Avenir at Mark Twain
11988 Mark Twain Lane, Bridgeton, MO 63044 · St. Louis County · 120 certified beds · avg 77 residents/day · certified since Apr 15, 1984
1/5
Health inspection rating (on-site)
3
Serious findings on record
$183,665
Fines, last 3 years
4.11
Nurse hours/resident/day (adjusted)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★☆☆☆☆1/5 · CMS overall rating: 1/5
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.
Most serious findings (actual harm or immediate jeopardy)
▲ Immediate jeopardy, one-off · Jun 22, 2026 · F-0689 · triggered by a complaint
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.
Severity (J): Inspectors found a situation that put a resident's life or safety in immediate danger, affecting one or a few residents. The facility must fix it immediately — these citations often come with large fines.
Corrected: Jul 27, 2026 (Deficient, Provider has date of correction)
▲ Immediate jeopardy, one-off · Jan 21, 2025 · F-0678 · triggered by a complaint
The facility did not provide basic life support, such as CPR, before emergency medical help arrived — care that's required when it matches the doctor's orders and the resident's own written wishes.
Why it matters: In a cardiac or breathing emergency, failure to start CPR promptly can be the difference between life and death.
Severity (J): Inspectors found a situation that put a resident's life or safety in immediate danger, affecting one or a few residents. The facility must fix it immediately — these citations often come with large fines.
Corrected: Jan 17, 2025 (Deficient, Provider has date of correction)
▲ Immediate jeopardy, repeated · Jan 19, 2024 · F-0689 · triggered by a complaint
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.
Severity (K): A life-threatening or extremely dangerous situation affected several residents. Among the most serious findings an inspection can produce.
Corrected: Jan 19, 2024 (Deficient, Provider has date of correction)
All citations in the current public record (63)
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Jun 22, 2026 | ▲ J · Immediate jeopardy, one-off | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint |
| Dec 19, 2025 | D · Potential for harm, one-off | The facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away. · from a complaint |
| Dec 19, 2025 | D · Potential for harm, one-off | The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow. · from a complaint |
| Dec 19, 2025 | D · Potential for harm, one-off | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · from a complaint |
| Oct 7, 2025 | D · Potential for harm, one-off | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · from a complaint |
| Aug 20, 2025 | E · Potential for harm, repeated | The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. · from a complaint |
| Aug 20, 2025 | E · Potential for harm, repeated | The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. |
| Aug 20, 2025 | E · Potential for harm, repeated | The facility required residents to give up Medicare or Medicaid benefits or pay privately as a condition of moving in, or failed to tell residents which types of care it does not provide. Both practices are against the rules. |
| Aug 20, 2025 | E · Potential for harm, repeated | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. |
| Aug 20, 2025 | E · Potential for harm, repeated | The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow. · from a complaint |
| Aug 20, 2025 | E · Potential for harm, repeated | The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. |
| Aug 20, 2025 | E · Potential for harm, repeated | The facility used bed rails without first trying safer alternatives, or without assessing the resident's safety risk, discussing the risks and benefits with the resident or family, getting consent, and installing the rails correctly. |
| Aug 20, 2025 | E · Potential for harm, repeated | The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature. · from a complaint |
| Aug 20, 2025 | E · Potential for harm, repeated | The facility did not provide food that accounts for each resident's allergies, intolerances, and personal preferences, or did not offer appealing alternatives. · from a complaint |
| Aug 20, 2025 | E · Potential for harm, repeated | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Aug 20, 2025 | E · Potential for harm, repeated | The facility did not have a written plan describing how it runs its quality improvement program — the ongoing process of finding problems in care and fixing them. |
| Aug 20, 2025 | E · Potential for harm, repeated | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Aug 20, 2025 | E · Potential for harm, repeated | The facility did not make sure its nurse aides had the skills needed to care for residents, including training in dementia care and abuse prevention. · from a complaint |
