River Oaks Care Center

Nursing Home, Hospice Care, Respite Care & Skilled Nursing · Steele, MO

CMS overall rating

1001 North Walnut, Steele, MO 63877-1355 View map

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River Oaks Care Center accepts Medicaid, Medicare, and private pay.

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River Oaks Care Center accepts Medicaid, Medicare, and private pay.

Overview of River Oaks Care Center

Located in Steele, Missouri, River Oaks Care Center is a nursing facility operated by Steele #1, Inc., owned by David Pierce and administered by Lisa Kelley. At 90 beds, the facility supports both short-term rehabilitation and ongoing nursing care. It accepts Medicaid, Medicare, and private pay residents. The facility’s current occupancy rate is 74%. Residents stay for an average of 216 days, placing it between short-term post-acute recovery stays and longer-term care placements.

Residents have access to comprehensive nursing services, with a total of 3 hours of nursing care per resident each day. They are supported by registered nurses, nurse aides, and licensed practical nurses on a 24-hour basis. There are also rehabilitation services and short-term rehab programs alongside routine skilled nursing care.

Nutritious meals are also provided as part of daily life at the facility. The surrounding area in Steele has a walkability score of 47 out of 100, so most daily activities and services require transportation; however, some nearby services can be reached on foot.

River Oaks is a relatively new facility now in its second year of operation. The inspection by the Missouri Department of Health and Senior Services identified areas of focus, including environmental safety, medication management practices, and care planning. The facility maintains review and oversight processes to address these findings and support residents’ safety and quality of care.

Facility Direct Line (573) 695-2121 adm@riveroakscares.com

Quality ratings

Measured by Centers for Medicare & Medicaid Services (CMS)

Staffing hours breakdown

Hours per resident per day — compared to state averages

Total nursing care / resident

3h 0m per day

vs avg

3 of 6 metrics below state avg

Standout metric LPN / LVN is +10% above state avg

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.	16m per day	▼ 41% 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.	45m per day	▲ 10% 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 19m per day	■ Avg 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.	3h 0m per day	■ Avg 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.	1m per day	▼ 32% 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.	12m per day	▼ 41% State avg: 20m per day · National avg: 28m per day

Capacity and availability

216 days

90-bed community

A larger shared setting that may offer more common spaces and organized community services.

1 year in operation

A newer community that may feature more recent facilities and programs.

Walk Score: 47 / 100

Somewhat walkable. A few nearby services may be reachable on foot, but most trips require transportation.

About this community

Occupancy

Occupancy rate

74%

Higher than the Missouri average: 66.6%

Occupied beds

67 / 90

Average occupied beds in Missouri homes 72 beds

Facility TypeSkilled Nursing Facility

StatusActive

IssuanceApril 6, 2025

ExpirationApril 5, 2027

CountyPemiscot

License Number052598

CMS Certification Number265210

Certification TypeMedicare / Medicaid

River Oaks Care Center is legally operated by Steele #1, Inc, and administered by Lisa Kelley.

Corporate EntitySTEELE #1, INC

Owner NameSteele #1, Inc

Skilled Nursing Facility

90 units

Total beds

90 units

Accept Medicaid

Rehabilitation Services

Short-Term Rehab

24-Hour Staffing

Since 2018 · 8 years of data 84 deficiencies 15 inspections

Inspection Scorecard This scorecard compares key inspection, deficiency, 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.

