Federal inspection record · CMS data as of October 1, 2026
Manchester Rehab And Healthcare Center
312 Solley Drive, Ballwin, MO · (636) 391-0666
- Certified beds
- 137
- Residents per day
- 92
- Ownership
- For-Profit
- Chain
- Ama Holdings
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- January 18, 1989
1
How this home got 1 star
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
-
Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Missouri.
-
Staffing
★★★★★−1 star
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
-
Quality measures
★★★★★no change (already 1)
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
-
Overall
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Missouri homes
Manchester Rehab And Healthcare Center carries 132.25 inspection points. That is fewer than 26% of Missouri's 479 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Missouri: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–20 pts
- 4★ 20–54 pts
- 3★ 54–93.75 pts
- 2★ 93.75–159 pts
- 1★ over 159 pts
Bars show every rated home in Missouri by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
53 health citations on record since 2020. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
Harm and immediate-jeopardy citations (2)
-
J
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
G
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Everything else, by area of care
Quality of Life and Care15E
- E
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Provide safe and appropriate respiratory care for a resident when needed.
- D
Provide safe, appropriate dialysis care/services for a resident who requires such services.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- E
Provide care and assistance to perform activities of daily living for any resident who is unable.
- E
Provide activities to meet all resident's needs.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- E
Provide care and assistance to perform activities of daily living for any resident who is unable.
- E
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.
- E
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- E
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- D
Provide activities to meet all resident's needs.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Pharmacy Service9E
- E
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.
- D
Ensure medication error rates are not 5 percent or greater.
- E
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.
- D
Ensure medication error rates are not 5 percent or greater.
- D
Ensure that residents are free from significant medication errors.
- E
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- E
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
- D
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
- D
Ensure that residents are free from significant medication errors.
Resident Rights8E
- 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.
- E
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- D
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
- D
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.
- C
Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.
- C
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
- E
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Resident Assessment and Care Planning7E
- D
Ensure each resident receives an accurate assessment.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- E
Ensure services provided by the nursing facility meet professional standards of quality.
- E
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Freedom from Abuse, Neglect, and Exploitation4E
- E
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
- D
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Nursing and Physician Services3F
- E
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.
- F
Observe each nurse aide's job performance and give regular training.
- E
Post nurse staffing information every day.
Nutrition and Dietary2E
- E
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Administration2F
- D
Provide timely, quality laboratory services/tests to meet the needs of residents.
- F
Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
Infection Control1E
- E
Provide and implement an infection prevention and control program.
Inspection history
2025-05-23
11 health deficiencies · 11 fire-safety deficiencies
Top issue: Quality of Life and Care (5 deficiencies)
2023-12-05
15 health deficiencies · 12 fire-safety deficiencies
Top issue: Resident Rights (6 deficiencies)
2020-02-25
27 health deficiencies · 7 fire-safety deficiencies
Top issue: Quality of Life and Care (9 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 22 min of nursing staff time a day, 22 min of it from a registered nurse.
