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1/5
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.
1/5
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 137-bed nursing community at Manchester Rehab and Healthcare Center operates under the direction of administrator Yakov Appelbaum, owner of Manchester Holdco LLC, and operator of Manchester Operator LLC in Ballwin, Missouri. Financial billing paths accommodate multiple standard insurance structures, accepting Medicare, Medicaid, and private pay. For visitors, the surrounding area carries a moderate walkability score of 52 out of 100, indicating a layout where family members can walk to a few nearby amenities, though a vehicle remains practical for most local trips.
Operational metrics show that residents stay at the facility for an average of roughly 82 days, a timeline that reflects a daily caseload mixing short-term post-hospital therapy with extended skilled nursing placements. To manage routine physical care and medical needs, the 24-hour staffing framework relies on registered nurses, licensed practical nurses, and certified nurse aides. Within this clinical rotation, nurse aides supply the primary share of daily hands-on personal support, averaging 2 hours and 27 minutes of direct care per resident each day.
Public health safety data tracks the facility’s historical compliance through recurring licensing reviews overseen by state regulators. Documented inspection files show that administrative teams have logged specific compliance deficiencies concerning timely laboratory service delivery, resident fund management, registered nurse shift coverage, and grievance documentation protocols, meaning the property’s total cumulative citations-per-inspection rate is not zero, and these items remain part of ongoing quality tracking.
Prospective residents have access to multi-specialty clinical programs, including physical rehabilitation, professional wound care, and on-site dental, podiatry, optometry, audiology, and counseling services.
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.
| Staff type | Hours / Day / Resident | vs state avg |
|---|---|---|
|
Registered Nurse (RN)
RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes.
| 22m per day | ▼ 22% State avg: 28m per day · National avg: 41m per day |
|
LPN / LVN
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care.
| 31m per day | ▼ 23% State avg: 41m per day · National avg: 52m per day |
|
Nurse Aide
Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life.
| 2h 29m per day | ▲ 7% State avg: 2h 19m per day · National avg: 2h 20m per day |
|
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.
| 2h 58m per day | ▼ 3% State avg: 3h 3m per day · National avg: 3h 26m per day |
|
Physical Therapist
Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
| 2m per day | ▲ 14% State avg: 2m per day · National avg: 4m per day |
|
Weekend RN
Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
| 10m per day | ▼ 50% State avg: 20m per day · National avg: 28m per day |
Lower than the Missouri average: 66.6%Manchester Rehab and Healthcare Center is legally operated by Manchester Operator Llc, and administrated by Yakov Appelbaum.
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.
| 213 | 35 | This facility has 509% more total deficiencies than a typical Missouri nursing home (213 vs. MO avg 35).↑ 509% worse |
|
Deficiencies per year
Average deficiencies per year since 2018.
| 26.6 | 4.4 | This facility has 505% more deficiencies per year than a typical Missouri nursing home (26.6 vs. MO avg 4.4).↑ 505% worse |
|
Deficiencies per inspection
Average deficiencies per inspection.
| 8.2 | 5 | This facility has 64% more deficiencies per inspection than a typical Missouri nursing home (8.2 vs. MO avg 5).↑ 64% worse |
Inspections
| This Facility | MO Average | vs. MO Avg |
|---|---|---|---|
|
Total inspections
Combined count of all routine and focused inspections. Excludes complaint investigations.
| 26 | 7 | This facility has 271% more total inspections than a typical Missouri nursing home (26 vs. MO avg 7).↑ 271% 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 May 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.
36 of 62 citations resulted from standard inspections; 17 of 62 resulted from complaint investigations; and 9 of 62 came from combined inspections (standard and complaint).
329% worse than Missouri averageMissouri average: 0.7
100% worse than Missouri averageMissouri average: 1
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
36% more staff per resident than Missouri average
5% better than Missouri average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
8 total: 7 full-time employees and 1 contractor.
8
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.8 hoursAssists with medical care and medications.
23 total: 11 full-time employees and 12 contractors.
23
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.3 hoursHelps with daily care and mobility.
46 total: 43 full-time employees and 3 contractors.
