Quick answers
- Where is Avenir at Mark Twain?
- 11988 Mark Twain Lane, Bridgeton, MO 63044, in St. Louis County, Missouri.
- What is the phone number of Avenir at Mark Twain?
- (314) 291-8240, as listed by Medicare (CMS).
- What is the Medicare star rating of Avenir at Mark Twain?
- Medicare overall rating: 1 out of 5 stars (CMS data updated 2026-10-01).
- Has Avenir at Mark Twain been fined?
- Medicare lists 3 fines totaling $226,126 and 3 payment denials.
- What did inspectors find at Avenir at Mark Twain?
- In its last three inspection cycles (November 8, 2019 to June 22, 2026), Medicare lists 62 health citations; the most serious was level K. 3 were level G or higher (actual harm or immediate jeopardy). See the list below (CMS data updated 2026-10-01).
Medicare ratings, explained
Star ratings are one piece of information. Visit, ask questions and talk with your doctor about what matters for your care.
Inspections, fines and staffing
In its last three inspection cycles (November 8, 2019 to June 22, 2026), Avenir at Mark Twain had 62 health citations; the most serious was level K (immediate jeopardy to resident health or safety). 3 of them were level G or higher (actual harm or immediate jeopardy). It was fined $226,126 in total (3 fines, the latest on June 22, 2026) and had 3 Medicare payment denials. Nurse staffing is 3.17 hours per resident per day; the Missouri average is 3.40 and the national average is 3.90.
Source: Medicare (CMS) Provider Data Catalog, data updated October 1, 2026, retrieved November 13, 2026.
Inspection history: last three cycles
State inspectors visit about once a year and also investigate complaints. Each citation (deficiency) has a tag number and a letter, A to L. The letter shows how serious the problem was and how many residents it affected.
What the letters A to L mean
| Seriousness | Isolated (a few residents) | Pattern (some) | Widespread (many) |
|---|---|---|---|
| No actual harm, potential for minimal harm | A | B | C |
| No actual harm, potential for more than minimal harm | D | E | F |
| Actual harm to residents | G | H | I |
| Immediate jeopardy to resident health or safety | J | K | L |
Source: the scope and severity grid Medicare (CMS) uses for nursing home citations.
Most recent cycle: August 20, 2025 — 30 health citations
Inspections in this cycle: August 20, 2025 (standard health inspection); October 7, 2025 (complaint investigation); December 19, 2025 (complaint investigation); June 22, 2026 (complaint investigation).
F0689 Level J
“Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.”
immediate jeopardy to resident health or safety; isolated (a few residents) · Quality of Life and Care Deficiencies
Show 29 less serious citations (levels A to F)
F0550 Level E
“Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.”
F0584 Level E
“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.”
F0620 Level E
“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.”
F0641 Level E
“Ensure each resident receives an accurate assessment.”
F0658 Level E
“Ensure services provided by the nursing facility meet professional standards of quality.”
F0695 Level E
“Provide safe and appropriate respiratory care for a resident when needed.”
F0700 Level E
“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.”
F0804 Level E
“Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.”
F0806 Level E
“Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.”
F0812 Level E
“Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.”
F0865 Level E
“Have a plan that describes the process for conducting QAPI and QAA activities.”
F0880 Level E
“Provide and implement an infection prevention and control program.”
F0947 Level E
“Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.”
F0580 Level D
“Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.”
F0658 Level D
“Ensure services provided by the nursing facility meet professional standards of quality.”
F0684 Level D
“Provide appropriate treatment and care according to orders, resident’s preferences and goals.”
F0684 Level D
“Provide appropriate treatment and care according to orders, resident’s preferences and goals.”
F0561 Level D
“Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.”
F0569 Level D
“Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.”
F0607 Level D
“Develop and implement policies and procedures to prevent abuse, neglect, and theft.”
F0677 Level D
“Provide care and assistance to perform activities of daily living for any resident who is unable.”
F0687 Level D
“Provide appropriate foot care.”
F0689 Level D
“Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.”
F0770 Level D
“Provide timely, quality laboratory services/tests to meet the needs of residents.”
F0808 Level D
“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.”
F0868 Level D
“Have the Quality Assessment and Assurance group have the required members and meet at least quarterly”
F0883 Level D
“Develop and implement policies and procedures for flu and pneumonia vaccinations.”
F0887 Level D
“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.”
F0925 Level D
“Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.”
Previous cycle: January 19, 2024 — 15 health citations
Inspections in this cycle: January 19, 2024 (standard health inspection); January 21, 2025 (complaint investigation); August 20, 2025 (complaint investigation).
F0689 Level K
“Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.”
immediate jeopardy to resident health or safety; pattern (some residents) · Quality of Life and Care Deficiencies
F0678 Level J
“Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.”
immediate jeopardy to resident health or safety; isolated (a few residents) · Quality of Life and Care Deficiencies
Show 13 less serious citations (levels A to F)
F0568 Level E
“Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.”
