Assistant | 27 | 0 | 27 | 10,991 | 92 | 100% | 8.4 |
| Nurse Aide in Training | 18 | 0 | 18 | 6,020 | 92 | 100% | 8.6 |
| Medication Aide/Technician | 11 | 0 | 11 | 5,251 | 92 | 100% | 8.8 |
| Licensed Practical Nurse | 9 | 0 | 9 | 2,917 | 92 | 100% | 7.5 |
| Registered Nurse | 7 | 0 | 7 | 2,036 | 92 | 100% | 9.3 |
| RN Director of Nursing | 2 | 0 | 2 | 1,001 | 72 | 78% | 7.7 |
| Dental Services Staff | 1 | 0 | 1 | 580 | 71 | 77% | 8.2 |
| Dietitian | 1 | 0 | 1 | 513 | 66 | 72% | 7.8 |
| Administrator | 1 | 0 | 1 | 507 | 66 | 72% | 7.7 |
| Nurse Practitioner | 1 | 0 | 1 | 430 | 57 | 62% | 7.5 |
| Speech Language Pathologist | 0 | 1 | 1 | 378 | 62 | 67% | 6.1 |
| Other Dietary Services Staff | 1 | 0 | 1 | 313 | 40 | 43% | 7.8 |
| Physical Therapy Aide | 0 | 2 | 2 | 139 | 45 | 49% | 2.8 |
| Qualified Social Worker | 0 | 1 | 1 | 94 | 52 | 57% | 1.8 |
| Physical Therapy Assistant | 0 | 3 | 3 | 73 | 32 | 35% | 2.3 |
| Clinical Nurse Specialist | 1 | 0 | 1 | 55 | 9 | 10% | 6.1 |
| Respiratory Therapy Technician | 0 | 3 | 3 | 45 | 34 | 37% | 1.3 |
| Occupational Therapy Aide | 0 | 1 | 1 | 32 | 4 | 4% | 8 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 29 | 6 | 7% | 4.8 |
Includes penalties issued in 2024-2025
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)
Penalties are imposed by CMS for violations of federal nursing home regulations.
4 penalties in the past 3 years
Multiple penalties were reported in the last 3 years.
Last updated: Jan 2026
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
6% of new residents, usually for short-term rehab.
33% of new residents, often for short stays.
60% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Residents meet regularly to discuss policies, care quality, and activities
Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.
Historical financial and operational data for Lewis & Clark Gardens from 2011–2023, based on CMS SNF Cost Reports.
Key figures below are for fiscal year ending in 12/2023.
Based on CMS SNF Cost Report for fiscal year ending in 12/2023.
Most residents stay for extended periods and receive ongoing daily care.
Most new residents arrive under Medicaid (60% of admissions), and a typical Medicaid stay runs around 7 - 8 months.
Coverage residents most often arrive under.
Coverage residents most often leave under.
0.0 miles from city center
Estimated distance in miles from Saint Charles's city center to Lewis & Clark Gardens's address, calculated via Google Maps.
Add your location
Info below is compiled from CMS reports & the MO Dept. of Health & Senior Services (DHSS), senior community websites & trusted data sources such as Walk Score & BBB.
Communities are listed from highest to lowest based on our ranking methodology.
The facility name. Click to view the full profile page on Assisted Living Magazine, including photos, services, and contact info.
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CMS (Centers for Medicare & Medicaid Services, the federal agency that regulates nursing homes) Overall 5-star rating — a composite of Health Inspection, Staffing, and Quality Measures scores. 5 stars = top 10% nationally. 1 star = bottom 10%. The single most important number to start with when comparing facilities.
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Care Types in This Table
AL (Assisted Living):
Housing with help for daily activities like bathing, dressing, and medication, without 24-hour skilled nursing.
NH (Nursing Home):
24/7 skilled nursing care for residents with complex, ongoing medical needs.
SNF (Skilled Nursing Facility):
Round-the-clock nursing care, often for recovery after surgery, injury, or illness.
MC (Memory Care):
Secured, specialized care for people living with Alzheimer's or dementia.
RC (Respite Care):
Short-term temporary care that gives family caregivers a break.