| Aug 20, 2025 | D · Potential for harm, one-off | The facility did not honor residents' right to make their own choices about their daily lives, such as when to wake up, what to eat, or how to spend their time. |
| Aug 20, 2025 | D · Potential for harm, one-off | The facility did not properly notify residents about the balance of money it holds for them, or failed to return those funds when a resident was discharged, evicted, or died. |
| Aug 20, 2025 | D · Potential for harm, one-off | The facility did not develop and follow policies and procedures to prevent abuse, neglect, and theft. These written safeguards are the foundation of resident protection. |
| Aug 20, 2025 | D · Potential for harm, one-off | The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. · from a complaint |
| Aug 20, 2025 | D · Potential for harm, one-off | The facility did not provide proper foot care for residents. Foot care includes routine care like nail trimming and attention to foot problems, which matter greatly for older adults. |
| Aug 20, 2025 | D · Potential for harm, one-off | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. |
| Aug 20, 2025 | D · Potential for harm, one-off | The facility did not provide timely, quality laboratory tests to meet residents' needs. |
| Aug 20, 2025 | D · Potential for harm, one-off | The facility did not make sure special medical diets — like low-sodium or diabetic diets — were properly ordered by the resident's doctor or managed by a qualified dietitian as state law allows. |
| Aug 20, 2025 | D · Potential for harm, one-off | The facility's quality committee — the internal group responsible for finding and fixing care problems — did not have the required members or did not meet at least every three months. |
| Aug 20, 2025 | D · Potential for harm, one-off | The facility did not develop and follow policies and procedures for offering residents flu and pneumonia vaccinations. |
| Aug 20, 2025 | D · Potential for harm, one-off | The facility did not educate residents and staff about COVID-19 vaccination, offer the vaccine to those eligible after that education, or properly document everyone's vaccination status. |
| Aug 20, 2025 | D · Potential for harm, one-off | The facility did not maintain an effective pest control program to prevent or deal with mice, insects, or other pests. |
| Jan 21, 2025 | ▲ J · Immediate jeopardy, one-off | The facility did not provide basic life support, such as CPR, before emergency medical help arrived — care that's required when it matches the doctor's orders and the resident's own written wishes. · from a complaint |
| Jan 21, 2025 | D · Potential for harm, one-off | The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint |
| Jan 21, 2025 | D · Potential for harm, one-off | The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow. · from a complaint |
| Sep 25, 2024 | D · Potential for harm, one-off | The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow. · from a complaint |
| Apr 5, 2024 | D · Potential for harm, one-off | The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint |
| Apr 5, 2024 | D · Potential for harm, one-off | The facility did not respond appropriately to alleged violations, such as reports of abuse, neglect, or mistreatment. Facilities must investigate every allegation and protect residents while they do. · from a complaint |
| Jan 19, 2024 | ▲ K · Immediate jeopardy, repeated | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint |
| Jan 19, 2024 | E · Potential for harm, repeated | The facility did not properly hold, secure, and manage residents' personal money that was deposited with it for safekeeping. Facilities holding residents' funds must keep careful, honest accounts. |
| Jan 19, 2024 | E · Potential for harm, repeated | The facility did not develop and follow policies and procedures to prevent abuse, neglect, and theft. These written safeguards are the foundation of resident protection. |
| Jan 19, 2024 | E · Potential for harm, repeated | The facility did not observe each nurse aide's job performance or provide regular training as required. |
| Jan 19, 2024 | E · Potential for harm, repeated | The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature. · from a complaint |
| Jan 19, 2024 | E · Potential for harm, repeated | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Jan 19, 2024 | D · Potential for harm, one-off | The facility did not properly notify residents about the balance of money it holds for them, or failed to return those funds when a resident was discharged, evicted, or died. |
| Jan 19, 2024 | D · Potential for harm, one-off | When a resident had a planned discharge, the facility did not make sure the necessary information was communicated to the resident and to the doctors or facility taking over their care. |
| Jan 19, 2024 | D · Potential for harm, one-off | The facility did not provide proper foot care for residents. Foot care includes routine care like nail trimming and attention to foot problems, which matter greatly for older adults. · from a complaint |
