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.
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
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-day | 3.56 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.39 | 0.55–0.75 |
| Weekend hours / resident-day | 3.08 | ≈ weekday level |
| Nursing turnover / year | 57% | median 45% |
| Fines (3-yr window) | 8 · $195,310 |
Inspection citations (62 in the current record)
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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
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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
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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
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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
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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
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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
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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
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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
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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
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Potential for harm · E August 20, 2025
Ensure each resident receives an accurate assessment.
Corrected October 3, 2025 · Resident Assessment and Care Planning
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Potential for harm · D August 20, 2025
Provide appropriate foot care.
Corrected October 3, 2025 · Quality of Life and Care
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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
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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
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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
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Potential for harm · D August 20, 2025
Provide timely, quality laboratory services/tests to meet the needs of residents.
Corrected October 3, 2025 · Administration
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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
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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
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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
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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
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Potential for harm · E August 20, 2025
Provide and implement an infection prevention and control program.
Corrected October 3, 2025 · Infection Control
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Potential for harm · D August 20, 2025
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Corrected October 3, 2025 · Infection Control
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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
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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
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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
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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
| Date | Type | Amount / length |
|---|---|---|
| January 21, 2025 | Fine | $134,043 |
| January 21, 2025 | Payment Denial | 14 days |
| January 19, 2024 | Fine | $26,687 |
| January 19, 2024 | Payment Denial | 19 days |
| September 25, 2023 | Fine | $4,587 |
| September 18, 2023 | Fine | $4,587 |
| September 11, 2023 | Fine | $4,587 |
| September 5, 2023 | Fine | $4,587 |
| August 28, 2023 | Fine | $4,587 |
| August 7, 2023 | Fine | $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.
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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.