344 of the 487 Medicare-certified nursing homes in Missouri (71%) are chain-owned, and all are listed below. 11 of the 340 graded homes earn an A and 66 earn a D or F. They average 3.3 nursing hours per resident per day, 0.13 hours below the 3.43 for every home in Missouri. Lutheran Convalescent Home in Webster Groves grades highest at A (99 out of 100).
How chain-owned homes in Missouri compare
This group set against every nursing home in Missouri, from the current CMS release.
Nursing hours per resident per day
3.3
All homes in Missouri: 3.43
Worse than the local average
Nurse staff turnover
57.3%
All homes in Missouri: 56%
Worse than the local average
Average ElderGrade score
64.2/100
All homes in Missouri: 65.7/100
Worse than the local average
Grade spread
B
C
D
11 grade A, 92 grade B, 171 grade C, 66 grade D,
The best-graded chain-owned home in Missouri is
Lutheran Convalescent Home
in Webster Groves, MO, grade A, 99/100.
Crestview Home runs on thin nursing coverage. At 2.89 nurse hours per resident per day, it sits about a quarter below the national average of 3.86, and weekends are slightly leaner than weekdays. Staff turnover is 57.5% a year, well above the national 45.8%, so familiar faces cycle out fast. The inspection record is heavy, 58 deficiencies, though none at harm or jeopardy level and none abuse-related. One fine of $14,498 is on file, and the most recent inspection was in March 2025. The quality measure rating of 3/5 suggests clinical outcomes aren't the problem; the staffing numbers and inspection volume are. For-profit, limited liability ownership. Ask about consistent weekday-to-weekend coverage before deciding.
St. Peters Post Acute runs 130 beds under for-profit LLC ownership, and the staffing numbers are where the trouble starts. At 3.66 nurse hours per resident day, it sits about 5% under the national average, and weekends drop roughly 13% below its own weekday levels, so coverage thins out exactly when families tend to visit. Staff turnover hits 72% against a national 45.8%, meaning most of the people caring for residents this year likely won't be there next year. The inspection record backs that up: 63 deficiencies, four of them at harm or jeopardy level and one abuse-related, with a single $69,999 fine. The last inspection was December 2024, so the picture is current, not stale.
Adair Village runs 4.01 total nurse hours per resident day, which edges past the national average of 3.86, but that average masks a real drop on weekends, when coverage falls roughly 16% below its own weekday level. Staff turnover sits at 61.5% against a national 45.8%, so the people providing that care are cycling through quickly. The current record carries 34 deficiencies, three at harm or jeopardy level and two tied to abuse, plus $72,950 in fines across two penalties. The last inspection was January 2026, so the picture is recent. Quality and staffing each score 2 out of 5 from CMS; health inspection sits at 3.
Livingston Manor Care Center in Chillicothe runs a for-profit corporate operation with 94 certified beds, and its nurse staffing sits at 3.99 hours per resident day, about 3% above the national average of 3.86. That's the strongest number here, though weekends drop roughly 21% below the home's own weekday staffing, and annual turnover hits 61.9% against a national average of 45.8%. The inspection record is where it gets hard to ignore: 54 deficiencies on file, including four at the harm or jeopardy level and nine tied to abuse, plus a $114,365 fine. CMS rated health inspections and quality measures 1 out of 5, with staffing at 4. The most recent inspection was August 21, 2025.
Greenville Health Care Center runs 60 certified beds as a for-profit limited liability company, and its state inspection history is genuinely decent: four out of five stars for health inspections, with the most recent visit in March 2025 and no deficiencies at the harm or jeopardy level. The staffing picture is the opposite story. One star out of five, with annual turnover at 64.1 percent against a national average of 45.8 percent, roughly two-thirds of the direct-care workforce cycling out in a year. Eighteen deficiencies sit on the current record, one tied to abuse. Quality measures land at three stars. Good inspections can't paper over thin, constantly changing staff.
Nazareth Living Center runs on thin staffing margins. At 3.69 nurse hours per resident day, it sits below the national average, and weekends dip about 11% below its own weekday levels, so the hours when families visit most are often the leanest. The bigger warning sign is turnover: 77.4% of nursing staff leaving annually, well above the 45.8% national figure, which typically means less continuity for residents who need consistent caregivers. Its inspection record shows 49 deficiencies, including two at harm or jeopardy level and three tied to abuse, with one fine of $11,928. The most recent inspection was March 2025, so the record is current, not stale. This nonprofit has real problems worth asking about directly.