IL (Independent Living):
Community living with dining, activities, and transportation for active seniors who need little personal care.
HOS (Hospice Care):
Comfort-focused care for those with a terminal illness, prioritizing quality of life over treatment.
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Neighborhood or city area where the facility is located. Proximity to family, hospitals, and green space matters for both quality of life and ease of visitation. Consider drive time and transit access when evaluating location.
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Licensed bed capacity. Larger facilities (300+ beds) often have more specialized programs but can feel institutional. Smaller homes (under 150 beds) tend to deliver more personalized care. Compare with Avg Res/Day to understand how full the facility typically runs.
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Percentage of licensed beds filled on an average day. Color indicates financial health: green (90%+) = operationally strong, typically profitable. Amber (80–89%) = stable but leaving revenue on the table. Orange (70–79%) = financial strain likely, may struggle with fixed costs. Red (<70%) = significant distress, closure or ownership change risk increases sharply.
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This facility's occupancy rate compared to the statewide average for similar facilities. A positive number means above-average demand. Facilities running 5%+ above the state average are typically the most sought-after in their market — a strong proxy for reputation.
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CMS-adjusted total nurse hours per resident per day (RN + LPN + CNA combined). The national average is approximately 3.5 hrs. Higher is better — more direct care time per resident. Below 3.0 is a red flag. CMS weights RN hours more heavily because RNs handle complex clinical decisions that CNAs cannot.
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CMS Health Inspection star rating (1–5 stars), based on the 3 most recent annual state surveys plus any complaint investigations. This is the hardest rating to manipulate — it reflects real surveyor findings on-site. 5 stars = fewest deficiencies found. 1 star = most. It carries the heaviest weight in the Overall CMS rating.
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CMS Staffing star rating (1–5 stars), based on daily nurse staffing hours submitted to CMS via verified payroll data. Compares RN, LPN, and CNA coverage relative to resident acuity level. 5 stars = well above expected staffing. Weekend staffing is evaluated separately, as that's where many facilities quietly reduce coverage.
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CMS Quality Measures star rating (1–5 stars), based on 15 clinical outcome metrics including fall rates, pressure ulcers, antipsychotic drug use, and hospital readmissions. Captures actual resident health outcomes, not just compliance. High QM combined with low Health Inspection scores can indicate a facility with strong care but weak documentation practices.
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Registered Nurse hours per resident/day compared to the statewide average. RNs are the highest-skilled nursing staff — they assess residents, manage medications, and respond to emergencies. A value of +50% means RN coverage is 50% above the state norm. Negative values are a concern for residents with complex or acute medical needs.
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Total nursing staff hours (RN + LPN + CNA combined) per resident/day vs. the statewide average. A broader measure than RN vs State — it captures the entire care team. A facility can have high total staffing but low RN hours, meaning more aides and fewer nurses. Read both columns together for the full picture.
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Total dollar amount of federal monetary fines (civil money penalties) issued by CMS in the past 3 years. Fines are only levied for serious violations — typically actual harm to residents, repeated uncorrected deficiencies, or systemic non-compliance. Even a single fine is noteworthy. Multiple fines strongly suggest a pattern, not isolated incidents.
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Total health deficiency citations from the most recent standard inspection cycle. Minor citations (scope A–C) are common and often administrative in nature. Higher counts aren't always disqualifying, but should be read alongside Severe Citations to understand actual harm levels. Under 10 is strong for a large facility; 30+ warrants a closer look.
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Average deficiency citations per CMS inspection (survey) in the reporting window — total citations divided by the number of inspections. Lower is better; compare alongside total Citations and Severe Citations for context.
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Citations at CMS scope/severity level G or higher — G–I means actual harm occurred; J–L means residents were placed in immediate jeopardy. (D–F is potential for harm only). Examples include unaddressed falls, medication errors causing injury, neglect, or abuse.
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Average number of residents in the building on any given day, derived from annual census data. Reflects true operating scale — a 400-bed facility running 200 residents/day operates very differently from one at 390. Higher resident counts generally mean more funded staffing hours.
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Better Business Bureau rating (A+ to F). Reflects complaint history, business transparency, and how family disputes were resolved. A+ means no significant unresolved complaints. A blank (—) means the facility isn't BBB-accredited, which is common for healthcare providers and not necessarily a negative signal.