F0607 Level E
“Develop and implement policies and procedures to prevent abuse, neglect, and theft.”
F0730 Level E
“Observe each nurse aide's job performance and give regular training.”
F0804 Level E
“Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.”
F0880 Level E
“Provide and implement an infection prevention and control program.”
F0609 Level D
“Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.”
F0658 Level D
“Ensure services provided by the nursing facility meet professional standards of quality.”
F0569 Level D
“Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.”
F0661 Level D
“Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.”
F0687 Level D
“Provide appropriate foot care.”
F0688 Level D
“Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.”
F0712 Level D
“Ensure that the resident and his/her doctor meet face-to-face at all required visits.”
F0732 Level C
“Post nurse staffing information every day.”
Earlier cycle: November 8, 2019 — 17 health citations
Inspections in this cycle: November 8, 2019 (standard health inspection); January 19, 2024 (complaint investigation); April 5, 2024 (complaint investigation); September 25, 2024 (complaint investigation).
Show 17 citations (levels A to F, no actual harm)
F0550 Level E
“Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.”
F0657 Level E
“Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.”
F0658 Level E
“Ensure services provided by the nursing facility meet professional standards of quality.”
F0677 Level E
“Provide care and assistance to perform activities of daily living for any resident who is unable.”
F0689 Level E
“Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.”
F0698 Level E
“Provide safe, appropriate dialysis care/services for a resident who requires such services.”
F0802 Level E
“Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.”
F0804 Level E
“Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.”
F0812 Level E
“Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.”
F0880 Level E
“Provide and implement an infection prevention and control program.”
F0658 Level D
“Ensure services provided by the nursing facility meet professional standards of quality.”
F0609 Level D
“Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.”
F0610 Level D
“Respond appropriately to all alleged violations.”
F0561 Level D
“Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.”
F0688 Level D
“Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.”
F0623 Level B
“Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.”
F0625 Level B
“Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.”
Citation descriptions are Medicare’s official wording. “From a complaint” means the citation came from a complaint investigation instead of the regular yearly inspection.
Full inspection reports on Medicare Care Compare →
Fire safety citations (21)
E0004 Level F
“Develop and maintain an Emergency Preparedness Program (EP).”
E0006 Level F
“Conduct risk assessment and an All-Hazards approach.”
E0039 Level F
“Conduct testing and exercise requirements.”
K0372 Level F
“Ensure smoke barriers are constructed to a 1 hour fire resistance rating.”
K0914 Level F
“Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.”
K0161 Level E
“Use approved construction type or materials.”
K0223 Level E
“Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.”
K0324 Level E
“Provide properly protected cooking facilities.”
K0345 Level E
“Have approved installation, maintenance and testing program for fire alarm systems.”
K0741 Level E
“Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.”
K0222 Level D
“Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.”
K0161 Level F
“Use approved construction type or materials.”
K0291 Level F
“Install emergency lighting that can last at least 1 1/2 hours.”
K0324 Level F
“Provide properly protected cooking facilities.”
K0353 Level F
“Inspect, test, and maintain automatic sprinkler systems.”
K0761 Level F
“To conduct inspection, testing and maintenance of fire doors by qualified individuals.”
K0372 Level E
“Ensure smoke barriers are constructed to a 1 hour fire resistance rating.”
K0741 Level E
“Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.”
K0353 Level E
“Inspect, test, and maintain automatic sprinkler systems.”
K0374 Level E
“Install smoke barrier doors that can resist smoke for at least 20 minutes.”
K0700 Level E
“Meet requirements for operating features, such as evacuation plans, fire drills, smoking regulations, draperies, decorations and the inspection, testing and maintenance of fire doors.”
Fines and payment denials
Total fines over about the last three years: $226,126 (3 fines). A payment denial means Medicare stopped paying for new admissions for a time.
| Date | Penalty | Amount or length |
|---|---|---|
| June 22, 2026 | Fine | $65,396 |
| June 22, 2026 | Payment denial | from July 23, 2026, 4 days |
| January 21, 2025 | Fine | $134,043 |
| January 21, 2025 | Payment denial | from February 25, 2025, 14 days |
| January 19, 2024 | Fine | $26,687 |
| January 19, 2024 | Payment denial | from February 17, 2024, 19 days |
Source: Medicare (CMS) Penalties file, data updated October 1, 2026.