Fulton Nursing & Rehab runs on 2.76 nurse hours per resident day, roughly 28% under the national figure of 3.86, and weekend coverage dips about 9% below its own weekday level. Staff turnover sits at 63.6% against a national average of 45.8%, meaning well over half the nursing staff leaves each year. Its inspection record, last reviewed in June 2025, carries 50 deficiencies, including one at the harm level and two tied to abuse, plus an $8,018 fine. All three CMS star ratings land at 2 out of 5. For a 100-bed for-profit home, those numbers describe thin, unstable staffing layered over a troubled survey history.
Lutheran Nursing Home runs 113 certified beds in Concordia under for-profit LLC ownership, and its staffing is the number that stands out: 3.14 nurse hours per resident day, about 19% under the national average, with weekends dipping roughly 12% below its own weekday coverage. Annual turnover sits at 52.5% against a 45.8% national figure, so the people providing that care are cycling through faster than average. Inspections look better on paper, a 4/5 health inspection rating as of August 2025, no deficiencies at the harm level, but 27 total deficiencies include 4 tied to abuse, and one fine of $41,886 is on record. The staffing rating of 2/5 tells you where the pressure actually lives.
Cotton Point Living Center runs about 4.11 nurse hours per resident day, roughly 7% above the national average, so the raw staffing number looks fine. The problem is what's around it. Weekend staffing drops about 14% below the home's own weekday level, and annual turnover sits at 63.1% against a national average of 45.8%, meaning the aides and nurses in the building keep changing, which matters most for residents who need consistent hands.
Then there's the record itself: 32 deficiencies, one at the level of actual harm or jeopardy and four tied to abuse, plus a $14,069 fine. The most recent inspection was March 2025.
Stonebridge Florissant runs on thin staffing. At 3.28 nurse hours per resident day, it sits roughly 15 percent under the national average, and weekends drop another 18 percent below its own weekday numbers, so the thinnest coverage lands when families tend to visit. Turnover tells a related story: 75.9 percent of staff leave within a year, well above the 45.8 percent national figure, which means unfamiliar faces and constant retraining.
The inspection record is current, dated August 2025, with 37 deficiencies but none flagged at harm or jeopardy level, and none abuse-related. That's a meaningful distinction. Still, a 1-out-of-5 staffing rating with that churn rate is the number to weigh hardest when you tour.
The Manor in Poplar Bluff runs about 4.10 nurse hours per resident day, roughly 6% above the national average, but that cushion thins on weekends when staffing drops about 18% below its own weekday level. Annual turnover sits at 61.9% against a national average of 45.8%, so a large share of the people providing that care are new or on their way out.
The current record shows 26 deficiencies, none at the harm or jeopardy level and none abuse-related, and the last inspection was April 2025. State inspectors rated health inspection at 4 of 5 stars, but quality measures came in at 1 of 5.
Ash Grove Healthcare Facility runs on thinner staffing than most homes you'll compare it to, about 3.20 nurse hours per resident day against a national average near 3.86, with weekends dropping roughly 16% below its own weekday coverage. That gap matters most on Saturdays and Sundays, when residents still need the same hands. Annual turnover of 63.6% is well above the 45.8% national figure, so the people providing that care are changing often. The inspection record is genuinely decent: a 4-out-of-5 health inspection rating, no deficiencies at the harm or jeopardy level, and a current survey from January 2025. But 16 deficiencies including two abuse-related citations, and a 1-out-of-5 quality measure rating, mean the day-to-day clinical picture doesn't match the strong inspection score.
Rehab Of Kansas City South runs about 3.10 nurse hours per resident each day, roughly 20% under the national average of 3.86, and weekends are about 17% thinner than its own weekdays. That staffing shortfall shows up in other numbers: 59.5% of staff left over the past year against a 45.8% national rate, and CMS gives staffing a single star out of five. The inspection record carries 45 deficiencies, including two tied to abuse, though none reached harm or jeopardy, and the last survey was in February 2025. This is a for-profit LLC with 100 certified beds, a two-star inspection rating, and a three-star quality measure score.
