8 health deficiencies
Top issue: Pharmacy Service (3 deficiencies)
6 fire-safety deficiencies
Top issue: Miscellaneous (2 deficiencies)
Town And Country, MO
3-star overall rating with 3-star inspections with $22,623 in total fines with 8 recent health deficiencies with 6 fire-safety deficiencies in the latest cycle
13550 South Outer 40 Road, Town And Country, MO
(314) 878-1330
Overall
3 / 5
CMS overall stars
Health inspections
3 / 5
Survey and complaint cycles
Staffing
4 / 5
RN + nurse staffing
Quality measures
2 / 5
Resident outcomes and process measures
Quick facts
Beds
321
Certified beds
Average residents
182
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Delmar Gardens
Operator or chain grouping
Approved since
1972-02-01
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
13 facilities
Chain averages 3 overall / 3 health / 3 staffing / 3 quality stars
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
RN hours / resident day
0.44
Registered nurse staffing · state 0.46 · national 0.68
LPN hours / resident day
0.77
Licensed practical nurse staffing · state 0.68 · national 0.87
Aide hours / resident day
2.64
Nurse aide staffing · state 2.33 · national 2.35
Total nurse hours
3.86
All reported nurse hours · state 3.47 · national 3.89
Licensed hours
1.21
RN + LPN hours · state 1.14 · national 1.54
Weekend hours
3.71
Weekend nurse staffing · state 3.04 · national 3.43
Weekend RN hours
0.36
Weekend registered nurse coverage · state 0.33 · national 0.47
Physical therapist
0.03
Reported PT staffing · state 0.05 · national 0.07
Adjusted RN hours
0.51
CMS adjusted RN staffing hours
Adjusted total hours
4.45
CMS adjusted total nurse staffing hours
Case-mix index
1.18
Higher values indicate more complex resident acuity
RN turnover
36%
Annual RN turnover · state 51% · national 45%
Total nurse turnover
33%
Annual nurse turnover · state 57% · national 46%
SNF VBP
Program rank
6,667
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
32.11
Composite VBP score used to determine payment impact.
Payment multiplier
0.9869
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
Readmission
0
Baseline 18.88% · Performance 23.86% · Measure score 0 · Achievement 0 · Improvement 0
Healthcare-associated infections
3.15
Baseline 5.98% · Performance 6.89% · Measure score 3.15 · Achievement 3.15 · Improvement 0
Total nurse turnover
4.88
Performance 43.72% · Measure score 4.88 · Achievement 4.88 · This facility did not have sufficient data to calculate a baseline period measure result.
Adjusted total nurse staffing
4.81
Baseline 3.48 hours · Performance 4.45 hours · Measure score 4.81 · Achievement 4.81 · Improvement 3.69
SNF QRP
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 11.65% |
10.72%
0.9 pts worse
|
No Different than the National Rate · Eligible stays 196 · Observed rate 14.8% · Lower 95% interval 9.15% |
| Discharge to community | 47.05% |
50.57%
3.5 pts worse
|
No Different than the National Rate · Eligible stays 139 · Observed rate 38.85% · Lower 95% interval 38.21% |
| Medicare spending per beneficiary | 0.73 |
1.02
0.3 pts better
|
|
| Drug regimen review with follow-up | 98.95% |
95.27%
3.7 pts better
|
Numerator 94 · Denominator 95 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 95 |
| Discharge self-care score | 26.09% |
53.69%
27.6 pts worse
|
Numerator 18 · Denominator 69 |
| Discharge mobility score | 21.74% |
50.94%
29.2 pts worse
|
Numerator 15 · Denominator 69 |
| Pressure ulcers or injuries, new or worsened | 2.13% |
2.29%
0.2 pts better
|
Numerator 2 · Denominator 94 · Adjusted rate 2.36% |
| Healthcare-associated infections requiring hospitalization | 6.89% |
7.12%
0.2 pts better
|
No Different than the National Rate · Eligible stays 95 · Observed rate 7.37% · Lower 95% interval 3.95% |
| Staff COVID-19 vaccination coverage | 6.4% |
8.2%
1.8 pts worse
|
Numerator 16 · Denominator 250 |
| Staff flu vaccination coverage | 8.78% |
42%
33.2 pts worse
|
Numerator 28 · Denominator 319 |
| Discharge function score | 27.54% |
56.45%
28.9 pts worse
|
Numerator 19 · Denominator 69 |
| Transfer of health information to provider | 97.83% |
95.95%
1.9 pts better
|
Numerator 45 · Denominator 46 |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 18 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | 25% |
25.2%
0.2 pts worse
|
Numerator 11 · Denominator 44 |
Quality measures
