Manchester Rehab and Healthcare Center
A nursing home in Ballwin, Missouri 63021
312 Solley Drive, Ballwin, Missouri 63021. (636) 391-0666.
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The short answer
Record last released by CMS on Oct 28, 2026.
- 1of 5 CMS’s overall rating
- 11 health citations at the latest inspection cycle Missouri average: 11.4
- 3.37 nurse hours per resident per day Missouri average: 3.40
- 1 fine 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?
11 health citations at the latest inspection cycle
The Missouri average is 11.4.
Last standard inspection May 23, 2025.
Most serious in three years: immediate jeopardy to health or safety (J), at a standard inspection on May 23, 2025
CMS, Provider Information, State and US Averages and Health Deficiencies. Released Oct 28, 2026. Updated monthly.
When those citations happened
33 citations in 7 months of the last 36. Last cited May 2025. Most serious: immediate jeopardy to health or safety (J). 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 33 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. 17 came from complaint inspections.
CMS, Health Deficiencies. Released Oct 28, 2026. Updated monthly.
May 23, 2025: standard inspection8 citations
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Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
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Develop and implement policies and procedures to prevent abuse, neglect, and theft.
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Ensure each resident receives an accurate assessment.
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Provide appropriate treatment and care according to orders, resident’s preferences and goals.
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Provide safe and appropriate respiratory care for a resident when needed.
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Provide safe, appropriate dialysis care/services for a resident who requires such services.
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Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
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Provide timely, quality laboratory services/tests to meet the needs of residents.
May 23, 2025: standard and complaint inspection3 citations
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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.
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Provide care and assistance to perform activities of daily living for any resident who is unable.
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Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Nov 7, 2024: complaint inspection1 citation
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Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Sep 20, 2024: complaint inspection1 citation
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Ensure services provided by the nursing facility meet professional standards of quality.
Jul 8, 2024: complaint inspection1 citation
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Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
May 23, 2024: complaint inspection3 citations
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Provide care and assistance to perform activities of daily living for any resident who is unable.
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Ensure medication error rates are not 5 percent or greater.
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Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Jan 16, 2024: complaint inspection2 citations
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Develop and implement policies and procedures to prevent abuse, neglect, and theft.
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Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Dec 5, 2023: standard inspection8 citations
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Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
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Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
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Develop and implement a complete care plan that meets all the resident’s needs, with timetables and actions that can be measured.
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Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
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Ensure medication error rates are not 5 percent or greater.
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Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
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Allow residents to easily view the nursing home’s survey results and communicate with advocate agencies.
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Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Dec 5, 2023: standard and complaint inspection6 citations
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Honor the resident’s right to a dignified existence, self-determination, communication, and to exercise his or her rights.
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Honor the resident’s right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
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Ensure services provided by the nursing facility meet professional standards of quality.
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Provide care and assistance to perform activities of daily living for any resident who is unable.
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Provide activities to meet all resident’s needs.
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Ensure that residents are free from significant medication errors.
Is it certified, and in good standing?
- Certified for Medicare and Medicaid since Jan 18, 1989.
- Not on CMS’s special focus list.
- No abuse icon from CMS.
- No change of ownership in the last 12 months.
- CMS lists its ownership as for profit, corporation.
- 137 certified beds.
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
Has it been fined or penalized?
- 1 fine in the last three years, $197,132 in all.
- 1 Medicare payment denial in the last three years.
- 17 citations in the last three years came from complaint inspections.
CMS, Penalties and Health Deficiencies. Released Oct 28, 2026. Updated monthly.
| Date | Kind | Amount |
|---|---|---|
| May 23, 2025 | Medicare payment denial | Not given |
| May 23, 2025 | Fine | $197,132 |
Who does the caring?
3.37 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 | 3.37 | 3.40 |
| Of which registered nurses | 0.37 | 0.46 |
| At weekends | 2.95 | 2.96 |
| Nursing staff turnover | 80.6% | 56.9% |
| Registered nurse turnover | 66.7% | 50% |
| Administrators who left | 3 | Not given |
Who owns it?
- Manchester Holdco LLC owns 100% directly since May 24, 2023.
- 9 owners or officers are people: Asher Marx (owns 5% or more through other companies, 40%); Asher Marx (corporate director, 40%); Asher Marx (runs it (operational or managerial control), 40%); Jacques Wolf (owns 5% or more through other companies, 40%); Jacques Wolf (corporate director, 40%); Jacques Wolf (runs it (operational or managerial control), 40%); David Andrew (owns 5% or more through other companies, 14.25%); David Andrew (managing employee (on the payroll), 14.25%); Rachel Carosone (managing employee (on the payroll)).
- Part of AMA Holdings (13 homes in CMS’s data).
- 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 |
|---|---|---|---|
| Manchester Partners LLC | Owns 5% or more through other companies | 100% | May 24, 2023 |
| Manchester Holdco LLC | Owns 5% or more directly | 100% | May 24, 2023 |
| Mo Operation Equities LLC | Owns 5% or more through other companies | 85% | May 24, 2023 |
| DEF Holdings LLC | Owns 5% or more through other companies | 42.5% | May 24, 2023 |
| AMA Holdings LLC | Owns 5% or more through other companies | 42.5% | May 24, 2023 |
| Andrew Capital LLC | Owns 5% or more through other companies | 15% | May 24, 2023 |
How do residents fare?
- CMS rates its quality measures 1 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 | 2 of 5 |
| Staffing | 1 of 5 |
| Quality measures | 1 of 5 |
How does it compare nearby?
- Among the 12 nearest homes, within 4.2 miles, this one had the 5th most health citations at the latest inspection cycle (11; the middle value was 9).
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
| Place | Miles away | Citations, latest cycle |
|---|---|---|
| Manchester Rehab and Healthcare Center This nursing home | 11 | |
| Lutheran Senior Services at Meramec Bluffs | 1.0 | 3 |
| Delmar Gardens on the Green | 2.1 | 12 |
| Athene Nursing and Rehabilitation | 2.7 | 31 |
| Big Bend Woods Healthcare Center | 3.1 | 9 |
| Garden View Care Center at Dougherty Ferry | 3.2 | 4 |
| The Quarters at Des Peres | 3.5 | 19 |
| Ellisville Rehabilitation and Nursing | 3.7 | 41 |
| Mason Pointe Care Center | 3.8 | 2 |
| Delmar Gardens West | 3.8 | 9 |
| Garden View Care Center of Chesterfield | 4.0 | 8 |
| Aegis Health and Rehabilitation | 4.2 | 7 |
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
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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).
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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).
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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).
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Centers for Medicare & Medicaid Services, All Owners (afe44b85-cc6d-40d7-b5df-00ae8910d1d2).
Checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
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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
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Paid listing
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