| Jan 19, 2024 | D · Potential for harm, one-off | The facility did not provide the care needed to maintain or improve residents' movement and flexibility — such as range-of-motion exercises — leading to avoidable decline. |
| Jan 19, 2024 | D · Potential for harm, one-off | The facility did not make sure residents actually saw their doctor face-to-face at all required visits. Doctors must examine nursing home residents in person on a regular schedule. |
| Jan 19, 2024 | C · Minimal risk, facility-wide | The facility did not post its nurse staffing information every day. Nursing homes must publicly display how many nurses and aides are on duty each day. |
| Sep 7, 2023 | D · Potential for harm, one-off | The facility did not provide basic life support, such as CPR, before emergency medical help arrived — care that's required when it matches the doctor's orders and the resident's own written wishes. · from a complaint |
| Nov 8, 2019 | E · Potential for harm, repeated | The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. |
| Nov 8, 2019 | E · Potential for harm, repeated | The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. |
| Nov 8, 2019 | E · Potential for harm, repeated | The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow. |
| Nov 8, 2019 | E · Potential for harm, repeated | The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. |
| Nov 8, 2019 | E · Potential for harm, repeated | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. |
| Nov 8, 2019 | E · Potential for harm, repeated | The facility did not provide safe, appropriate care for residents who need dialysis — the treatment that filters the blood when kidneys fail. |
| Nov 8, 2019 | E · Potential for harm, repeated | The facility did not have enough support staff to safely and effectively run its food and nutrition service. |
| Nov 8, 2019 | E · Potential for harm, repeated | The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature. |
| Nov 8, 2019 | E · Potential for harm, repeated | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Nov 8, 2019 | E · Potential for harm, repeated | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Nov 8, 2019 | D · Potential for harm, one-off | The facility did not honor residents' right to make their own choices about their daily lives, such as when to wake up, what to eat, or how to spend their time. |
| Nov 8, 2019 | D · Potential for harm, one-off | The facility did not provide the care needed to maintain or improve residents' movement and flexibility — such as range-of-motion exercises — leading to avoidable decline. |
| Nov 8, 2019 | B · Minimal risk, repeated | The facility did not give residents (and their representatives and the ombudsman, a state advocate for residents) proper advance notice before a transfer or discharge, including information about their right to appeal. |
| Nov 8, 2019 | B · Minimal risk, repeated | The facility did not give the resident or their representative written notice of how long it would hold the resident's bed during a hospital stay or approved leave. |
Inspection trend by year
Citations from standard inspections increased between the last two inspection cycles (12 → 25).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2019 | 14 | 0 | E |
| 2023 | 1 | 0 | D |
| 2024 | 15 | 1 | K ▲ |
| 2025 | 32 | 1 | J ▲ |
| 2026 | 1 | 1 | J ▲ |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
Fines and enforcement (last 3 years)
7 fines totaling $183,665, plus 2 Medicare payment denial periods.
| Date | Type | Amount / length |
|---|---|---|
| Jan 21, 2025 | Fine | $134,043 |
| Jan 21, 2025 | Payment Denial | 14 days from Feb 25, 2025 |
| Jan 19, 2024 | Fine | $26,687 |
| Jan 19, 2024 | Payment Denial | 19 days from Feb 17, 2024 |
| Sep 25, 2023 | Fine | $4,587 |
| Sep 18, 2023 | Fine | $4,587 |
| Sep 11, 2023 | Fine | $4,587 |
| Sep 5, 2023 | Fine | $4,587 |
| Aug 28, 2023 | Fine | $4,587 |
Nurse staffing (from payroll records, adjusted for how much care residents need)
| Measure | This facility | Missouri avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 4.11 | 3.66 | 3.95 | top 29% in Missouri; top 35% in the U.S. |
| Registered Nurse hours | 0.58 | 0.49 | 0.69 | top 26% in Missouri; bottom 49% in the U.S. |
| Weekend total nurse staffing | 3.65 | 3.22 | 3.50 | top 29% in Missouri; top 36% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.29 | 0.33 | 0.48 | top 44% in Missouri; bottom 31% in the U.S. |
| Total nursing staff turnover (%) | 71.4 | 56.0 | 45.8 | bottom 14% in Missouri; bottom 5% in the U.S. |
| RN turnover (%) | 75.0 | 47.8 | 42.9 | bottom 15% in Missouri; bottom 9% in the U.S. |
Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 3.47, RN 0.49, weekend 3.08. Staffing rating: 2/5.
Self-reported quality measures
Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.
