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.
Carnegie Village runs 3.99 nurse hours per resident day, slightly above the national average of 3.86, but the staffing picture gets thinner on weekends, about 13% below its own weekday level. More telling is the 69.4% annual turnover, well above the 45.8% national figure, which means the people showing up are often new. The inspection record shows 42 deficiencies, including one at the harm level and two tied to abuse, with a $15,646 fine and a survey as recent as July 2025. The quality measure rating sits at 4 out of 5, but the staffing rating is 2 out of 5, and with a for-profit corporate owner, that gap between clinical scores and day-to-day coverage is worth asking about directly.
Aspire Senior Living Advance runs on 3.37 nurse hours per resident day, about 13% under the national average of 3.86, and weekends drop roughly 19% below its own weekday staffing. That thin coverage shows up in the staffing star rating of 2 out of 5, and annual turnover of 51.6% means more than half the nursing staff leaves each year, compared with 45.8% nationally. The inspection record is the bright spot: a 4-out-of-5 health inspection rating with 32 deficiencies, none at harm or jeopardy level, though one is abuse-related. This corporate-owned 55-bed home was inspected recently, in March 2026. Families should ask how the weekend shift is actually covered.
Lewis & Clark Gardens runs 142 certified beds under for-profit LLC ownership, and its staffing sits around 3.48 nurse hours per resident day, roughly 10% under the national average, with weekends about 13% thinner than weekdays. Turnover is 53.4% against a national 45.8%, so the people caring for residents keep changing. The inspection record is the harder part: 63 deficiencies, four at harm or jeopardy level, nine abuse-related, and $139,916 in fines across three events, with the last inspection in August 2024. A 1-out-of-5 health inspection rating alongside a 4-out-of-5 staffing rating tells you the hours exist on paper, but the survey history shows what happens in practice.
Shady Oaks runs a split operation: its last inspection, in December 2025, came back clean on the things that hurt residents most, thirteen deficiencies on record, but none at the harm level and none tied to abuse. The strain shows up in daily care instead. At 3.18 nurse hours per resident day, staffing sits about 18% under the national average, and weekends drop roughly 15% below the home's own weekday coverage. Annual turnover of 54% runs well past the 45.8% national figure, so the people handing out medications and answering call lights keep changing. For a 120-bed corporate-owned building, the pattern is straightforward: safe on paper, thin on the floor.
Parkside Manor runs about 3.00 nurse staffing hours per resident day, roughly 22% below the national average, and weekend coverage dips another 11% below its own weekday levels. Annual turnover sits at 57.1% against a national 45.8%, so the people around your family member change often. The inspection record shows 51 deficiencies, including one at the harm level and two tied to abuse, with the last visit in December 2024. Columbia has other options, and it's worth comparing them on staffing hours and turnover before deciding.
Camelot runs on thin staffing margins despite what the headline number suggests. The 4.12 nurse hours per resident day sits about 7% above the national average, but weekends drop roughly 15% below the home's own weekday levels, so the coverage you see on a Tuesday isn't what you get on a Saturday. Turnover is the bigger concern: 66.3% annually against a national average of 45.8%, meaning most of the people caring for residents are relatively new or on their way out. Inspections look strong on paper, a 5/5 star rating, 12 deficiencies on record, none at harm or jeopardy level, and a recent survey in February 2026. Owned by a for-profit LLC.
Memory Lane of Dexter runs 73 certified beds under for-profit LLC ownership, and its strongest card is inspections: a recent January 2025 survey, no harm-level deficiencies, and nothing abuse-related across 18 total citations. The trouble sits on the other side of the ledger. Nurse staffing averages 3.29 hours per resident day, roughly 15% under the national figure, and weekends drop about 12% below the home's own weekday coverage, which matters in a memory care setting where needs don't pause on Saturday. Quality measure scores land near the bottom of CMS's five-point scale. A clean inspection record buys some confidence, but thin and thinning weekend staffing is the number a family should press on before choosing this home.
Odessa Health Care Center runs on 1.40 nurse staffing hours per resident day, roughly 64% under the national average of 3.86, and weekends drop about 5% further below its own weekday level, so the thinnest coverage happens when families tend to visit. Its record shows 74 deficiencies, including three tied to abuse, with a health inspection rating of 1 out of 5 and staffing at 1 out of 5; quality measures score 3. The last inspection was February 2026, so the findings are recent. None of the 74 deficiencies rose to harm or jeopardy level, which matters. This is a for-profit limited liability company with 60 certified beds.
Hubble Creek runs about 3.28 nurse hours per resident day, roughly 15% under the national average, and weekends drop another 14% below its own weekday levels, that staffing shortfall is what a 1-out-of-5 staffing rating reflects. The inspection record shows 42 deficiencies, including two at the harm level and three tied to abuse, plus $26,628 in fines across two penalties. Ownership changed hands within the past year, which can unsettle routines. A recent inspection in February 2026 and a 4-star health inspection rating suggest the home can pass muster when surveyors arrive, but quality measures sit at 2 stars. Ask directly how weekend coverage is handled and who is on the floor overnight.
Delmar Gardens North runs 240 beds in Black Jack, and the staffing numbers are the first thing worth knowing. At 3.56 nurse hours per resident day, it sits about 8% under the national average, and weekends drop roughly another 8% below its own weekday level, so the thinnest coverage lands when families tend to visit. Turnover, at 42.9%, is slightly better than the 45.8% national figure, which is one genuine bright spot. The rest is harder: 34 deficiencies on the current record, including 3 at harm or jeopardy level and 2 tied to abuse, plus a $39,299 fine. Its last inspection was November 2025, so the record is recent.
