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Nursing homes in Missouri

Missouri has 487 Medicare- or Medicaid-certified nursing homes in 113 counties, with 50,053 certified beds in total. The state average CMS overall rating is 2.5 of 5 against a national average of 3.0, and homes report 3.43 nurse staffing hours per resident per day against 3.86 nationally.

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Missouri against the national average

MeasureMissouriUnited States
Overall rating (1 to 5)2.53.0
Health inspection rating2.82.8
Staffing rating2.22.9
Nurse staffing hours per resident per day3.433.86
Registered nurse hours per resident per day0.460.69
Nursing staff turnover56.0%45.8%
Health deficiencies in the latest inspection11.49.2
Fines per home, past three years0.80.9

Averages are published by CMS. Health inspection ratings are set within each state, so compare them across states with care.

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Cities with at least 3 homes, by the city in each home's CMS address. Every home is also listed by county below.

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Nursing home rules and contacts in Missouri

Federal rules on residents' rights, discharge notices and Medicare coverage are the same in every state. These are the offices to call in Missouri, and the rules the state sets for itself.

Minimum staffing
Missouri's nursing home licensing rules set staffing by position and shift rather than by a number of nursing hours per resident per day. Every home must have a full-time director of nursing, enough nursing staff to meet residents' needs, and a per-shift minimum number of staff for safety and protective oversight. Skilled nursing facilities need a registered nurse (RN) director of nursing, an RN on duty on the day shift, an LPN or RN on evening and night shifts, and an RN on call when only an LPN is on duty. Intermediate care facilities need an LPN or RN on duty on the day shift and on call 24/7. DHSS may grant time-limited exceptions to its own licensing rules (not to state statutes or federal regulations) if the exception would not potentially jeopardize residents' health, safety or welfare. Source: 19 CSR 30-85.042(34)-(37); 19 CSR 30-85.022(41); 19 CSR 30-82.010(4)
Personal needs allowance (Medicaid)
Missouri Medicaid (MO HealthNet) allows a nursing home resident to keep a personal needs allowance of $50 per month; the rest of the resident's income goes toward the cost of care, apart from allowed deductions such as health insurance premiums and income set aside for a spouse or dependents. The $50 amount took effect January 1, 2015. State law says that once the allowance reaches $50 there are no further increases unless authorized by annual appropriation. Source: RSMo 208.016; Family Support Division MO HealthNet for the Aged, Blind and Disabled Manual 0815.030.10.05; Memorandum IM-04 (Jan. 15, 2015)
Holding a bed during a hospital stay or leave
Missouri Medicaid pays a home its per-diem rate for hospital leave days (to reserve the bed) only if the home is licensed and certified, the stay is 3 days or less for a condition that cannot be treated as an outpatient, the hospital plans the resident's return, and the home's occupancy was at least 97% of Medicaid-certified beds the prior quarter. Leave days, including visits with friends or relatives, are covered up to 12 days in each half of the year if in the plan of care and prescribed by a physician; each hospital leave day counts as two. Refusing to readmit a resident counts as a discharge unless the resident was away over 90 days. Source: 13 CSR 70-10.070; 13 CSR 70-10.020(5)(C); 19 CSR 30-82.050(1)(B)
Visiting
Missouri law gives residents the right to communicate, associate and meet privately with persons of their choice unless this would infringe on other residents' rights, and ensures privacy for visits by a spouse. Homes must set and post regular daily visiting hours, and relatives, guardians and clergy must be allowed to see critically ill residents at any time unless a physician orders otherwise in writing. Under the Essential Caregiver Program Act, during a declared state of emergency for infectious disease, homes must let residents designate essential caregivers (at least two) for in-person contact of at least four hours a day, with limited suspensions. Source: RSMo 198.088.1(6)(k), (n); 19 CSR 30-85.042(11); RSMo 191.2290 (Essential Caregiver Program Act)
Discharge notice
Missouri's resident-rights law allows transfer or discharge only for medical reasons, the resident's welfare or that of other residents, or nonpayment; state rules list the permitted reasons as needs that cannot be met, improved health, endangered safety or health of others, nonpayment after notice, or the home closing. Written notice is required at least 30 days ahead except in emergencies. State rules require the notice to go to the resident, any legally authorized representative and at least one family member, or the regional ombudsman if no family member is known. The resident may appeal to the Department of Health and Senior Services within 30 days of receiving the notice (DHSS Appeals Unit, 573-522-1699). Filing an appeal stays the discharge unless the home shows good cause. Source: RSMo 198.088.1(2)(c), (6)(d); 19 CSR 30-82.050
Cameras in rooms
Missouri's Authorized Electronic Monitoring in Long-Term Care Facilities Act gives residents the right to place an audio or video monitoring device in their own room. The request is made on a state form provided by the home, and any roommate must consent (and may limit camera direction or audio). Monitoring cannot start until all forms are returned. The resident pays all costs except electricity, including installation, maintenance and internet. A notice must be posted at the room entrance, and the device must be in plain view in a fixed position. A home may not refuse admission or remove a resident because of a monitoring request. Source: RSMo 198.610-198.632 (Authorized Electronic Monitoring in Long-Term Care Facilities Act)
When private funds run out
Missouri law says that if the Family Support Division cannot decide Medicaid eligibility for a nursing home resident within 60 days of a completed application for nursing facility services, the resident is treated as Medicaid eligible until the application is approved or denied; benefits cannot start before the application date. This section is set to expire Sept. 30, 2029. Source: RSMo 198.428

Checked against Missouri state sources on Oct 11, 2026. Rules and phone numbers change, so confirm with the office listed. For the rules that apply in every state, see residents' rights, how to file a complaint and how Medicaid pays for a nursing home.

Source: CMS Provider Data Catalog, nursing home datasets processed Sep 1, 2026.