46
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.8 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
168 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 43 | 3 | 46 | 11,074 | 92 | 100% | 8.8 |
| Physical Therapist | 36 | 0 | 36 | 5,065 | 92 | 100% | 7.4 |
| Medication Aide/Technician | 18 | 0 | 18 | 3,913 | 92 | 100% | 9.2 |
| Licensed Practical Nurse | 11 | 12 | 23 | 3,504 | 92 | 100% | 9.3 |
| Nurse Aide in Training | 15 | 0 | 15 | 3,087 | 92 | 100% | 8.9 |
| Registered Nurse | 7 | 1 | 8 | 2,047 | 85 | 92% | 9.8 |
| Qualified Social Worker | 3 | 0 | 3 | 855 | 71 | 77% | 6.9 |
| Speech Language Pathologist | 2 | 0 | 2 | 567 | 68 | 74% | 8.3 |
| Nurse Practitioner | 1 | 0 | 1 | 504 | 63 | 68% | 8 |
| Administrator | 2 | 0 | 2 | 488 | 59 | 64% | 8 |
| Mental Health Service Worker | 1 | 0 | 1 | 485 | 61 | 66% | 7.9 |
| Other Dietary Services Staff | 3 | 0 | 3 | 471 | 56 | 61% | 6.7 |
| Physical Therapy Aide | 3 | 0 | 3 | 468 | 64 | 70% | 7.1 |
| RN Director of Nursing | 2 | 0 | 2 | 312 | 37 | 40% | 7.6 |
| Respiratory Therapy Technician | 5 | 0 | 5 | 275 | 59 | 64% | 4 |
| Physical Therapy Assistant | 2 | 0 | 2 | 273 | 55 | 60% | 5 |
| Clinical Nurse Specialist | 1 | 0 | 1 | 88 | 11 | 12% | 8 |
Includes penalties issued in 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)
229% higher than Missouri averageMissouri average: $73K
18% fewer fines than Missouri averageMissouri average: 2.4
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
Penalties are imposed by CMS for violations of federal nursing home regulations.
2 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.
May 23, 2025
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
May 23, 2025Last 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.
4.7
57% better than Missouri averageMissouri average: 10.9
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
11.2
43% better 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
8.5%
57% better than Missouri averageMissouri average: 19.8%
Percent of long-stay residents whose ability to move independently worsened
3.8%
82% better than Missouri averageMissouri average: 20.6%
Percent of low risk long-stay residents who lose control of their bowels or bladder
21.2%
17% worse than Missouri averageMissouri average: 18.1%
Percent of long-stay residents experiencing one or more falls with major injury
1.0%
76% better than Missouri averageMissouri average: 4.0%
Percent of long-stay high risk residents with pressure ulcers
10.3%
106% worse than Missouri averageMissouri average: 5.0%
Percent of long-stay residents with a urinary tract infection
0.5%
81% better than Missouri averageMissouri average: 2.7%
Percent of long-stay residents who lose too much weight
0.0%
100% better than Missouri averageMissouri average: 5.6%
Percent of long-stay residents who have depressive symptoms
55.3%
330% worse than Missouri averageMissouri average: 12.8%
Percent of long-stay residents who received an antipsychotic medication
10.4%
53% better than Missouri averageMissouri average: 22.0%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
81.5%
In line with Missouri averageMissouri average: 85.2%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
90.3%
In line with Missouri averageMissouri average: 90.9%
Number of hospitalizations per 1,000 long-stay resident days.
2.52
21% worse than Missouri averageMissouri average: 2.08
Number of outpatient emergency department visits per 1,000 long-stay resident days.
1.34
43% better than Missouri averageMissouri average: 2.35
CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
24.1%
64% worse than Missouri averageMissouri average: 66.6%
Percent of short-stay residents who newly received an antipsychotic medication
1.9%
15% better than Missouri averageMissouri average: 2.2%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
26.2%
59% worse than Missouri averageMissouri average: 63.5%
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
33.1%
31% worse than Missouri averageMissouri average: 25.3%
Percentage of short-stay residents who had an outpatient emergency department visit.
20.6%
54% worse than Missouri averageMissouri average: 13.4%
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
100% better than Missouri averageMissouri average: 0.8%
Percentage of residents at or above expected ability to care for themselves at discharge.
33.3%
38% worse than Missouri averageMissouri average: 53.7%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
20% of new residents, usually for short-term rehab.
49% of new residents, often for short stays.
31% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
74Residents 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.
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 Manchester Rehab and Healthcare Center from 2012–2023, based on CMS SNF Cost Reports.
Based on the 2023 CMS SNF Cost Report.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #242 / 286Payroll — State benchmarkedThis home is ranked 242nd 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.