Since 2018 vs. Missouri state average

Overall vs. MO average

Latest Inspection August 8, 2025 Annual Inspection

Deficiencies Deficiencies are formal regulatory issues recorded during state inspections.	This Facility	MO Average	vs. MO Avg
Total deficiencies Formal regulatory issues recorded by inspectors across all inspection types.	84	35	This facility has 140% more total deficiencies than a typical Missouri assisted living residence (84 vs. MO avg 35).↑ 140% worse
Deficiencies per year Average deficiencies per year since 2018.	10.5	4.4	This facility has 139% more deficiencies per year than a typical Missouri assisted living residence (10.5 vs. MO avg 4.4).↑ 139% worse
Deficiencies per inspection Average deficiencies per inspection.	5.6	2.9	This facility has 93% more deficiencies per inspection than a typical Missouri assisted living residence (5.6 vs. MO avg 2.9).↑ 93% worse

Inspections State inspections evaluate whether the facility meets health and safety standards.	This Facility	MO Average	vs. MO Avg
Total inspections Combined count of all routine and focused inspections. Excludes complaint investigations.	15	12	This facility has had 25% more total inspections than the Missouri average (15 vs. MO avg 12). More inspections can mean more regulatory scrutiny rather than worse care.↑ 25% more

Inspection Reports Summary An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.

November 20, 2024 complaint investigation found immediate jeopardy for physical and verbal abuse by staff and failure to investigate, removed after corrective actions one week later.
August 8, 2025 annual inspection cited five deficiencies including unsafe environment, medication errors over 38%, and failure to provide trauma-informed care for residents with PTSD.
May 4, 2023 annual inspection found three deficiencies but no abuse or immediate jeopardy, with care plan and environment issues consistent with later findings.

Show Inspection Reports

Inspections since 2020

Total health inspections 4

State average N/A

Last Health inspection on Nov 2024

Total health citations

State average N/A

Citations per inspection

4.5

State average N/A

Health citations are formal notices following inspections when they fail to comply with safety and care standards.

15 of 18 citations resulted from standard inspections; 2 of 18 resulted from complaint investigations; and 1 of 18 came from combined inspections (standard and complaint).

Breakdown of citation severity (last 6 years)

Critical health citations

In line with State average

State average: N/A

Serious health citations

In line with State average

State average: N/A

2 critical citations State average: N/A

0 serious citations State average: N/A

15 moderate citations State average: N/A

1 minor citation State average: N/A

Citations history (last 6 years)

Abuse/Neglect critical citation Nov 20, 2024

Corrected

Abuse/Neglect critical citation Nov 20, 2024

Corrected

Infection Control moderate citation Aug 16, 2024

Corrected

Pharmacy moderate citation Aug 16, 2024

Corrected

Total staff 83

Employees 72

Contractors 11

Staff to resident ratio 1.24 : 1

0% compared with State average

State average ratio: 0 : 0

Avg staff/day 28

Average shift 8.7 hours

0% compared with State average

State average: 0 hours

Total staff hours (quarter) 22,476

Nursing staff breakdown

8.6 hours

8.7 hours

Contractor staffing

1,031 contractor hours this quarter

Qualified Social Worker: 3 Physical Therapy Aide: 2 Speech Language Pathologist: 2 Respiratory Therapy Technician: 1 Occupational Therapy Assistant: 1 Occupational Therapy Aide: 1 Medical Director: 1

Staff by category


Certified Nursing Assistant	25	0	25	8,694	92	100%	8.7
Licensed Practical Nurse	13	0	13	4,023	92	100%	8.7
Nurse Aide in Training	18	0	18	3,873	92	100%	9.3
Medication Aide/Technician	4	0	4	1,113	84	91%	10.7
Registered Nurse	5	0	5	1,086	87	95%	8.6
Administrator	2	0	2	528	66	72%	8
Nurse Practitioner	1	0	1	528	66	72%	8
Physical Therapy Aide	0	2	2	511	60	65%	8.5
Dental Services Staff	1	0	1	471	58	63%	8.1
RN Director of Nursing	1	0	1	415	51	55%	8.1
Dietitian	1	0	1	414	52	57%	8
Other Dietary Services Staff	1	0	1	302	38	41%	8
Qualified Social Worker	0	3	3	253	64	70%	3.9
Respiratory Therapy Technician	0	1	1	133	33	36%	4
Occupational Therapy Aide	0	1	1	53	6	7%	8.8
Speech Language Pathologist	0	2	2	47	17	18%	2.7
Medical Director	0	1	1	24	3	3%	8
Occupational Therapy Assistant	0	1	1	12	3	3%	4

