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.
Riverdell Care Center runs about 2.82 nurse hours per resident each day, roughly 27% below the national average of 3.86, and weekend coverage drops another 16% below its own weekday level. Staff turnover sits at 69.4% against a national average of 45.8%, so the people around your family member change often. The good news: inspectors gave it four stars and found no abuse or harm-level deficiencies, though 10 total issues remain on the record, with the most recent inspection in December 2024. The quality measure rating tells a different story from the inspection score, and that gap between a clean-ish inspection and thin, unstable staffing is what the numbers actually show.
Brent B Tinnin Manor runs 60 beds in Ellington under individual for-profit ownership, and the staffing numbers are the place to start. At 3.20 nurse hours per resident day, it sits about 17% under the national average, and weekends drop roughly 23% below its own weekday level, so coverage thins out exactly when families tend to visit. Annual turnover of 74.5% is well above the 45.8% national figure, meaning most of the people caring for residents are relatively new to the building. The inspection record shows 33 deficiencies, three tied to abuse, though none reached harm or jeopardy level, and the most recent survey was March 2025.
Eldon Nursing & Rehab runs on 3.36 nurse hours per resident per day, roughly 13% under the national average, and weekends dip about 16% below what the home staffs on weekdays. That thin coverage sits behind a CMS staffing rating of 1 out of 5, and it's hard to keep anyone long-term: annual turnover is 77.6% against a national 45.8%, meaning most of the people caring for residents are new to the building. The record shows 32 deficiencies, including 4 at harm or jeopardy level and 5 abuse-related, with three fines totaling $79,671. Inspectors were last in on February 26, 2026. Individual for-profit ownership.
Carrie Elligson Gietner Health Care Center runs 130 certified beds in Saint Louis, and the numbers behind its record aren't reassuring. Nurse staffing sits at 2.48 hours per resident day, roughly 36% under the national average of 3.86, and weekends run about 13% thinner than weekdays, so coverage is lightest exactly when families tend to visit. The inspection history carries 55 deficiencies, seven of them at the harm or jeopardy level and five tied to abuse, along with two CMS fines totaling $92,561. The most recent inspection was in June 2024. Corporate for-profit ownership and a one-star inspection and staffing rating round out a picture worth weighing carefully against other options.
St Joe Manor runs 155 certified beds in Bonne Terre under for-profit LLC ownership, and its most recent inspection in February 2025 produced 28 deficiencies, none at the harm level, but one tied to abuse, which is the kind of citation families should ask about directly. Staffing tells a starker story than the inspection record: the home earns just 1 of 5 stars for staffing, and annual turnover hits 73.3% against a national average of 45.8%, meaning roughly three of every four employees leave within a year. High turnover at that scale usually shows up as inconsistent caregivers and less experienced hands on the floor. Worth weighing carefully against the quality measure rating of 1 out of 5.
Bluebird Wellness and Rehabilitation runs on 2.96 nurse staffing hours per resident day, roughly a quarter below the national average, and weekends drop about 18% below what the home itself staffs Monday through Friday. Turnover sits at 62.3% against a national 45.8%, so the aides and nurses present on any given shift are often new to the building.
The inspection record backs up the numbers: 84 deficiencies, eight of them serious enough to put residents in harm’s way and four tied to abuse, plus a $234,836 fine. CMS gave its lowest marks to both staffing and health inspections. At 188 beds under for-profit LLC ownership, this is a home where the people providing care are stretched thin and frequently replaced.
Butler Rehab runs 98 certified beds as a for-profit LLC, and its staffing sits at 3.36 nurse hours per resident day, about 13% under the national average of 3.86, with weekends running another 13% below its own weekday levels. Turnover tells a harder story: 73.6% of nursing staff leave annually, against a national average near 46%, which means roughly three of every four caregivers are new to the building each year. Its current record carries 33 deficiencies, three tied to abuse, with the most recent inspection dated February 2026. The low quality-measure score reflects how residents are actually doing day to day, not just paperwork.
Carriage Square runs on thinner staffing than most homes its size, 3.50 nurse hours per resident day against a national average of 3.86, and weekends drop about 11% below its own weekday coverage, which matters when a resident needs help on a Sunday. More striking is the churn: 77% annual turnover, well above the 45.8% national figure, so the people caring for your family member are frequently new. The inspection record backs that up. Fifty-six deficiencies, including two at harm or jeopardy level and five tied to abuse, with a $48,685 fine and a March 2025 inspection. A for-profit limited liability company operates it. Worth asking the administrator directly what's changed since then.
Edgewood Manor is a for-profit LLC home in Raytown with 91 certified beds, and the numbers that matter most here are the staffing ones. At 2.61 nurse hours per resident per day, it runs roughly a third below the national average of 3.86, weekends dip even further, and 70% of staff turned over in a year, well above the 45.8% norm. Its inspection record carries 72 deficiencies, including 6 at harm or jeopardy level and 10 tied to abuse, plus two fines totaling $84,557. The last inspection was October 2024. Quality measures score mid-range, but thin, churning staffing and that deficiency history are what families should weigh.
Windsor Estates of St Charles runs on thin staffing: 3.53 nurse hours per resident day against a national average of 3.86, with weekends about 13% leaner than weekdays. That shortfall shows up in the workforce itself, 71.4% annual turnover, well above the 45.8% national figure, meaning most of the people caring for residents weren't there a year ago. The inspection record is heavier still: 77 deficiencies, 13 involving harm or jeopardy, 4 tied to abuse, and 8 fines totaling $229,906. The last inspection was in March 2024. This is a for-profit limited liability company, and the numbers suggest care that has been under-resourced and under-scrutinized for a while.