Quality measures rating: 3/5 · long-stay residents: 3/5 · short-stay residents: —/5
Who owns this facility
For profit - Limited Liability company · changed ownership in the last 12 months
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Delta Edge Strategic Advisors | Organization | Indirect Ownership Interest | NOT APPLICABLE | 10/01/2025 |
| Felheim, Yitchok | Individual | Indirect Ownership Interest | NOT APPLICABLE | 10/01/2025 |
| HHHH Ventures LLC | Organization | Indirect Ownership Interest | NOT APPLICABLE | 10/01/2025 |
| Jacobovitch, Yossi | Individual | Indirect Ownership Interest | NOT APPLICABLE | 10/01/2025 |
| KRPSS Partners | Organization | Indirect Ownership Interest | NOT APPLICABLE | 10/01/2025 |
| Lapciuc, Avraham | Individual | Indirect Ownership Interest | NOT APPLICABLE | 10/01/2025 |
| Mark Twain Holdco LLC | Organization | Direct Ownership Interest | NOT APPLICABLE | 10/01/2025 |
| Bicknell, Jacqueline | Individual | Operational/Managerial Control | NOT APPLICABLE | 10/06/2025 |
| Bicknell, Jacqueline | Individual | ADP of the SNF | NOT APPLICABLE | 10/06/2025 |
| Delta Edge Strategic Advisors | Organization | ADP of the SNF | NOT APPLICABLE | 10/01/2025 |
| HHHH Ventures LLC | Organization | ADP of the SNF | NOT APPLICABLE | 10/01/2025 |
| Jacobovitch, Yossi | Individual | Managing Control - Governing Body | NOT APPLICABLE | 10/01/2025 |
| Jacobovitch, Yossi | Individual | Operational/Managerial Control | NOT APPLICABLE | 10/01/2025 |
| KRPSS Partners | Organization | ADP of the SNF | NOT APPLICABLE | 10/01/2025 |
| Lapciuc, Avraham | Individual | Managing Control - Governing Body | NOT APPLICABLE | 10/01/2025 |
| Lapciuc, Avraham | Individual | Operational/Managerial Control | NOT APPLICABLE | 10/01/2025 |
| NBH1 Mtpropco LLC | Organization | ADP of the SNF | NOT APPLICABLE | 10/01/2025 |
| San, Manuel | Individual | Operational/Managerial Control | NOT APPLICABLE | 10/01/2025 |
| San, Manuel | Individual | ADP of the SNF | NOT APPLICABLE | 10/01/2025 |
| Sterling, Cory | Individual | Operational/Managerial Control | NOT APPLICABLE | 10/06/2025 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
- "Are staff on every shift trained and certified in CPR, and how do they know each resident's resuscitation wishes?"
- "If my family member falls or their condition changes, exactly when and how will I be notified?"
- "Can you tell me what this citation involved and what steps you took to bring care back up to standard?"
- "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
- "Can you give me examples of how your staff protect residents' dignity in everyday care, like bathing and dressing?"
- "Can we tour the resident rooms, bathrooms, and common areas today, including areas not on the usual tour route?"
- "Do you accept Medicaid from day one, and will you put in writing that no private payment is required as a condition of admission?"
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the results and plan of correction from your most recent state inspection?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| SSM Health Depaul Hospital - Anna House | 0.4 mi | Bridgeton, MO | ★★★☆☆ | 3/5 | |
| Parkwood Skilled Nursing and Rehabilitation Center | 0.6 mi | Maryland Heights, MO | ★☆☆☆☆ | 1/5 | |
| Stonebridge Maryland Heights | 1.1 mi | Maryland Heights, MO | ★★☆☆☆ | 2/5 | |
| Life Care Center of Bridgeton | 1.5 mi | Bridgeton, MO | ★★☆☆☆ | 3/5 | |
| NHC Healthcare, Maryland Heights | 1.6 mi | Maryland Heights, MO | ★★★★☆ | 4/5 | |
| River Crossing Rehab and Healthcare Center | 2.1 mi | Saint Louis, MO | ★★☆☆☆ | 3/5 | |
| Bentleys Extended Care | 3.3 mi | Overland, MO | ★☆☆☆☆ | 1/5 | abuse |
| Laurel Meadows Wellness & Rehabilitation | 4.1 mi | Saint Charles, MO | ★★☆☆☆ | 2/5 | |
| Lewis & Clark Gardens | 4.2 mi | Saint Charles, MO | ★☆☆☆☆ | 1/5 | |
| Windsor Estates of St Charles | 4.8 mi | Saint Charles, MO | ★☆☆☆☆ | 1/5 | abuse |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 265236.