Map showing the location of ESTATES OF ST LOUIS, LLC, THE in SAINT LOUIS, Missouri
2115 KAPPEL DRIVE, SAINT LOUIS, MO, 63136

Overall Score

CMS Five-Star Quality Rating
1/5Much below averageCMS Five-Star overall rating
  1. Much below average
  2. Below average
  3. Average
  4. Above average
  5. Much above average

Where it ranks

  • MissouriLowest tier among peers479 rated homes · average 2.5★
  • St. Louis CountyLowest tier among peers69 rated homes · average 2.3★
  • United StatesLowest tier among peers14,574 rated homes · average 3.0★

How the rating is built

  • Health inspectionsStarting point1★−1.8 vs MO avg
  • StaffingCan add or remove a star1★−1.1 vs MO avg
  • Quality measuresCan add or remove a star4★+1.3 vs MO avg

CMS starts from the health inspection stars, then adds or subtracts a star for staffing and for quality measures. Stars are assigned relative to other facilities in the same state.

Ratings & measures

Tap a row to see what it means
Health inspection ratingCMS stars from the last three on-site inspection cycles1★Lowest tier among peersMO avg2.8★U.S. avg2.8★
What is health inspection rating?

Stars assigned from the last three standard surveys and every complaint investigation in that window, weighted toward the most recent and the most serious findings. CMS assigns these stars relative to other facilities in the same state.

Why it matters

It carries the most weight in the overall rating and is the only domain based on what trained inspectors saw on site rather than what the facility reported.

Staffing ratingCMS stars from payroll-reported hours and turnover1★Lowest tier among peersMO avg2.1★U.S. avg2.9★
What is staffing rating?

Nurse and aide hours per resident day from payroll records CMS collects every quarter, adjusted for how much care residents need, plus staff turnover and weekend coverage.

Why it matters

More hours and lower turnover are the strongest predictors of fewer falls, pressure sores, and avoidable hospital stays.

Quality measures ratingCMS stars from clinical outcomes and resident assessments4★Above 71% of peersMO avg2.7★U.S. avg3.6★
What is quality measures rating?

Clinical outcomes from resident assessments and Medicare claims: falls with injury, pressure ulcers, hospitalizations, antipsychotic use, and more, for both short-stay and long-stay residents.

Why it matters

It shows whether care is working, but part of it comes from the facility’s own assessments, so read it alongside the inspection results.

Total nurse hoursPer resident per day, all nursing staff2.68hrsAbove only 11% of peersMO avg3.47Benchmark4.10
What is total nurse hours?

All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.

Why it matters

Federal research links 4.1 hours a day to fewer avoidable harms. Below about 3 hours, residents wait longer for help with basics like toileting and repositioning.

RN hoursPer resident per day, registered nurses only0.13hrsAbove only 3% of peersMO avg0.46Benchmark0.75
What is rn hours?

Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.

Why it matters

RN coverage is the staffing measure most tied to fewer hospital transfers and infections, and it is where thinly staffed facilities cut first.

Nursing staff turnoverShare of nursing staff who left within a year · lower is better61%Above only 38% of peersMO avg57%RN turnover
What is nursing staff turnover?

The share of nursing staff who left within the past year, from the same payroll data.

Why it matters

High turnover means residents are cared for by people who do not know them, and it is one of the strongest predictors of inspection problems.

Fines in the last three yearsCivil money penalties imposed by CMS · lower is better$66,640Above only 19% of peersMO avg$37,310Fines · denials1 · 0
What is fines in the last three years?

Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.

Why it matters

Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.

Inspection history

Last three inspection cycles
59citations
11inspection dates
2actual harm (G–I)
0immediate jeopardy (J–L)
Dec 19, 2025most recent

Citations by monthFeb 2020 – Dec 2025

  • No actual harm (D–F)
  • Actual harm (G–I)
  • Immediate jeopardy (J–L)
  • $Fine or payment denial

Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.

