Avenir at Mark Twain
A nursing home in Bridgeton, Missouri 63044
11988 Mark Twain Lane, Bridgeton, Missouri 63044. (314) 291-8240.
- Changed ownership in the last 12 months
Watch and the shortlist are kept with a free account, on every device. Your watch list. CMS’s own record is on Care Compare.
The short answer
Record last released by CMS on Oct 28, 2026.
- 1of 5 CMS’s overall rating
- 30 health citations at the latest inspection cycle Missouri average: 11.4
- 3.17 nurse hours per resident per day Missouri average: 3.40
- 3 fines in the last three years (needs attention)
Each figure’s source sits beside it, in its section below.
What these words mean8
- Star ratings
- CMS rates some kinds of place from 1 to 5 stars, more stars meaning better on CMS’s own measures for that kind: for a nursing home, its health inspections, staffing and quality measures. A rating is CMS’s summary of those measures; it doesn’t promise good care. Source: CMS, Care Compare and the Five-Star Quality Rating System.
- Inspection (survey)
- A visit by state inspectors, often unannounced, who check a place against the rules it must meet. For nursing homes and other places Medicare pays, CMS calls these visits surveys: a standard survey of a nursing home comes at least every 15 months, and a complaint survey whenever a complaint calls for one. Source: CMS; 42 CFR 488.308.
- Deficiency, citation, violation
- What inspectors write up when a place didn’t meet a rule: the rule, what they saw, and when. CMS calls it a deficiency; states may say citation or violation. It is the inspectors’ finding, not a court’s, and the place is usually asked for a plan to correct it. Source: CMS, statement of deficiencies (Form CMS-2567); each state’s licensing agency.
- Scope and severity (A to L)
- CMS grades each nursing home deficiency with a letter. A to C: no actual harm, with potential for minimal harm. D to F: no actual harm, but potential for more. G to I: actual harm. J to L: immediate jeopardy. Within each band, the letter rises as more residents were affected or could be: one or a few, a pattern, or widespread. Source: CMS, nursing home scope and severity grid (State Operations Manual, chapter 7).
- Nurse staffing hours
- The hours registered nurses, licensed practical nurses and nurse aides worked, per resident per day, from the payroll records each home sends CMS. Source: CMS, Payroll-Based Journal.
- Fines and payment denials
- A fine (civil money penalty) is money CMS makes a nursing home pay when it falls short of federal rules. A payment denial means Medicare and Medicaid stop paying for new admissions until the home meets the rules again. Source: CMS; 42 CFR 488.430 and 488.417.
- Immediate jeopardy
- CMS’s most serious finding: the place’s failure to meet a rule caused, or was likely to cause, serious injury, harm, impairment or death to someone in its care. Source: CMS; 42 CFR 489.3.
- Capacity
- The most people the licence or certification lets the place care for at once: residents, children, beds or apartments, as the state counts them. It isn’t how many are there now. Source: Each state’s licensing agency.
What did inspectors find?
30 health citations at the latest inspection cycle
The Missouri average is 11.4.
Last standard inspection Aug 20, 2025.
Most serious in three years: immediate jeopardy to health or safety (J), at a complaint inspection on Jun 22, 2026
CMS, Provider Information, State and US Averages and Health Deficiencies. Released Oct 28, 2026. Updated monthly.
When those citations happened
48 citations in 8 months of the last 36. Last cited Jun 2026. Most serious: immediate jeopardy to health or safety (K). The last 3 years, to Nov 5, 2026.
| Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2023 | Dec | |||||||||||
| 2024 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2025 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2026 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov |
Hover or focus a month to read it.
Hearth Record drew this from the dates and levels in the source’s own records.
All 48 citations in the last three years
Grouped by inspection, newest first. Each carries CMS grades each nursing home deficiency with a letter. A to C: no actual harm, with potential for minimal harm. D to F: no actual harm, but potential for more. G to I: actual harm. J to L: immediate jeopardy. Within each band, the letter rises as more residents were affected or could be: one or a few, a pattern, or widespread. Source: CMS, nursing home scope and severity grid (State Operations Manual, chapter 7)., from A, the least serious, to L, the most. 20 came from complaint inspections.
CMS, Health Deficiencies. Released Oct 28, 2026. Updated monthly.
Jun 22, 2026: complaint inspection1 citation
-
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Dec 19, 2025: complaint inspection3 citations
-
Immediately tell the resident, the resident’s doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
-
Ensure services provided by the nursing facility meet professional standards of quality.
