Avenir at Mark Twain

11988 Mark Twain Lane · Bridgeton, MO · 63044 · 3142918240

120 certified beds For profit - Limited Liability company

Why this verdict

  • Inspection record is far worse than the national median (deficiency count and severity).
  • Federal penalties on record: $134,043 in fines in the last 24 months.
  • Inspection results have improved across recent cycles.

The complete Safety Report — $19

Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.

Get the Safety Report

Red flags

2 immediate-jeopardy citations in prior inspection cycles

Serious past findings — check whether the underlying problems were fixed and stayed fixed.

$134,043 in federal fines in the last 24 months

1 fine — CMS fines are reserved for verified, serious non-compliance.

Score breakdown

Inspection record 30% of score 26
Serious harm & abuse 20% 88
Staffing 20% 58
Federal penalties 15% 0
Trend 10% 74
Context 5% 100

Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.

CMS ratings & staffing

Overall: 1 of 5 Inspections: 1 of 5 Staffing: 3 of 5 Quality measures: 2 of 5

Total nurse hours / resident-day3.563.48 min · 4.1 strong
RN hours / resident-day0.390.55–0.75
Weekend hours / resident-day3.08≈ weekday level
Nursing turnover / year57%median 45%
Fines (3-yr window)8 · $195,310

Inspection citations (62 in the current record)

  • Potential for harm · D December 19, 2025 · found via complaint

    Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

    Corrected January 15, 2026 · Resident Rights

  • Potential for harm · D December 19, 2025 · found via complaint

    Ensure services provided by the nursing facility meet professional standards of quality.

    Corrected January 15, 2026 · Resident Assessment and Care Planning

  • Potential for harm · D December 19, 2025 · found via complaint

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Corrected January 15, 2026 · Quality of Life and Care

  • Potential for harm · D October 7, 2025 · found via complaint

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Corrected November 14, 2025 · Quality of Life and Care

  • Potential for harm · D August 20, 2025

    Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.

    Corrected October 3, 2025 · Resident Rights

  • Potential for harm · D August 20, 2025

    Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.

    Corrected October 3, 2025 · Resident Rights

  • Potential for harm · E August 20, 2025

    Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

    Corrected October 3, 2025 · Resident Rights

  • Potential for harm · D August 20, 2025

    Develop and implement policies and procedures to prevent abuse, neglect, and theft.

    Corrected October 3, 2025 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · E August 20, 2025

    Not require residents to give up Medicare or Medicaid benefits, or pay privately as a condition of admission; and must tell residents what care they do not provide.

    Corrected October 3, 2025 · Resident Rights

  • Potential for harm · E August 20, 2025

    Ensure each resident receives an accurate assessment.

    Corrected October 3, 2025 · Resident Assessment and Care Planning

  • Potential for harm · D August 20, 2025

    Provide appropriate foot care.

    Corrected October 3, 2025 · Quality of Life and Care

  • Potential for harm · D August 20, 2025

    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

    Corrected October 3, 2025 · Quality of Life and Care

  • Potential for harm · E August 20, 2025

    Provide safe and appropriate respiratory care for a resident when needed.

    Corrected October 3, 2025 · Quality of Life and Care

  • Potential for harm · E August 20, 2025

    Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.

    Corrected October 3, 2025 · Quality of Life and Care

  • Potential for harm · D August 20, 2025

    Provide timely, quality laboratory services/tests to meet the needs of residents.

    Corrected October 3, 2025 · Administration

  • Potential for harm · D August 20, 2025

    Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.

    Corrected November 19, 2025 · Nutrition and Dietary

  • Potential for harm · E August 20, 2025

    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

    Corrected October 3, 2025 · Nutrition and Dietary

  • Potential for harm · E August 20, 2025

    Have a plan that describes the process for conducting QAPI and QAA activities.

    Corrected October 3, 2025 · Administration

  • Potential for harm · D August 20, 2025

    Have the Quality Assessment and Assurance group have the required members and meet at least quarterly

    Corrected October 3, 2025 · Administration

  • Potential for harm · E August 20, 2025

    Provide and implement an infection prevention and control program.

    Corrected October 3, 2025 · Infection Control

  • Potential for harm · D August 20, 2025

    Develop and implement policies and procedures for flu and pneumonia vaccinations.

    Corrected October 3, 2025 · Infection Control

  • Potential for harm · D August 20, 2025

    Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.

    Corrected October 3, 2025 · Infection Control

  • Potential for harm · D August 20, 2025

    Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

    Corrected October 3, 2025 · Environmental

  • Potential for harm · E August 20, 2025 · found via complaint

    Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

    Corrected October 3, 2025 · Resident Rights

  • Potential for harm · E August 20, 2025 · found via complaint

    Ensure services provided by the nursing facility meet professional standards of quality.

    Corrected October 3, 2025 · Resident Assessment and Care Planning

Showing the 25 most recent. The Safety Report includes every citation with full findings.

Federal penalties

DateTypeAmount / length
January 21, 2025Fine$134,043
January 21, 2025Payment Denial14 days
January 19, 2024Fine$26,687
January 19, 2024Payment Denial19 days
September 25, 2023Fine$4,587
September 18, 2023Fine$4,587
September 11, 2023Fine$4,587
September 5, 2023Fine$4,587
August 28, 2023Fine$4,587
August 7, 2023Fine$11,645

Family & resident reviews — a separate signal, never mixed into the score

No approved reviews yet. If your family has experience with this facility, yours could be the review that helps the next family decide.

Sign in to share your family's experience — reviews are moderated and never affect the Safety Score.

Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 265236 · certified since April 15, 1984. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.