Abuse citationNot flagged by Medicare3 abuse-related citations · last 3 years
Complaint citations4Last 3 years · MO avg 9
Fines, last 3 years
None
Medicare payment denials
None
Citations where a resident was harmed (actual harm)
None
Immediate-jeopardy citations (serious risk of injury or death)
None
Abuse citation
Not flagged by Medicare · 3 abuse-related citations · last 3 years
Complaint citations (inspections triggered by a complaint)
4 · MO avg 9
Loading citation details from Medicare…
“Actual harm” and “immediate jeopardy” are Medicare’s most serious inspection findings. Fines and payment denials are penalties Medicare imposed. Ask the home what changed since. A home with nothing listed here can still have lower-level citations — see Inspections below.
Sources from Medicare’s agency (CMS): CMS Provider Information & Penalties, snapshot 2026-09-01, retrieved 2026-10-09; CMS Health Deficiencies summary, as of 2026-08-01, retrieved 2026-10-08.
Staffing stability
Health inspections
3 · Average
Staffing
1 · Much below average
Quality measures
1 · Much below average
Total nurse time per resident per day: 3.36 hours (MO avg 3.43). Registered nurse time: 0.31 hours.
Staffing stability
Total nursing staff turnover73.6%High turnover can mean less continuity of care. Medicare counts staff who left over about a year.
Registered nurse (RN) turnover71.4%RNs handle assessments and complex care, so frequent changes can affect continuity.
Administrators who left the home2Counted over about a year. Frequent leadership changes can affect day-to-day management.
Weekend nurse staffing, total hours per resident per day2.93 hoursStaffing can be lower on weekends. Compare with the weekday figure above.
Weekend RN staffing, hours per resident per day0.29 hours
Case-mix-adjusted nurse staffing, hours per resident per day5.21 hoursAdjusted by Medicare for how much care residents are expected to need.
Case-mix-adjusted weekend nurse staffing, hours per resident per day4.62 hours
Source: CMS Nursing Home Care Compare — Provider Information, snapshot 2026-09-01, retrieved 2026-10-09. “Not reported” means CMS left the value blank. The CMS file has no state or national averages for these facts, so none are shown. These are facts to ask about on a visit, not a rating.
Inspections and citations
Inspections & safety
Most recent inspection2026-02-27
Previous inspection2024-04-05
Most recent inspection more than 2 years agoNoMedicare normally expects a full inspection about once a year.
Infection-control citationsNot reported
Automatic sprinklersIn all required areas
Resident and family councilResident councilA council is a group residents or families can use to raise concerns with management.
Source: CMS Nursing Home Care Compare — Provider Information, snapshot 2026-09-01, retrieved 2026-10-09. “Not reported” means CMS left the value blank. The CMS file has no state or national averages for these facts, so none are shown. These are facts to ask about on a visit, not a rating.
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Quality of care
1 out of 5
Medicare overall rating
Medicare's roll-up of health inspections, staffing, and quality measures on a 1-to-5 scale. It does not measure family experience, cost, or bed availability, and it does not by itself say whether this home is right for one specific resident.
CMS Nursing Home Care Compare — Provider Information & Penalties · 2026-09-01 · retrieved 2026-10-09
3 out of 5
Health inspections
How this home did on its most recent unannounced state health inspections, compared to other homes. It does not measure staffing levels or clinical quality on its own.
CMS Nursing Home Care Compare — Provider Information & Penalties · 2026-09-01 · retrieved 2026-10-09
1 out of 5
Staffing
Nurse staffing hours per resident per day, from payroll-based records Medicare verifies against payroll data. It does not measure the skill or attentiveness of the staff on duty, only the hours reported.
CMS Nursing Home Care Compare — Provider Information & Penalties · 2026-09-01 · retrieved 2026-10-09
1 out of 5
Quality measures
A Medicare composite of clinical outcomes reported by the facility, such as falls, pressure ulcers, and hospitalizations. It does not measure every aspect of clinical care, and it relies on the facility's own reporting.
CMS Nursing Home Care Compare — Provider Information & Penalties · 2026-09-01 · retrieved 2026-10-09
Quality measures: this home compared with the Missouri and national averages
Measure
This home
MO average
National average
Long-stay residents who need more help with daily activities than before
18.2%
18.1%
13.9%
Long-stay residents who lose too much weight
1.7%
5.3%
5.2%
Long-stay residents with a catheter left in the bladder
0.0%
1.1%
0.8%
Long-stay residents with a urinary tract infection
0.5%
2.3%
1.6%
Long-stay residents with depressive symptoms
87.3%
18.5%
12.8%
Long-stay residents who were physically restrained
0.0%
0.0%
0.1%
Long-stay residents who had a fall with major injury
1.9%
4.1%
3.2%
Long-stay residents given the pneumococcal (pneumonia) vaccine
85.8%
84.1%
93.5%
Long-stay residents whose ability to walk independently worsened
16.8%
17.4%
14.1%
Long-stay residents who received an antianxiety or sleep medication
34.2%
25.6%
19.5%
Long-stay residents given the seasonal flu vaccine
75.8%
90.9%
95.5%
Long-stay residents with pressure ulcers
7.4%
4.5%
4.6%
Long-stay residents with new or worsened bowel or bladder incontinence
14.9%
17.8%
19.0%
Long-stay residents who received an antipsychotic medication
14.0%
23.5%
15.4%
Hospitalizations per 1,000 long-stay resident days
3.88 per 1,000 days
2.11 per 1,000 days
1.90 per 1,000 days
Outpatient emergency room visits per 1,000 long-stay resident days
3.91 per 1,000 days
2.33 per 1,000 days
1.78 per 1,000 days
Short-stay residents given the pneumococcal (pneumonia) vaccine
29.7%
65.7%
82.0%
Short-stay residents who newly received an antipsychotic medication
3.1%
2.2%
1.6%
Short-stay residents given the seasonal flu vaccine
23.7%
63.5%
79.8%
Short-stay residents who were rehospitalized after admission
37.5%
26.0%
23.8%
Short-stay residents who had an outpatient emergency room visit
15.3%
13.7%
12.0%
Lower is better for falls, pressure ulcers, medications and hospital visits; higher is better for vaccines. Compare with the state, not with zero.