25 Certified Nursing Assistant

% of Days 100%

13 Licensed Practical Nurse

% of Days 100%

18 Nurse Aide in Training

% of Days 100%

4 Medication Aide/Technician

% of Days 91%

5 Registered Nurse

% of Days 95%

2 Administrator

% of Days 72%

1 Nurse Practitioner

% of Days 72%

2 Physical Therapy Aide

% of Days 65%

1 Dental Services Staff

% of Days 63%

1 RN Director of Nursing

% of Days 55%

1 Dietitian

% of Days 57%

1 Other Dietary Services Staff

% of Days 41%

3 Qualified Social Worker

% of Days 70%

1 Respiratory Therapy Technician

% of Days 36%

1 Occupational Therapy Aide

% of Days 7%

2 Speech Language Pathologist

% of Days 18%

1 Medical Director

% of Days 3%

1 Occupational Therapy Assistant

% of Days 3%

View All Staffing Data

Total fines amount $41K

43% lower than State average

State average: $73K

Number of fines 1

59% fewer fines than State average

State average: 2.4

Payment Denials 0

100% fewer payment denials than State average

State average: 0.7

Fines amount comparison

This facility $41K

State average $73K

Penalty History

Penalties are imposed by CMS for violations of federal nursing home regulations.

1 penalty in the past 3 years

Nov 20, 2024 · $41K

Civil Money Penalty Nov 20, 2024

$41K

Last updated: Jan 2026

High-risk clinical events score 11.9

9% worse than State average

State average: 10.9

Functional decline score 17.5

10% better than State average

State average: 19.5

Long-stay resident measures

Significantly below average State avg: 2.7

Need for Help with Daily Activities Increased 19.1%

In line with State average

State average: 19.8%

Walking Ability Worsened 26.5%

29% worse than State average

State average: 20.6%

Low Risk Residents with Bowel/Bladder Incontinence 7.0%

62% better than State average

State average: 18.1%

Falls with Major Injury 3.3%

18% better than State average

State average: 4.0%

High Risk Residents with Pressure Ulcers 2.1%

59% better than State average

State average: 5.0%

Urinary Tract Infection 3.1%

13% worse than State average

State average: 2.7%

Lost Too Much Weight 8.7%

57% worse than State average

State average: 5.6%

Depressive Symptoms 0.0%

100% better than State average

State average: 12.8%

Antipsychotic Use 30.6%

39% worse than State average

State average: 22.0%

Pneumococcal Vaccine 100.0%

17% better than State average

State average: 85.2%

Influenza Vaccine 96.0%

6% better than State average

State average: 90.9%

Hospitalizations per 1,000 days 3.15

51% worse than State average

State average: 2.08

ED visits per 1,000 days 5.71

143% worse than State average

State average: 2.35

Short-stay resident measures

Significantly below average State avg: 2.1

Pneumococcal Vaccine 100.0%

50% better than State average

State average: 66.6%

Antipsychotic medication increase 3.5%

56% worse than State average

State average: 2.2%

Re-hospitalized after SNF stay 26.7%

6% worse than State average

State average: 25.3%

Emergency department visits 14.3%

7% worse than State average

State average: 13.4%

Falls with major injury 0.0%

100% better than State average

State average: 0.8%

Breakdown by payment type

Medicare

14% of new residents, usually for short-term rehab.

Typical stay 3 - 4 months

Private pay

35% of new residents, often for short stays.

Typical stay 21 days

Medicaid

51% of new residents, often for long-term daily care.

Typical stay 1 - 2 years

Total residents 67

Medicare

3% of residents

Medicaid

80.6% of residents

Private pay or other

16.4% of residents

Programs & Services

Residents Group

Residents meet regularly to discuss policies, care quality, and activities

Nurse Aide Training

State-approved Nurse Aide Training and Competency Evaluation Program on-site

Active Resident Council

Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.