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 1.2 |
2.1
0.9 pts better
|
1.9
0.7 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.2 · Observed 1.2 · Expected 1.9 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 0.9 |
2.3
1.4 pts better
|
1.8
0.9 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.9 · Observed 0.7 · Expected 1.4 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 82.7% |
84.8%
2.1 pts worse
|
93.4%
10.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 89.0% · Q2 89.2% · Q3 88.3% · Q4 65.1% · 4Q avg 82.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 93.5% |
90.9%
2.6 pts better
|
95.5%
2 pts worse
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 93.5% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 4.4% |
4.1%
0.3 pts worse
|
3.3%
1.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 4.3% · Q2 2.5% · Q3 3.7% · Q4 7.1% · 4Q avg 4.4% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 1.1% |
14.7%
13.6 pts better
|
11.4%
10.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.4% · Q2 0.0% · Q3 0.7% · Q4 2.1% · 4Q avg 1.1% |
| Percentage of long-stay residents who lose too much weight | 4.8% |
5.5%
0.7 pts better
|
5.4%
0.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 4.8% · Q2 5.6% · Q3 6.5% · Q4 2.7% · 4Q avg 4.8% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 21.5% |
25.3%
3.8 pts better
|
19.6%
1.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 20.9% · Q2 20.3% · Q3 23.6% · Q4 21.2% · 4Q avg 21.5% |
| Percentage of long-stay residents who received an antipsychotic medication | 24.2% |
25.0%
0.8 pts better
|
16.7%
7.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 30.2% · Q2 27.6% · Q3 19.3% · Q4 19.4% · 4Q avg 24.2% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.0%
About the same
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 19.4% |
20.3%
0.9 pts better
|
16.3%
3.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 28.3% · Q2 5.8% · Q3 23.0% · Q4 20.1% · 4Q avg 19.4% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 15.4% |
19.8%
4.4 pts better
|
14.9%
0.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 19.7% · Q2 12.6% · Q3 12.9% · Q4 16.3% · 4Q avg 15.4% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.7% |
1.4%
0.7 pts better
|
1.0%
0.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.7% · Q2 0.6% · Q3 0.0% · Q4 1.5% · 4Q avg 0.7% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 3.1% |
2.6%
0.5 pts worse
|
1.7%
1.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 4.9% · Q2 3.2% · Q3 2.5% · Q4 1.8% · 4Q avg 3.1% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 9.8% |
18.1%
8.3 pts better
|
19.8%
10 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 5.7% · Q2 4.6% · Q3 8.6% · Q4 19.8% · 4Q avg 9.8% |
| Percentage of long-stay residents with pressure ulcers | 5.4% |
5.0%
0.4 pts worse
|
5.1%
0.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 6.3% · Q2 5.7% · Q3 3.8% · Q4 5.6% · 4Q avg 5.4% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 84.3% |
66.4%
17.9 pts better
|
81.7%
2.6 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 81.0% · Q2 81.9% · Q3 83.7% · Q4 91.0% · 4Q avg 84.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 8.9% |
13.4%
4.5 pts better
|
12.0%
3.1 pts better
|
Short Stay · 20240701-20250630 · Adjusted 8.9% · Observed 9.4% · Expected 11.8% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 2.1% |
2.2%
0.1 pts better
|
1.6%
0.5 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 2.2% · Q3 3.1% · Q4 2.7% · 4Q avg 2.1% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 74.8% |
63.5%
11.3 pts better
|
79.7%
4.9 pts worse
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 74.8% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 24.5% |
25.3%
0.8 pts better
|
23.9%
0.6 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 24.5% · Observed 26.6% · Expected 25.8% · Used in QM five-star |
Survey summary
Top issue: Pharmacy Service (3 deficiencies)
6 fire-safety deficiencies
Top issue: Miscellaneous (2 deficiencies)
Top issue: Quality of Life and Care (6 deficiencies)
11 fire-safety deficiencies
Top issue: Smoke (4 deficiencies)
Top issue: Freedom from Abuse and Neglect and Exploitation (1 deficiency)
5 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (3 deficiencies)
Fire safety
Fire Safety
Provide a written emergency evacuation plan.