Chain average overall rating1.6 of 5An average across this chain's homes, from Medicare. This home's own overall rating is 1 of 5.
Changed ownership in the last 12 monthsNoA recent change can mean new management, staff or policies. Ask what has changed.
Source: CMS Nursing Home Care Compare — Provider Information, snapshot 2026-09-01, retrieved 2026-10-09. “Not reported” means CMS left the value blank. The CMS file has no state or national averages for these facts, so none are shown. These are facts to ask about on a visit, not a rating.
Owners listed with Medicare
Butler Holdco LLC (organization) · 100% · Owns 5% or more directly
Ama Holdings LLC (organization) · Owns 5% or more indirectly
Butler Manager LLC (organization) · Owns 5% or more indirectly
Butler Partners LLC (organization) · Owns 5% or more indirectly
Def Holdings LLC (organization) · Owns 5% or more indirectly
Excel Ntad LLC (organization) · Owns 5% or more indirectly
Marx, Asher (person) · Owns 5% or more indirectly; Corporate director; Has operational or managerial control
Mo Butler LLC (organization) · Owns 5% or more indirectly
Treitel, Nassan (person) · Owns 5% or more indirectly
Wolf, Jacques (person) · Has operational or managerial control; Corporate director; Owns 5% or more indirectly
Managers and operators
Leffert, Joyce · Managing employee (on payroll)
Source: CMS Nursing Home Ownership, as of 2026-08-01, retrieved 2026-10-08.
Your next step
Ratings cannot answer the most urgent questions.
Walk the building, ask what a rating can’t tell you, and write down who showed you around and what they said.
These survey medians are not this home’s price. Ask the facility for a written estimate. Medicaid may cover long-term care for those who qualify — participation is not a guarantee of coverage or an available bed.
What may pay for nursing-home care
Medicare. Covers only a short stay for skilled care after a qualifying hospital stay. That is up to 100 days, and you pay part of the cost after day 20. It does not cover ongoing custodial long-term care.
Medicaid. Medicaid pays for most long nursing home stays. You must qualify by income and savings. A home that takes Medicaid may not have a Medicaid bed open, so ask. In most states, a Medicaid health plan sets up this care. Your state Medicaid office can tell you which one.
Veterans (VA) benefits. May help eligible veterans and some spouses; rules and facilities vary.
Long-term care insurance. Pays per your policy's terms, elimination period, and daily limits.
Private pay. Out of pocket, often combined with the above. Ask each home for a written estimate.
Medicaid managed care in MO: In MO, Medicaid long-term care is generally provided directly (fee-for-service) rather than through a managed-care plan (2024). Check your state Medicaid office for current rules.
Questions to ask on a tour
What is your nurse-to-resident ratio on evenings, nights, and weekends?
How do you handle a resident's specific medical needs and medication changes?
May I see your most recent inspection results and how you fixed any issues?
Your staffing rating is below average — what are you doing to improve nurse coverage?
Your quality-measure rating is below average — how do you track falls, pressure ulcers, and rehospitalizations?
Printable — use your browser’s print.
Other nursing homes to compare nearby
Nearby means the same city first, then the same ZIP-code area and state. This is not a quality ranking.
Firsthand experiences from patients, families, and people who toured or interviewed this provider. These are separate from Medicare ratings and inspection findings.
Email ownership is verified; receipt of care is not independently verified. Positive and critical reviews follow the same moderation policy.
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How reviews are moderated
We review all ratings under the same rules: firsthand experience, no spam, harassment, conflicts of interest, or someone else’s private information. A low rating alone is never a removal reason. Tours are labeled separately. Reviews do not establish clinical quality.
Use a nickname or first name and last initial. Do not include medical records, diagnoses, contact details, or patient or staff names. Sign in with the same email to edit or withdraw your review. Provider responses require email verification, content review, and a separate check of representative authority through an independently listed contact.
Reports go to our team; they do not automatically hide reviews. For urgent safety issues, contact the provider, your state regulator, or emergency services.
Where this information comes from
Ratings, staffing, fines and safety flags: CMS Nursing Home Care Compare — Provider Information & Penalties, reporting snapshot 2026-09-01, retrieved 2026-10-09.
Harm or serious-risk, abuse and complaint citation counts: Medicare Health Deficiencies, as of 2026-08-01, retrieved 2026-10-08.
“Not reported” and “Not rated” mean Medicare left the value blank — never a zero. PlanScout is independent and not paid by any facility.