Financial Trends

Historical financial and operational data for River Oaks Care Center from 2011–2023, based on CMS SNF Cost Reports.

Key figures below are for fiscal year ending in 12/2023.

Occupancy Rate 75.1% ↑ 2.9pp vs 2022

Net Patient Income $289.1K ↓ ~$69.2K vs 2022

Payroll Costs $2.1M ↑ ~$49.4K vs 2022

Operating Margin 6.1% ↓ 1.4pp vs 2022

Metric	2011	2012	2013	2014	2015	2016	2017	2018	2019	2020	2021	2022	2023
Occupancy %	44.9%	43.3%	44.6%	44.2%	44.1%	51.2%	44.9%	58.0%	59.3%	67.0%	68.9%	72.2%	75.1%
Beds	90	90	90	90	90	90	90	90	90	90	90	90	90
Net Income	$8,567	-$74,896	$6,195	-$97,692	-$76,294	$69,438	$18,082	$258,578	$244,825	$1,331,386	$518,837	$591,344	$434,533
Gross Revenue	$2,802,683	$2,808,483	$2,782,865	$2,637,945	$2,940,014	$3,006,939	$2,454,816	$3,250,975	$3,540,435	$4,169,441	$4,262,612	$5,277,479	$6,057,674
Operating Expenses	$2,381,163	$2,492,290	$2,438,972	$2,500,937	$2,584,548	$2,791,128	$2,405,931	$2,907,330	$3,094,883	$3,978,455	$3,873,145	$4,408,479	$4,440,577
Net Patient Income	-$16,391	-$94,697	-$24,583	-$111,821	-$89,528	$46,165	-$16,290	$230,910	$230,893	$395,671	$338,726	$358,272	$289,088
Net Patient Revenue	$2,364,772	$2,397,593	$2,414,389	$2,389,116	$2,495,020	$2,837,293	$2,389,641	$3,138,240	$3,325,776	$4,374,126	$4,211,871	$4,766,751	$4,729,665
Payroll Costs	$930,611	$992,654	$1,039,765	$1,081,688	$1,168,779	$1,290,425	$1,267,263	$1,421,310	$1,476,438	$1,748,471	$1,703,969	$2,010,653	$2,060,047
Operating Margin %	-0.7%	-4.0%	-1.0%	-4.7%	-3.6%	1.6%	-0.7%	7.4%	6.9%	9.1%	8.0%	7.5%	6.1%
Medicare %	13.2%	10.6%	8.5%	7.6%	9.9%	9.0%	6.8%	6.4%	6.0%	11.5%	8.0%	9.7%	5.2%
Medicaid %	73.5%	75.6%	76.9%	78.5%	74.0%	74.9%	79.9%	78.1%	83.8%	78.4%	87.1%	87.5%	91.9%
Private %	13.3%	13.8%	14.7%	13.9%	16.2%	16.1%	13.3%	15.4%	10.2%	10.1%	4.8%	2.8%	2.9%
Net Patient Revenue/Day	$160	$168	$165	$165	$172	$168	$162	$165	$171	$198	$186	$201	$192
Cost/Day	$161	$175	$167	$172	$179	$165	$163	$153	$159	$180	$171	$186	$180
Avg Length of Stay	167.7 days	241.9 days	206.3 days	161.4 days	13.8 days	123.2 days	171.6 days	127.9 days	152.2 days	149.1 days	116.0 days	128.2 days	216.4 days

Finances and operations

Based on CMS SNF Cost Report for fiscal year ending in 12/2023.

Net patient revenue

$4.7M

Net patient income

$289.1K

For-profit Individual

Net patient revenue

$4.7M

Net patient income

$289.1K

Other income

$145.4K

Payroll costs

$2.1M 43.6% of net patient revenue

Other operating costs

$2.4M

Total costs

$4.4M

What does this home offer?

Pets Allowed

TYPE OF STAY

Mostly long-term care residents

Most residents stay for extended periods and receive ongoing daily care.