-
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Oct 7, 2025: complaint inspection1 citation
-
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Aug 20, 2025: standard inspection19 citations
-
Honor the resident’s right to and the facility must promote and facilitate resident self-determination through support of resident choice.
-
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
-
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.
-
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
-
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.
-
Ensure each resident receives an accurate assessment.
-
Provide appropriate foot care.
-
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
Provide safe and appropriate respiratory care for a resident when needed.
-
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.
-
Provide timely, quality laboratory services/tests to meet the needs of residents.
-
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.
-
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
-
Have a plan that describes the process for conducting QAPI and QAA activities.
-
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
-
Provide and implement an infection prevention and control program.
-
Develop and implement policies and procedures for flu and pneumonia vaccinations.
-
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.
-
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Aug 20, 2025: standard and complaint inspection6 citations
-
Honor the resident’s right to a dignified existence, self-determination, communication, and to exercise his or her rights.
-
Ensure services provided by the nursing facility meet professional standards of quality.
-
Provide care and assistance to perform activities of daily living for any resident who is unable.
-
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
-
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
-
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
Jan 21, 2025: complaint inspection3 citations
-
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
-
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
-
Ensure services provided by the nursing facility meet professional standards of quality.
Sep 25, 2024: complaint inspection1 citation
-
Ensure services provided by the nursing facility meet professional standards of quality.
Apr 5, 2024: complaint inspection2 citations
-
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
-
Respond appropriately to all alleged violations.
Jan 19, 2024: standard inspection9 citations
-
Properly hold, secure, and manage each resident’s personal money which is deposited with the nursing home.
-
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
-
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
-
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
-
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.
-
Ensure that the resident and his/her doctor meet face-to-face at all required visits.
-
Observe each nurse aide’s job performance and give regular training.
-
Provide and implement an infection prevention and control program.
-
Post nurse staffing information every day.
Jan 19, 2024: standard and complaint inspection3 citations
-
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
Provide appropriate foot care.
-
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Is it certified, and in good standing?
- Certified for Medicare and Medicaid since Apr 15, 1984.
- Not on CMS’s special focus list.
- No abuse icon from CMS.
- Changed ownership in the last 12 months.
- CMS lists its ownership as for profit, limited liability company.
- 120 certified beds.
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
Has it been fined or penalized?
- 3 fines in the last three years, $226,126 in all.
- 3 Medicare payment denials in the last three years.
- 20 citations in the last three years came from complaint inspections.
CMS, Penalties and Health Deficiencies. Released Oct 28, 2026. Updated monthly.
| Date | Kind | Amount |
|---|---|---|
| Jun 22, 2026 | Medicare payment denial | Not given |
| Jun 22, 2026 | Fine | $65,396 |
| Jan 21, 2025 | Medicare payment denial | Not given |
| Jan 21, 2025 | Fine | $134,043 |
| Jan 19, 2024 | Medicare payment denial | Not given |
| Jan 19, 2024 | Fine | $26,687 |
Who does the caring?
3.17 nurse hours per resident per day
The Missouri average is 3.40.
CMS publishes staffing about four months after the fact.
CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.
| Measure | This home | Missouri average |
|---|---|---|
| Nurse hours per resident per day | 3.17 | 3.40 |
| Of which registered nurses | 0.48 | 0.46 |
| At weekends | 2.77 | 2.96 |
| Nursing staff turnover | 70.1% | 56.9% |
| Registered nurse turnover | 66.7% | 50% |
| Administrators who left | 2 | Not given |
Who owns it?
- Mark Twain Holdco LLC owns 100% directly since Oct 1, 2025.
- 16 owners or officers are people: Yitzchok Felheim (owns a share through other companies, 28.65%); Yossi Jacobovitch (owns a share through other companies, 25.81%); Avraham Lapciuc (owns a share through other companies, 17.21%); A person CMS lists without a name (owns a share through other companies, 1%); A person CMS lists without a name (owns a share through other companies, 1%); Jacqueline Bicknell (runs it (operational or managerial control)); Jacqueline Bicknell (additional disclosable party (controls, leases property to, or provides services to the home)); Cory Sterling (runs it (operational or managerial control)); Cory Sterling (additional disclosable party (controls, leases property to, or provides services to the home)); Manuel L San (runs it (operational or managerial control)); Manuel L San (additional disclosable party (controls, leases property to, or provides services to the home)); Yossi Jacobovitch (runs it (operational or managerial control)); Yossi Jacobovitch (on the governing body (managing control)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); Avraham Lapciuc (runs it (operational or managerial control)); Avraham Lapciuc (on the governing body (managing control)).