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Walk Score® (0–100). Measures walkability of the surrounding area. 90–100 = Walker's Paradise. 70–89 = Very Walkable. 50–69 = Somewhat Walkable. Below 50 = Car-Dependent. Higher scores benefit family visitors, resident outings, and staff commuting.
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The licensed owner or operator of record filed with CMS — the individual or organization legally accountable for the facility. Searching the operator name across other facilities can reveal chain or multi-site ownership, which matters: chain-operated homes tend to have more variable quality outcomes than independently run facilities.
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What the home actually collects for resident care, after contractual allowances, bad debt and discounts — not gross billings. Taken from the latest complete annual cost report, so it is comparable across homes reporting the same period. Revenue alone doesn't indicate care quality, but it funds staffing and capital reinvestment. Pair with Payroll %. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
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Staff salaries plus wage-related benefits from the latest complete annual cost report. Contract and agency labour is counted separately, under other operating costs, so a home leaning on agency staff can show a low figure here. Payroll is the cost most directly tied to care quality — compare with Payroll % for full context. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
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Payroll as a share of NET PATIENT REVENUE (not gross revenue). Both figures come from the same cost-report year. A higher figure means more of each revenue dollar goes to staff pay. Read with the Staffing star rating to judge whether spend translates into coverage — and note that homes whose patient revenue covers only part of their operation can read implausibly high. The Missouri average is: 54.9% Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
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CMS Certification Number: the unique federal identifier for this skilled nursing provider.
|
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Laclede Groves | NH AL IL MC SNF | St. Louis | 251
Facility
251
MO AVG
96
Rank
#3 / 450 |
40.9%
Facility
40.9%
MO AVG
66.5%
Rank
#365 / 407 | -39% | 5.27
Facility
5.27
MO AVG
3.74
Rank
#20 / 268 | +48% | +41% | $0
Facility
$0
MO AVG
$76.9k
Rank
#1 / 276 | 9
Facility
9
MO AVG
36.5
Rank
#10 / 274 | 4.5
Facility
4.5
MO AVG
5.7
Rank
#99 / 274 | - | 103 | - |
35
Facility
35
MO AVG
46
Rank
#353 / 545 | John Komlos | $24.9MFiscal year ending 12/2023
Facility
$24.9MFiscal year ending 12/2023
MO AVG
$7.4M
Rank
#3 / 251 | $27.4MFiscal year ending 12/2023
Facility
$27.4MFiscal year ending 12/2023
MO AVG
$3.9M
Rank
#2 / 251 | 109.9%Fiscal year ending 12/2023
Facility
109.9%Fiscal year ending 12/2023
MO AVG
54.9%
Rank
#1 / 251 | 265600 | ||||
| Linden Woods Village | NH AL IL SNF | Gladstone | 40
Facility
40
MO AVG
96
Rank
#415 / 450 |
85.0%
Facility
85.0%
MO AVG
66.5%
Rank
#73 / 407 | +28% | 4.20
Facility
4.20
MO AVG
3.74
Rank
#65 / 268 | +31% | +12% | $0
Facility
$0
MO AVG
$76.9k
Rank
#1 / 276 | 12
Facility
12
MO AVG
36.5
Rank
#27 / 274 | 4.0
Facility
4.0