This home
3 h 22 min
Missouri average
3 h 24 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 81% of nursing staff and 67% of registered nurses left in the past year, along with 3 administrators.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Fines and payment denials
$197,132 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2025-05-23 | Fine | $197,132 |
| 2025-05-23 | Payment Denial · 12 day denial | $0 |
6
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days1.1 pts worse | 3.1 | 2.0 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident daysAbout the same | 2.2 | 2.2 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine23.5 pts worse | 60.5% | 84.0% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine4.7 pts better | 95.5% | 90.8% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury1.7 pts better | 2.3% | 4.0% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms53.6 pts worse | 73.6% | 20.0% | 13.5% |
| Percentage of long-stay residents who lose too much weight0.2 pts worse | 5.3% | 5.1% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication5.5 pts better | 20.1% | 25.6% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication11.8 pts better | 11.7% | 23.5% | 15.4% |
| Percentage of long-stay residents who were physically restrainedAbout the same | 0.0% | 0.0% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened0.3 pts worse | 16.1% | 15.8% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased1.6 pts better | 15.8% | 17.4% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.7 pts better | 0.2% | 0.9% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection0.9 pts better | 1.3% | 2.2% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence5.4 pts worse | 22.5% | 17.1% | 18.3% |
| Percentage of long-stay residents with pressure ulcers1.1 pts worse | 5.5% | 4.4% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine57.7 pts worse | 8.0% | 65.7% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit6.5 pts worse | 19.9% | 13.4% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication3.3 pts worse | 5.4% | 2.1% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine33.7 pts worse | 27.7% | 61.4% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission8.5 pts worse | 34.2% | 25.7% | 23.4% |
·
Who owns and runs it
15 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Manchester Holdco LLC | 5% Or Greater Direct Ownership Interest · Organization | 100% | 1 facilities |
| Ama Holdings LLC | 5% Or Greater Indirect Ownership Interest · Organization | 0% | 13 facilities |
| Andrew Capital LLC | 5% Or Greater Indirect Ownership Interest · Organization | 0% | 1 facilities |
| Andrew, David | 5% Or Greater Indirect Ownership Interest · Individual | 0% | 1 facilities |
| Andrew, David | W-2 Managing Employee · Individual | 0% | 1 facilities |
| Carosone, Rachel | W-2 Managing Employee · Individual | 0% | 1 facilities |
| Def Holdings LLC | 5% Or Greater Indirect Ownership Interest · Organization | 0% | 13 facilities |
| Manchester Partners LLC | 5% Or Greater Indirect Ownership Interest · Organization | 0% | 1 facilities |
| Marx, Asher | 5% Or Greater Indirect Ownership Interest · Individual | 0% | 13 facilities |
| Marx, Asher | Corporate Director · Individual | 0% | 13 facilities |
| Marx, Asher | Operational/Managerial Control · Individual | 0% | 13 facilities |
| Mo Operation Equities LLC | 5% Or Greater Indirect Ownership Interest · Organization | 0% | 2 facilities |
| Wolf, Jacques | 5% Or Greater Indirect Ownership Interest · Individual | 0% | 13 facilities |
| Wolf, Jacques | Corporate Director · Individual | 0% | 13 facilities |
| Wolf, Jacques | Operational/Managerial Control · Individual | 0% | 13 facilities |
·
Fire safety
30 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke14F
- F
Have approved installation, maintenance and testing program for fire alarm systems.
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- E
Install a fire alarm system that can be heard throughout the facility.
- E
Install an approved automatic sprinkler system.
- E
Inspect, test, and maintain automatic sprinkler systems.
- E
Install corridor and hallway doors that block smoke.
- F
Inspect, test, and maintain automatic sprinkler systems.
- F
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- E
Properly select, install, inspect, or maintain portable fire extinguishes.
- E
Install smoke barrier doors that can resist smoke for at least 20 minutes.
- F
Have approved installation, maintenance and testing program for fire alarm systems.
- F
Inspect, test, and maintain automatic sprinkler systems.
- E
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Egress5E
- E
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- E
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
- E
Install proper backup exit lighting.
- E
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.
- E
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.
Emergency Preparedness5F
- F
Develop a communication plan.
- F
List the names and contact information of those in the facility.
- F
Develop and maintain an Emergency Preparedness Program (EP).
- F
Implement emergency and standby power systems.
- F
Develop and maintain an Emergency Preparedness Program (EP).
Construction2E
- E
Use approved construction type or materials.
- E
Use approved construction type or materials.
Services2E
- E
Have properly installed electrical wiring and gas equipment.
- E
Have properly installed electrical wiring and gas equipment.
Gas, Vacuum, and Electrical Systems1F
- F
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Miscellaneous1E
- E
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
·
Other homes nearby
-
Lutheran Senior Services At Meramec Bluffs
Ballwin, MO · Evertrue
★★★★★- Worst citation, 3 yrs
- D
- Nursing / resident / day
- 7 h 32 min
- Fines
- $0
-
Delmar Gardens On The Green
Chesterfield, MO · Delmar Gardens
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 5 h 23 min
- Fines
- $46,589
-
Athene Nursing And Rehabilitation
Town And Country, MO · Vertical Health Services · Abuse icon
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 3 h 22 min
- Fines
- $149,066