- No private-equity firm among the owners CMS lists.
- No real-estate investment trust among the owners CMS lists.
CMS, All Owners. Checked Nov 5, 2026. Updated monthly.
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
| Organisation | Role | Share | Since |
|---|---|---|---|
| Mark Twain Holdco LLC | Owns a share directly | 100% | Oct 1, 2025 |
| Krpss Partners | Owns a share through other companies | 57.35% | Oct 1, 2025 |
| HHHH Ventures LLC | Owns a share through other companies | 26.34% | Oct 1, 2025 |
| Delta Edge Strategic Advisors | Owns a share through other companies | 25.81% | Oct 1, 2025 |
| HHHH Ventures LLC | Additional disclosable party (controls, leases property to, or provides services to the home) | Oct 1, 2025 | |
| Krpss Partners | Additional disclosable party (controls, leases property to, or provides services to the home) | Oct 1, 2025 | |
| Nbh1 Mtpropco LLC | Additional disclosable party (controls, leases property to, or provides services to the home) | Oct 1, 2025 | |
| Delta Edge Strategic Advisors | Additional disclosable party (controls, leases property to, or provides services to the home) | Oct 1, 2025 | |
| An organisation CMS lists without a name | Additional disclosable party (controls, leases property to, or provides services to the home) | Oct 1, 2025 | |
| An organisation CMS lists without a name | Additional disclosable party (controls, leases property to, or provides services to the home) | Sep 26, 2025 | |
| An organisation CMS lists without a name | Additional disclosable party (controls, leases property to, or provides services to the home) | Sep 26, 2025 |
How do residents fare?
- CMS rates its quality measures 4 of 5 (Missouri average 2.9).
CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.
| Measure | Rating |
|---|---|
| Overall rating | 1 of 5 |
| Health inspections | 1 of 5 |
| Staffing | 1 of 5 |
| Quality measures | 4 of 5 |
How does it compare nearby?
- Among the 12 nearest homes, within 4.9 miles, this one had the 3rd most health citations at the latest inspection cycle (30; the middle value was 16.5).
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
| Place | Miles away | Citations, latest cycle |
|---|---|---|
| Avenir at Mark Twain This nursing home | 30 | |
| SSM Health Depaul Hospital - Anna House | 0.4 | 14 |
| Parkwood Skilled Nursing and Rehabilitation Center | 0.6 | 31 |
| Stonebridge Maryland Heights | 1.1 | 16 |
| Life Care Center of Bridgeton | 1.5 | 14 |
| Nhc Healthcare, Maryland Heights | 1.6 | 4 |
| River Crossing Rehab and Healthcare Center | 2.1 | 8 |
| Bentleys Extended Care | 3.3 | 31 |
| Laurel Meadows Wellness & Rehabilitation | 4.1 | 9 |
| Lewis & Clark Gardens | 4.2 | 17 |
| Windsor Estates of St Charles | 4.8 | 17 |
| Creve Coeur Manor | 4.9 | 22 |
What the record doesn’t say
- Complaints that didn’t lead to a citation aren’t published.
- Inspections reach CMS’s data about six weeks after they happen, and staffing about four months after.
- CMS publishes the inspectors’ full written findings in a separate monthly file, which isn’t loaded yet.
- Fines and Medicare payment denials are the only enforcement CMS publishes; state licence actions aren’t included.
Sources
-
Centers for Medicare & Medicaid Services, Provider Information (4pq5-n9py).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
-
Centers for Medicare & Medicaid Services, Health Deficiencies (r5ix-sfxw).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
-
Centers for Medicare & Medicaid Services, Penalties (g6vv-u9sr).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
-
Centers for Medicare & Medicaid Services, All Owners (afe44b85-cc6d-40d7-b5df-00ae8910d1d2).
Checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
-
Centers for Medicare & Medicaid Services, State and US Averages (xcdc-v8bm).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
If you believe something here is wrong, a correction starts with the agency whose record this copies: CMS. CMS’s own record is on Care Compare. If Hearth Record copied something wrongly, it will fix it and log the correction publicly, with its date: how corrections work.
This copy of the record was made on Nov 5, 2026.
From the home
The public record above comes first. Anything the home adds will appear here, below it, and say who wrote it.
Replies
None. Replies aren’t open yet. When they open, the home will be able to answer any finding for free, and the reply will show beside that finding, unedited and dated.
Paid listing
None. Paid listings aren’t open yet. When they open, anything paid for will say “Paid by the home”, and paying will never change a finding, a rating or the order of results.