MO AVG
5.7
Rank
#71 / 274 | - | 34 | - |
53
Facility
53
MO AVG
46
Rank
#216 / 545 | Amanda Fizer | $8.5MFiscal year ending 12/2023
Facility
$8.5MFiscal year ending 12/2023
MO AVG
$7.4M
Rank
#67 / 251 | $3.8MFiscal year ending 12/2023
Facility
$3.8MFiscal year ending 12/2023
MO AVG
$3.9M
Rank
#93 / 251 | 44.8%Fiscal year ending 12/2023
Facility
44.8%Fiscal year ending 12/2023
MO AVG
54.9%
Rank
#207 / 251 | 265855 | ||||
| St. Clair Nursing Center | NH HOS MC SNF | St Clair | 79
Facility
79
MO AVG
96
Rank
#273 / 450 |
73.4%
Facility
73.4%
MO AVG
66.5%
Rank
#159 / 407 | +10% | 3.81
Facility
3.81
MO AVG
3.74
Rank
#116 / 268 | -19% | +2% | $12.7k
Facility
$12.7k
MO AVG
$76.9k
Rank
#170 / 276 | 7
Facility
7
MO AVG
36.5
Rank
#6 / 274 | 2.3
Facility
2.3
MO AVG
5.7
Rank
#10 / 274 | - | 58 | A+ |
48
Facility
48
MO AVG
46
Rank
#261 / 545 | St. Clair Nursing LLC | $5.7MFiscal year ending 12/2023
Facility
$5.7MFiscal year ending 12/2023
MO AVG
$7.4M
Rank
#125 / 251 | $3.1MFiscal year ending 12/2023
Facility
$3.1MFiscal year ending 12/2023
MO AVG
$3.9M
Rank
#131 / 251 | 55.5%Fiscal year ending 12/2023
Facility
55.5%Fiscal year ending 12/2023
MO AVG
54.9%
Rank
#105 / 251 | 265495 | ||||
| Farmington Presbyterian Manor | NH AL IL MC SNF | Farmington | 90
Facility
90
MO AVG
96
Rank
#225 / 450 |
74.4%
Facility
74.4%
MO AVG
66.5%
Rank
#147 / 407 | +12% | 4.33
Facility
4.33
MO AVG
3.74
Rank
#59 / 268 | +49% | +16% | $12.6k
Facility
$12.6k
MO AVG
$76.9k
Rank
#169 / 276 | 9
Facility
9
MO AVG
36.5
Rank
#10 / 274 | 2.3
Facility
2.3
MO AVG
5.7
Rank
#10 / 274 | 1 | 67 | A+ |
66
Facility
66
MO AVG
46
Rank
#113 / 545 | Jane Hull | $8.7MFiscal year ending 06/2024
Facility
$8.7MFiscal year ending 06/2024
MO AVG
$7.4M
Rank
#65 / 251 | $4.7MFiscal year ending 06/2024
Facility
$4.7MFiscal year ending 06/2024
MO AVG
$3.9M
Rank
#61 / 251 | 53.6%Fiscal year ending 06/2024
Facility
53.6%Fiscal year ending 06/2024
MO AVG
54.9%
Rank
#128 / 251 | 265583 | ||||
| Lewis & Clark Gardens | NH HOS RC SNF | Saint Charles | 142
Facility
142
MO AVG
96
Rank
#64 / 450 |
59.9%
Facility
59.9%
MO AVG
66.5%
Rank
#269 / 407 | -10% | 4.86
Facility
4.86
MO AVG
3.74
Rank
#26 / 268 | -1% | +30% | $139.9k
Facility
$139.9k
MO AVG
$76.9k
Rank
#256 / 276 | 57
Facility
57
MO AVG
36.5
Rank
#235 / 274 | 4.8
Facility
4.8
MO AVG
5.7
Rank
#114 / 274 | 4 | 85 | - |
87
Facility
87
MO AVG
46
Rank
#33 / 545 | Melissa Yates | $5.4MFiscal year ending 12/2023
Facility
$5.4MFiscal year ending 12/2023
MO AVG
$7.4M
Rank
#139 / 251 | $3.3MFiscal year ending 12/2023
Facility
$3.3MFiscal year ending 12/2023
MO AVG
$3.9M
Rank
#126 / 251 | 61.1%Fiscal year ending 12/2023
Facility
61.1%Fiscal year ending 12/2023
MO AVG
54.9%
Rank
#65 / 251 | 265160 |
Lewis & Clark Gardens is legally operated by N & R Of St Charles, LLC, and administered by Amanda Marsten.
Lewis & Clark Gardens has a walk score of 87. Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.
According to MO state health department records, Lewis & Clark Gardens's license number is 052018.
Lewis & Clark Gardens's occupancy is 60%.
Lewis & Clark Gardens has been operating for approximately 31 years, based on available licensing and registration records.
No, Lewis & Clark Gardens has a no-pet policy.
Lewis & Clark Gardens is registered as a for-profit in MO.
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