Most new residents arrive under Medicaid (51% of admissions), and a typical Medicaid stay runs around 1 - 2 years.

Coverage residents most often arrive under.

Medicare 14%

Private pay 35%

Medicaid 51%

Coverage residents most often leave under.

Medicare 19%

Private pay 29%

Medicaid 52%

0.0 miles from city center Estimated distance in miles from Steele's city center to River Oaks Care Center's address, calculated via Google Maps.

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The information below is reported by the Missouri Department of Health and Senior Services, Division of Regulation and Licensure.


Laclede Groves	NH AL IL MC	St. Louis	-	251	-	35	-
Republic Nursing and Rehab	NH SNF	Republic	-	127	-	48	Private / Semi-Private Rooms
Chaffee Nursing Center	NH HOS SNF	Chaffee	-	71	-	25	Studio
Heisinger Bluffs	NH AL IL MC RC SNF	Jefferson City	-	111	-	32	1 Bed / 2 Bed / 3 Bed
River Oaks Care Center	NH HOS RC SNF	Walnut Steele	-	90	-	47	-

Nursing Home Explorer

Who is the owner of River Oaks Care Center?

River Oaks Care Center is legally operated by Steele #1, Inc, and administered by Lisa Kelley.

Is River Oaks Care Center in a walkable area?

River Oaks Care Center has a walk score of 47. Somewhat walkable. A few nearby services may be reachable on foot, but most trips require transportation.

What is the license number of River Oaks Care Center?

According to MO state health department records, River Oaks Care Center's license number is 052598.

When does River Oaks Care Center's license expire?

According to MO state health department records, River Oaks Care Center's license expires on April 5, 2027.

What is the occupancy rate at River Oaks Care Center?

River Oaks Care Center's occupancy is 74%.

Are pets allowed at River Oaks Care Center?

Yes, River Oaks Care Center allows residents to bring their pets.

Does River Oaks Care Center operate as a for-profit or non-profit?

River Oaks Care Center is registered as a for-profit in MO.

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River Oaks Care Center

Overview of River Oaks Care Center

Quality ratings

Staffing hours breakdown

Capacity and availability

About this community

Occupancy

License Details

Ownership & Operating Entity

Type Of Units

Payment & Insurance

Therapy & Rehabilitation

Staffing & Medical

Contact River Oaks Care Center

Inspection History

Inspection Scorecard This scorecard compares key inspection, deficiency, 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 Deficiencies are formal regulatory issues recorded during state inspections.

Inspections State inspections evaluate whether the facility meets health and safety standards.

Inspection Reports Summary An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.

Health Inspection History

Inspections since 2020

Breakdown of citation severity (last 6 years)

Citations history (last 6 years)

Staffing Data

Nursing staff breakdown

Registered Nurse

Licensed Practical Nurse

Certified Nursing Assistant

Contractor staffing

Staff by category

25 Certified Nursing Assistant

13 Licensed Practical Nurse

18 Nurse Aide in Training

4 Medication Aide/Technician

5 Registered Nurse

2 Administrator

1 Nurse Practitioner

2 Physical Therapy Aide

1 Dental Services Staff

1 RN Director of Nursing

1 Dietitian

1 Other Dietary Services Staff

3 Qualified Social Worker

1 Respiratory Therapy Technician

1 Occupational Therapy Aide

2 Speech Language Pathologist

1 Medical Director

1 Occupational Therapy Assistant

Penalties and fines

Fines amount comparison

Fines amount comparison

Penalty History

Quality of care over time

Long-stay resident measures

Short-stay resident measures

Breakdown by payment type

Medicare

Private pay

Medicaid

Facility Characteristics

Programs & Services

Residents Group

Nurse Aide Training

Active Resident Council

Financial Trends

Financial Performance

Payroll & Labor Costs

Payer Mix (percentage)

Finances and operations

What does this home offer?

Who this home usually serves

Mostly long-term care residents

Admissions

Discharges

Places of interest near River Oaks Care Center

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