Lakeview runs lean on nursing hours, 3.13 per resident per day, about 19% under the national average, and weekends are thinner still, roughly 12% below its own weekday staffing. That shortfall shows up in turnover: 57.5% of staff left over the year, well above the 45.8% national rate, and CMS gives the home one star each for staffing and quality measures, even though its inspection rating sits at four. The record carries 32 deficiencies, including one at the harm level and two tied to abuse, plus a $49,335 fine. A recent inspection date doesn't erase what's underneath it.
Nurse staffing at Life Care Center of Cape Girardeau runs about 8% under the national average, and weekends drop roughly another 12% below its own weekday levels, meaning the thinnest coverage lands when families tend to visit. Turnover is the harder number to sit with: 68.5% annually against a national average of 45.8%, so most of the people caring for residents are relatively new. The inspection record backs that up, 45 deficiencies, 7 serious enough to put residents at harm or jeopardy, and four fines totaling $149,578. The most recent inspection was in May 2025, so the picture is current, not stale. Ownership is corporate and for-profit.
Lakeview Post Acute runs 3.97 nurse hours per resident day, which edges past the national average of 3.86, but that number hides a staffing churn problem. Turnover sits at 83.3%, nearly double the national rate, and weekend coverage drops about 11% below weekdays, so the aide who knows your mother on Tuesday may be gone by next month. The inspection record is where it gets hard to ignore: 92 deficiencies, 8 at harm or jeopardy level, 5 tied to abuse, and a $176,501 fine, with the last inspection in October 2024. For-profit LLC ownership, and CMS rates staffing and health inspections 1 out of 5.
Heritage Care Center runs on 1.85 nurse staffing hours per resident day, roughly half the national average, and weekends drop another 23% below its own weekday level. That thin coverage shows up in the record: 95 deficiencies, 15 of them involving harm or jeopardy to residents, 17 tied to abuse, and six fines totaling $424,748. Staff turnover sits at 75%, well above the 45.8% national figure, so the people caring for residents keep changing. CMS has placed this for-profit LLC home in its Special Focus Facility program, and its last inspection was September 9, 2025. The four-out-of-five quality measure rating rests on a staffing and inspection picture that is among the weakest CMS tracks.
Hillside Health Care Center runs on 2.46 nurse staffing hours per resident day, roughly a third less than the national average, and weekends drop about 15% below what it manages on weekdays. Annual turnover of 60.3% means most of the staff you'd meet are relatively new. The record shows 122 deficiencies, 17 of them at the harm or jeopardy level and 10 tied to abuse, plus $106,588 in federal fines. CMS has placed it in the Special Focus Facility program, which is reserved for homes with a persistent pattern of serious problems. The last inspection was July 2024. If you're considering this one, ask what specifically has changed since then.
South Hampton Place runs on thin staffing. At 3.23 nurse hours per resident day, it sits about 16% under the national average, and weekends dip roughly 8% below its own weekday level, so the thinnest coverage lands when families are most likely to visit. Turnover tells its own story: 66.7% of nursing staff leaving annually, against a national average of 45.8%. The inspection record is worse. Forty deficiencies, including three tied to abuse and one at the harm or jeopardy level, with a $12,735 fine and the most recent inspection in April 2025. Boone County families comparing options should weigh that record carefully.
Brookfield Health Care Center runs on 2.74 nurse hours per resident per day, roughly 29% below the national average, and weekend coverage slips about 5% below its own weekday level. Annual staff turnover sits at 78.4%, well above the national 45.8%, so the people caring for residents here change constantly. The current record shows 43 deficiencies, including four at the harm or jeopardy level and two tied to abuse. Its last inspection was June 12, 2025. Under a for-profit limited liability company, this 60-bed home carries CMS ratings of one star for health inspections, two for quality measures, and one for staffing.
Manchester Rehab and Healthcare Center is a 137-bed for-profit in Ballwin, and the numbers behind its record are worth walking through. Nurse staffing sits at 3.23 hours per resident day, roughly 16 percent under the national average, and weekends drop about another 10 percent below its own weekday levels, so coverage is thinnest exactly when families tend to visit. Its current inspection file carries 53 deficiencies, including two at the harm or jeopardy level and four tied to abuse, plus a single $197,132 fine. Federal ratings give it one star each for staffing and quality measures and two for health inspections, with the most recent inspection in May 2025.
Lincoln County Nursing & Rehab runs on 2.45 nurse hours per resident day, roughly a third below the national average, and weekends get about 10 percent less attention than weekdays. Staff turnover sits at 74.2 percent against a national 45.8 percent, so the people caring for your relative are likely to be new and soon to be gone. The record shows 115 deficiencies, nine of them serious enough to put residents in harm's way, five tied to abuse, and $235,414 in federal fines. CMS has placed the home in its Special Focus Facility program, which it reserves for the country's most persistently troubled nursing homes. The most recent inspection was May 2024.
Springfield Skilled Care Center runs on 2.96 nurse hours per resident day, roughly a quarter below the national average of 3.86, and weekends drop another 17% below its own weekday coverage. Staff turnover sits at 79% against a national 45.8%, which means the people caring for residents are, more often than not, new to the building. The inspection record shows 97 deficiencies, including 5 at harm or jeopardy level and 6 tied to abuse, with two fines totaling $189,066. Corporate-owned and Medicare-certified for 120 beds, its last inspection was February 2025. A 1/5 inspection rating and 1/5 staffing rating are the numbers families should weigh hardest here.
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?