Pine Grove Manor runs 3.14 nurse hours per resident day, about 19 percent under the national average, and weekend coverage drops roughly 11 percent below its own weekday levels. That thin staffing sits alongside a one-star inspection record carrying 34 deficiencies, three of them at harm or jeopardy level and two tied to abuse, plus $31,665 in fines across two penalties. Quality measures score well, but that's family-reported and assessment-based data; the inspection and staffing numbers are what regulators actually observed. The last inspection was March 2026, so the record is current. For-profit corporate ownership, 77 beds, and a staffing picture that leaves little margin when a resident needs more attention than the schedule allows.
Woodland Manor runs 178 certified beds under for-profit LLC ownership, and its last health inspection came through in late March 2026 with a clean record on harm-level deficiencies, 39 findings total, none rising to actual harm or jeopardy, though one is abuse-related. The staffing picture is where the trouble sits: 3.76 nurse hours per resident day, a bit under the national average, with weekends about 8% thinner than weekdays and turnover at 63.1% against a national 45.8%. Inspectors rated the place 4 of 5, but quality measures and staffing both came back 1 of 5. High turnover plus weekend gaps is what tends to wear on day-to-day care.
Grandview Healthcare Center runs on thin staffing: 3.11 nurse hours per resident day, roughly a fifth below the national average, and weekends drop about 9% below what the home already provides on weekdays. That's the number worth weighing, because turnover sits at 68.6% against a national 45.8%, most of the people caring for your relative are likely new to the building. The record shows 24 deficiencies, including one at the harm level and one tied to abuse, and the quality measure score came in low. A recent inspection doesn't erase a pattern like that. If you're considering this one, ask how they hold staffing on weekends and what's changed since January.
Nick's Health Care Center runs on 2.55 nurse hours per resident day, roughly a third below the national average of 3.86, and weekend coverage drops further below its own weekday level. That thin margin shows up in the numbers: 64.4% annual staff turnover against a national 45.8%, and a one-out-of-five CMS staffing rating. The inspection record carries 30 deficiencies, including two at the harm or jeopardy level and five tied to abuse, with $21,922 in fines across two penalties. The most recent inspection was in October 2025, so the picture is current, not stale. A 70-bed for-profit limited liability company in Plattsburg, it's worth asking direct questions about direct-care staffing on weekends before you decide.
Stonebridge Desoto runs 56 beds under a for-profit limited liability company, and its inspection history is the strongest thing going for it, four out of five stars, with the most recent visit in March 2025 and no abuse citations on record. The trouble sits elsewhere. Staffing earns one star, and the home loses about 68 percent of its staff each year against a national average near 46 percent, which is a lot of churn for a building this size. There are 25 deficiencies on the current record, one serious enough to involve harm, plus a single fine of $6,368. Quality measures land at two stars. Families should ask how the home keeps consistent caregivers on the floor.
Joplin Gardens runs on 92 certified beds and a for-profit LLC structure, and the staffing numbers are the first thing worth knowing: 3.08 nurse hours per resident per day against a national average of 3.86, with weekend coverage dipping about 7% below its own weekdays. That thin schedule sits alongside 61.9% annual staff turnover, well above the 45.8% national figure, so the people providing care change often. Inspectors last visited in August 2024 and found 25 deficiencies on the current record, one serious enough to reach harm or jeopardy level, though none abuse-related. Federal ratings put quality measures and staffing at the bottom of the scale, with health inspections somewhat higher at two stars.
Lee's Summit Place runs on thin nursing coverage: 2.91 nurse hours per resident per day against a national average of 3.86, and weekends dip roughly 15% below what the home itself staffs on weekdays. That shortfall shows up in the federal staffing rating, which sits at the lowest mark, and in turnover of 73.9%, well above the 45.8% national figure, meaning the aides and nurses around your family member are likely to keep changing. The inspection record is more reassuring: a 4-out-of-5 health inspection rating, with the most recent survey in April 2025 and 30 deficiencies logged, just one of them serious enough to involve harm or jeopardy. No abuse deficiencies appear on the current record.
Frequently asked questions
How many chain-owned nursing homes are there in Missouri?
There are 344 chain-owned Medicare-certified nursing homes in Missouri, 71% of the 487 nursing homes there.
Are chain-owned nursing homes better staffed?
In Missouri they average 3.3 total nursing hours per resident per day, against 3.43 for all nursing homes in Missouri, a difference of -0.13 hours. Staff turnover averages 57.3% against 56%.
Which chain-owned nursing home grades best in Missouri?