This home supports both short-term rehab and long-term care, with residents staying for a wide range of durations.
New residents most often arrive under private pay (49% of admissions), and a typical private pay stay runs around 1 months.
Coverage residents most often arrive under.
Coverage residents most often leave under.
0.0 miles from city center
Estimated distance in miles from Ballwin's city center to Manchester Rehab and Healthcare Center's address, calculated via Google Maps.
Add your location
Manchester Rehab and Healthcare Center is located in BALLWIN, 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.
| Heisinger Bluffs |
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.
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. | Jefferson City | 111
Facility
111
MO AVG
97
Rank
#156 / 454 |
49.5%
Facility
49.5%
MO AVG
66.6%
Rank
#370 / 428 | -26% | 3.36
Facility
3.36
MO AVG
3.74
Rank
#184 / 276 | +42% | -10% | $8.1k
Facility
$8.1k
MO AVG
$76.9k
Rank
#206 / 283 | 17
Facility
17
MO AVG
36.5
Rank
#61 / 281 | 5.7
Facility
5.7
MO AVG
5.7
Rank
#169 / 281 | - | 56 | - |
32
Facility
32
MO AVG
45
Rank
#376 / 563 | Hb Operations Holdco LLC | $5.4M
Facility
$5.4M
MO AVG
$8.4M
Rank
#183 / 286 | $3.7M
Facility
$3.7M
MO AVG
$3.3M
Rank
#138 / 286 | 68.1%
Facility
68.1%
MO AVG
45.6%
Rank
#43 / 286 | 265794 | ||||
| Cottages of Lake St. Louis |
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). | Lake St Louis (Lake Saint Louis) | 60
Facility
60
MO AVG
97
Rank
#343 / 454 |
81.7%
Facility
81.7%
MO AVG
66.6%
Rank
#95 / 428 | +23% | 6.04
Facility
6.04
MO AVG
3.74
Rank
#6 / 276 | -32% | +62% | $17.7k
Facility
$17.7k
MO AVG
$76.9k
Rank
#195 / 283 | 11
Facility
11
MO AVG
36.5
Rank
#25 / 281 | 2.8
Facility
2.8
MO AVG
5.7
Rank
#22 / 281 | 2 | 55 | - |
13
Facility
13
MO AVG
45
Rank
#486 / 563 | Cottages Master LLC | $9.9M
Facility
$9.9M
MO AVG
$8.4M
Rank
#74 / 286 | $5.5M
Facility
$5.5M
MO AVG
$3.3M
Rank
#67 / 286 | 55.4%
Facility
55.4%
MO AVG
45.6%
Rank
#133 / 286 | 265860 | ||||
| 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 |
74.9%
Facility
74.9%
MO AVG
66.6%
Rank
#146 / 428 | +12% | 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 | ||||
| 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. | 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 | ||||
| Manchester Rehab and Healthcare 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). | Ballwin | 137
Facility
137
MO AVG
97
Rank
#68 / 454 |
54.0%
Facility
54.0%
MO AVG
66.6%
Rank
#318 / 428 | -19% | - | -39% | - | $197.1k
Facility
$197.1k
MO AVG
$76.9k
Rank
#280 / 283 | 62
Facility
62
MO AVG
36.5
Rank
#252 / 281 | 5.2
Facility
5.2
MO AVG
5.7
Rank
#141 / 281 | 5 | 79 | A+ |
52
Facility
52
MO AVG
45
Rank
#232 / 563 | Manchester Holdco LLC | $2.5M
Facility
$2.5M
MO AVG
$8.4M
Rank
#276 / 286 | $2.1M
Facility
$2.1M
MO AVG
$3.3M
Rank
#242 / 286 | 82.6%
Facility
82.6%
MO AVG
45.6%
Rank
#9 / 286 | 265352 |
The legal owner and operator of Manchester Rehab and Healthcare Center is Manchester Operator Llc.
Manchester Rehab and Healthcare Center has a walk score of 52. Moderately walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.
According to MO state health department records, Manchester Rehab and Healthcare Center's license number is 052588.
According to MO state health department records, Manchester Rehab and Healthcare Center's license expires on March 31, 2027.
Manchester Rehab and Healthcare Center's occupancy is 54%.
Yakov Appelbaum is the administrator of Manchester Rehab and Healthcare Center.
Manchester Rehab and Healthcare Center has 137 beds.
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