Dec 19, 20251 citationCycle 1worst E · no actual harm
  1. F567Honor the resident's right to manage his or her financial affairs.Resident RightsE · patternCorrected Jan 27, 2026
Sep 3, 20251 citationCycle 1worst D · no actual harm
  1. F658Ensure services provided by the nursing facility meet professional standards of quality.Resident Assessment and Care PlanningD · isolatedCorrected Sep 29, 2025
Apr 17, 20251 citationCycle 1worst D · no actual harm
  1. F552Ensure that residents are fully informed and understand their health status, care and treatments.Resident RightsD · isolatedCorrected May 7, 2025
Feb 7, 20252 citationsCycle 1worst D · no actual harm
  1. F790Provide routine and 24-hour emergency dental care for each resident.Quality of Life and CareD · isolatedCorrected Feb 26, 2025
  2. F685Assist a resident in gaining access to vision and hearing services.Quality of Life and CareD · isolatedCorrected Feb 26, 2025
Dec 23, 202419 citationsCycle 1worst F · no actual harm
  1. F575Post a list of names, addresses, and telephone numbers of all pertinent State agencies and advocacy groups and a statement that the resident may file a complaint with the State Survey Agency.Resident RightsC · widespreadCorrected Feb 3, 2025
  2. F577Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.Resident RightsC · widespreadCorrected Feb 3, 2025
  3. F582Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.Resident RightsD · isolatedCorrected Feb 3, 2025
  4. F607Develop and implement policies and procedures to prevent abuse, neglect, and theft.Freedom from Abuse, Neglect, and ExploitationE · patternCorrected Feb 3, 2025
  5. F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Feb 3, 2025
  6. F610Respond appropriately to all alleged violations.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Feb 3, 2025
  7. F623Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.Resident RightsE · patternCorrected Feb 3, 2025
  8. F641Ensure each resident receives an accurate assessment.Resident Assessment and Care PlanningD · isolatedCorrected Feb 3, 2025
  9. F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.Resident Assessment and Care PlanningE · patternCorrected Feb 3, 2025
  10. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareD · isolatedCorrected Feb 3, 2025
  11. F695Provide safe and appropriate respiratory care for a resident when needed.Quality of Life and CareD · isolatedCorrected Feb 3, 2025
  12. F585Honor 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.Resident RightsD · isolatedCorrected Feb 3, 2025
  13. F761Ensure 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.Pharmacy ServiceD · isolatedCorrected Feb 3, 2025
  14. F880Provide and implement an infection prevention and control program.Infection ControlF · widespreadCorrected Feb 3, 2025
  15. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryF · widespreadCorrected Feb 3, 2025
  16. Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.Resident RightsE · patternCorrected Feb 3, 2025
  17. F925Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.EnvironmentalF · widespreadCorrected Feb 3, 2025
  18. F790Provide routine and 24-hour emergency dental care for each resident.Quality of Life and CareD · isolatedCorrected Feb 26, 2025
  19. F685Assist a resident in gaining access to vision and hearing services.Quality of Life and CareD · isolatedCorrected Feb 26, 2025
Jul 12, 20242 citationsCycle 2worst G · actual harm$66,640
  1. F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.Freedom from Abuse, Neglect, and ExploitationG · isolatedCorrected Jul 22, 2024
  2. F744Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.Quality of Life and CareD · isolatedCorrected Jul 22, 2024
May 31, 20241 citationCycle 2worst D · no actual harm
  1. F658Ensure services provided by the nursing facility meet professional standards of quality.Resident Assessment and Care PlanningD · isolatedCorrected Jun 3, 2024
Apr 3, 20241 citationCycle 2worst D · no actual harm
  1. F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Apr 8, 2024
Feb 26, 20241 citationCycle 2worst G · actual harm
  1. F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.Freedom from Abuse, Neglect, and ExploitationG · isolatedCorrected Feb 10, 2024
Aug 24, 202321 citationsCycle 2worst F · no actual harm
  1. F925Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.EnvironmentalF · widespreadCorrected Oct 6, 2023
  2. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareD · isolatedCorrected Oct 6, 2023