Corrected 2025-05-13
Fire Safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2025-05-13
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2025-05-13
Fire Safety
Install corridor and hallway doors that block smoke.
Corrected 2025-05-13
Fire Safety
Have properly installed electrical wiring and gas equipment.
Corrected 2025-05-13
Fire Safety
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Corrected 2025-05-13
Fire Safety
List the names and contact information of those in the facility.
Corrected 2023-12-26
Fire Safety
Develop and maintain an Emergency Preparedness Program (EP).
Corrected 2023-12-26
Fire Safety
Ensure proper usage of power strips and extension cords.
Corrected 2023-12-26
Fire Safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2023-12-26
Fire Safety
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.
Corrected 2023-12-26
Fire Safety
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Corrected 2023-12-26
Fire Safety
Install an approved automatic sprinkler system.
Corrected 2024-02-29
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2024-02-29
Fire Safety
Install corridor and hallway doors that block smoke.
Corrected 2023-12-26
Fire Safety
Have properly installed electrical wiring and gas equipment.
Corrected 2023-12-26
Fire Safety
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Corrected 2023-12-26
Fire Safety
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Corrected 2020-02-21
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2020-02-21
Fire Safety
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Corrected 2020-02-21
Fire Safety
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Corrected 2020-02-21
Fire Safety
Have proper medical gas storage and administration areas.
Corrected 2020-02-21
Inspection history
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2025-05-13
Health
Ensure medication error rates are not 5 percent or greater.
Corrected 2025-05-13
Health
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.
Corrected 2025-05-13
Health
Provide and implement an infection prevention and control program.
Corrected 2025-05-13
Health
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 2025-05-13
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2025-05-13
Health
Provide for the safe, appropriate administration of IV fluids for a resident when needed.
Corrected 2025-05-13
Health
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Corrected 2025-05-13
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2024-10-30
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2024-10-30
Health
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Corrected 2024-10-04
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2024-10-30
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2024-10-30
Health
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 2024-06-03
Health
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
Corrected 2024-06-03
Health
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
Corrected 2024-03-24
Health
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected 2023-12-26
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2023-12-26
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2023-12-26
Health
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected 2023-12-26
Health
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2023-12-26
Health
Ensure that residents are free from significant medication errors.
Corrected 2023-12-26
Health
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.
Corrected 2023-12-26
Health
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2023-07-10
Health
Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.
Corrected 2020-02-21
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2020-03-02
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2020-02-21
Health
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Corrected 2020-02-21
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2020-02-21
Health
Provide and implement an infection prevention and control program.
Corrected 2020-03-02
Penalties and ownership
Fine · fine $14,433
Fine
Fine · fine $8,190
Fine
5% Or Greater Direct Ownership Interest · Organization
5% Or Greater Indirect Ownership Interest · Organization
5% Or Greater Indirect Ownership Interest · Individual
5% Or Greater Indirect Ownership Interest · Individual
5% Or Greater Indirect Ownership Interest · Organization
5% Or Greater Indirect Ownership Interest · Organization
5% Or Greater Indirect Ownership Interest · Organization
5% Or Greater Indirect Ownership Interest · Organization
5% Or Greater Indirect Ownership Interest · Organization
Operational/Managerial Control · Organization
Corporate Officer · Individual
Corporate Officer · Individual
W-2 Managing Employee · Individual
Corporate Officer · Individual
W-2 Managing Employee · Individual
Nearby options
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5-star overall rating with 5-star inspections with $19,460 in total fines with 1 recent health deficiencies with 6 fire-safety deficiencies in the latest cycle
Chesterfield, MO
3-star overall rating with 3-star inspections with $15,646 in total fines with 18 recent health deficiencies with 15 fire-safety deficiencies in the latest cycle
Chesterfield, MO
4-star overall rating with 4-star inspections with 9 recent health deficiencies with 4 fire-safety deficiencies in the latest cycle
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