Aspire Senior Living Poplar Bluff runs 83 certified beds under for-profit, limited-liability ownership, and its strongest card is inspection history: a four-star health inspection rating with the most recent survey in January 2025. The clinical picture is shakier. Nurse staffing sits at 3.72 hours per resident day, roughly 4% under the national average, and drops about 11% further on weekends. Turnover is the number that stands out, 63.6% of staff leaving annually against a national rate near 46%. Its record shows 37 deficiencies, including one abuse-related citation, though none rose to harm or jeopardy level. Quality measures score one star despite that clean inspection. Those two things together tell you care planning and daily consistency are where the gaps likely live.
Mt Vernon Nursing runs on 3.08 nurse hours per resident day, roughly a fifth below the national average of 3.86, and weekends drop another 10% below its own weekday staffing. The 37.5% annual turnover is better than the 45.8% national figure, so the people who stay tend to stay. Inspectors were last in on October 10, 2024, and found 12 deficiencies on the current record, one serious enough to involve harm or jeopardy, none related to abuse. The four-star health inspection rating reflects that recent visit, while the two-star quality measure rating suggests the clinical numbers families watch most closely aren't where they should be.
Pleasant View runs about 24% below the national average for total nurse staffing, 2.40 hours per resident day against 3.86, and weekends dip roughly 11% below its own weekday levels, so coverage thins exactly when families tend to visit. That shortfall anchors its one-star staffing rating, even though turnover at 45% is essentially in line with the national figure. The health inspection side looks stronger: 24 deficiencies on record with none at the harm or jeopardy level, one tied to abuse, and a survey as recent as May 2025. Quality measures sit at two stars. With 60 certified beds under corporate for-profit ownership, the gap between decent inspections and thin daily staffing is what pulls the overall picture down to average.
Spring Valley runs 194 beds in Springfield under individual for-profit ownership, and its nurse staffing sits about 28% under the national average, 2.77 hours per resident day against 3.86. Weekends dip roughly a fifth below its own weekday coverage, and 56.1% of staff turned over in a year, against 45.8% nationally. The inspection record is the harder problem: 68 deficiencies, two at harm or jeopardy level, and eight tied to abuse. State surveyors were last in on August 25, 2025. What the five-star quality measure score reflects is hard to know when that much turns over and that few nurses are on the floor.
Aspire Senior Living Webb City runs 120 beds under for-profit LLC ownership, and its nurse staffing sits at 2.68 hours per resident day, roughly 31% under the national average of 3.86. That gap widens on weekends, when coverage drops about 9% below the home's own weekday level. The inspection record shows 36 deficiencies, including 2 at harm or jeopardy level and 4 tied to abuse, with one fine of $25,454 and a health inspection rating of 2 out of 5. The most recent inspection was December 9, 2025. Quality measures score a middling 3, but staffing lands at 1 out of 5, the number that should weigh heaviest when you're deciding.
Riverways Manor runs 3.27 nurse hours per resident day, about 15% under the national average, and weekends drop roughly another 15% below its own weekday numbers. That thin coverage shows up in the staffing rating, and a 50% annual turnover rate means the aides and nurses working those shifts are often new. The last inspection was recent, and the home came through without any deficiencies at the harm or jeopardy level, which matters. But 22 total deficiencies sit on the record, including one abuse-related citation, and the quality measure rating is as low as it gets. Family-run for-profit ownership, sixty beds, and a pattern worth asking about directly: who's actually on the floor on a Saturday night.
Glenwood Healthcare runs 60 certified beds in Seymour under corporate for-profit ownership, and its inspection record is genuinely decent, a 4-out-of-5 health inspection rating, last surveyed in April 2024, with 17 deficiencies on file but none at the harm or jeopardy level. The trouble sits elsewhere. Nurse staffing comes in at 3.11 hours per resident day, roughly 19% under the national average, and weekends dip about 15% below the home's own weekday coverage. Staff turnover hits 49%, a few points above the 45.8% national figure, and two of those deficiencies are abuse-related. Quality measures land mid-pack. The inspection side looks steady; the everyday staffing math is where families should focus their questions.
Monarch Springs runs thin on nursing staff, 2.87 hours per resident day against a national average of 3.86, and weekends drop roughly 12% below what the building already provides on weekdays. That gap matters most on Saturdays and Sundays, when families often visit and notice. The inspection record adds weight: 34 deficiencies, two serious enough to involve harm or jeopardy, with the most recent state visit in July 2024. Corporate for-profit ownership and 119 certified beds round out the picture. Nothing here suggests abuse, and quality measures land mid-range, but the staffing numbers and the harm-level findings are the two things I'd ask about directly before choosing this one.
Highland Rehabilitation & Health Care Center runs 162 certified beds in Kansas City under for-profit LLC ownership, and its staffing is the clearest problem: 3.01 nurse hours per resident day against a national average of 3.86, roughly 22 percent below. Weekend coverage drops another 9 percent under its own weekday level, and annual turnover sits at 49 percent. The current inspection record shows 34 deficiencies, including 4 at harm or jeopardy level and 4 abuse-related, with $48,935 in fines across two penalties. A recent February 2025 inspection means the picture is current, not stale. The 5/5 quality measure score stands out against 2/5 for both staffing and health inspections, worth asking what's behind that gap.
Osage Beach Rehabilitation runs 94 beds as a for-profit corporation, and its nurse staffing sits just under the national average, 3.83 hours per resident day against 3.86. That gap is small, but weekends run about 16 percent leaner than weekdays, so coverage thins out exactly when families tend to visit. Turnover is 38.7 percent, actually better than the 45.8 percent national figure, which matters for continuity of care. What pulls the record down is the inspection history: 31 deficiencies, four at harm or jeopardy level, one tied to abuse, and a $107,324 fine. The most recent inspection was February 2025. Ask about weekend staffing and the abuse-related finding before you decide.
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?