Staffing
Hours of nursing care per resident per day, from the payroll records nursing homes send to Medicare, next to the state and national averages.
| Measure | This home | Missouri | National |
|---|---|---|---|
| Registered nurse (RN) hours per resident per day | 0.48 | 0.46 | 0.69 |
| Licensed practical nurse (LPN) hours per resident per day | 0.43 | 0.68 | 0.86 |
| Nurse aide hours per resident per day | 2.26 | 2.26 | 2.35 |
| Total nurse staff hours per resident per day | 3.17 | 3.40 | 3.90 |
| Total nurse staff hours per resident per day on the weekend | 2.77 | 2.96 | 3.43 |
| RN hours per resident per day on the weekend | 0.27 | 0.32 | 0.48 |
| Nursing staff turnover (per year) | 70.1% | 56.9% | 45.3% |
| RN turnover (per year) | 66.7% | 50.0% | 42.5% |
| Administrators who left in the last year | 2.0 | 0.7 | 0.5 |
Source: Medicare (CMS) Provider Information and State US Averages, data updated October 1, 2026.
Owners and operator
Legal business name: NBH1 Mtopco LLC.
Owners and managers Medicare lists (7)
| Name | Role | Share | Since |
|---|---|---|---|
| Mark Twain Holdco LLC | Direct owner | NOT APPLICABLE | October 1, 2025 |
| Delta Edge Strategic Advisors | Indirect owner | NOT APPLICABLE | October 1, 2025 |
| HHHH Ventures LLC | Indirect owner | NOT APPLICABLE | October 1, 2025 |
| KRPSS Partners | Indirect owner | NOT APPLICABLE | October 1, 2025 |
| Felheim, Yitchok | Indirect owner | NOT APPLICABLE | October 1, 2025 |
| Jacobovitch, Yossi | Indirect owner | NOT APPLICABLE | October 1, 2025 |
| Lapciuc, Avraham | Indirect owner | NOT APPLICABLE | October 1, 2025 |
Source: Medicare (CMS) Ownership file, data updated October 1, 2026. Only owners with an ownership interest and management companies are shown.
Compare with other nursing homes
Key facts
| Type | Nursing home |
|---|---|
| Certified beds | 120 |
| Average residents per day | 81.6 |
| Takes part in | Medicare and Medicaid |
| Ownership | For profit – limited liability company |
| Legal business name | NBH1 Mtopco LLC |
| First approved by Medicare/Medicaid | 1984-04-15 |
| Resident and family councils | Resident council |
| Sprinklers in all required areas | Yes |
| Changed ownership in the last 12 months | Yes |
| Address | 11988 Mark Twain Lane, Bridgeton, MO 63044 |
| County | St. Louis County |
| State | Missouri |
| Phone | (314) 291‑8240 |
| CMS Certification Number | 265236 |
| Name in Medicare records | AVENIR AT MARK TWAIN |
| Corrections | Report an error or suggest an update → |
What to ask when you call or visit
A general checklist for any nursing home, not advice about this one. Medicare also publishes guides on medicare.gov.
- Is the home certified by Medicare and/or Medicaid, and does it have a bed for the care you need (short-term rehab or long-term care)?
- Can you see the latest state inspection report? Ask how any problems found were fixed.
- How many nurses and aides work on each shift, at night and on weekends? Is there a registered nurse on site at all times?
- Which doctors see residents, and how often? What happens in a medical emergency, and which hospital is used?
- What therapy (physical, occupational, speech) is offered, and how many days a week?
- Are residents clean, dressed and taking part in activities? Do staff speak to them kindly and answer call lights quickly?
- What do the daily rate and extra services cost, and what do Medicare, Medicaid or your insurance pay? Ask for it in writing.
- Is there a resident council and a family council? How are complaints handled? Ask for the long-term care ombudsman’s contact.
- Are meals appetizing, and can the home meet special diets, language needs and religious or cultural preferences?
- Visit more than once, including at a mealtime or in the evening, without an appointment.
Other nursing homes nearby
By straight-line distance (not driving distance).
- SSM Health Depaul Hospital - Anna House0.4 mi · Bridgeton, MO · 3 of 5 stars
- Parkwood Skilled Nursing and Rehabilitation Center0.6 mi · Maryland Heights, MO · 1 of 5 stars
- Stonebridge Maryland Heights1.1 mi · Maryland Heights, MO · 2 of 5 stars
- Life Care Center of Bridgeton1.5 mi · Bridgeton, MO · 3 of 5 stars
- NHC Healthcare, Maryland Heights1.6 mi · Maryland Heights, MO · 4 of 5 stars
Nearest hospital emergency rooms
- SSM Health Depaul Hospital St Louis0.6 mi · Bridgeton, MO · Acute Care Hospital
- SSM St Joseph Health Center3.7 mi · Saint Charles, MO · Acute Care Hospital
- Barnes-Jewish West County Hospital5.0 mi · Creve Coeur, MO · Acute Care Hospital
Sources
- Provider Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-01, retrieved 2026-11-13
- Medicare Care Compare — official Medicare profile of this provider
- Health Deficiencies — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Fire Safety Deficiencies — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Penalties — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Ownership — CMS, data updated 2026-10-01, retrieved 2026-11-13
- State US Averages — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Survey Summary — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Citation Code Look-up — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Inspection Dates — CMS, data updated 2026-10-01, retrieved 2026-11-13