  3. F567Honor the resident's right to manage his or her financial affairs.Resident RightsE · patternCorrected Oct 6, 2023
  4. F568Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.Resident RightsE · patternCorrected Oct 6, 2023
  5. F569Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.Resident RightsD · isolatedCorrected Oct 6, 2023
  6. F570Assure the security of all personal funds of residents deposited with the facility.Resident RightsC · widespreadCorrected Oct 6, 2023
  7. F575Post a list of names, addresses, and telephone numbers of all pertinent State agencies and advocacy groups and a statement that the resident may file a complaint with the State Survey Agency.Resident RightsC · widespreadCorrected Oct 6, 2023
  8. F576Ensure residents have reasonable access to and privacy in their use of communication methods.Resident RightsB · patternCorrected Oct 6, 2023
  9. F577Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.Resident RightsC · widespreadCorrected Oct 6, 2023
  10. F583Keep residents' personal and medical records private and confidential.Resident RightsD · isolatedCorrected Oct 6, 2023
  11. F584Honor 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.Resident RightsE · patternCorrected Oct 6, 2023
  12. F585Honor 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.Resident RightsE · patternCorrected Oct 6, 2023
  13. F610Respond appropriately to all alleged violations.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Oct 6, 2023
  14. F658Ensure services provided by the nursing facility meet professional standards of quality.Resident Assessment and Care PlanningD · isolatedCorrected Oct 6, 2023
  15. F677Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and CareD · isolatedCorrected Oct 6, 2023
  16. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareE · patternCorrected Oct 6, 2023
  17. F727Have 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.Nursing and Physician ServicesE · patternCorrected Oct 6, 2023
  18. F801Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.Nutrition and DietaryF · widespreadCorrected Oct 6, 2023
  19. F759Ensure medication error rates are not 5 percent or greater.Pharmacy ServiceD · isolatedCorrected Oct 6, 2023
  20. F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Resident Assessment and Care PlanningD · isolatedCorrected Oct 6, 2023
  21. F880Provide and implement an infection prevention and control program.Infection ControlE · patternCorrected Oct 6, 2023
Feb 11, 20209 citationsCycle 3worst E · no actual harm
  1. F637Assess the resident when there is a significant change in conditionResident Assessment and Care PlanningD · isolatedCorrected Mar 25, 2020
  2. Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.Resident Assessment and Care PlanningD · isolatedCorrected Mar 25, 2020
  3. Assure that each resident’s assessment is updated at least once every 3 months.Resident Assessment and Care PlanningE · patternCorrected Mar 25, 2020
  4. F658Ensure services provided by the nursing facility meet professional standards of quality.Resident Assessment and Care PlanningD · isolatedCorrected Mar 25, 2020
  5. F568Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.Resident RightsE · patternCorrected Mar 25, 2020
  6. F569Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.Resident RightsE · patternCorrected Mar 25, 2020
  7. F636Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.Resident Assessment and Care PlanningE · patternCorrected Mar 25, 2020
  8. F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Resident Assessment and Care PlanningE · patternCorrected Mar 25, 2020
  9. F759Ensure medication error rates are not 5 percent or greater.Pharmacy ServiceE · patternCorrected Mar 25, 2020

Staffing

From quarterly payroll reports

Hours per resident per day

  • All nursing staffRNs, LPNs and aides combined2.68hrsAbove only 11% of peers−0.79 vs MO avg
  • Registered nursesRN hours only0.13hrsAbove only 3% of peers−0.33 vs MO avg
  • Licensed practical nursesLPN hours0.67hrs
  • Nurse aidesCNA hours1.88hrs
  • Weekend nursingAll staff on Saturdays and Sundays2.33hrs
  • Missouri average
  • Research benchmark (4.10 total, 0.75 RN)

Turnover & capacity

  • Nursing staff turnoverShare who left within a year · lower is better61%Above only 38% of peersMO avg 57%
  • RN turnoverRegistered nurses onlyNot ranked by CMS
  • Administrators who leftIn the past year1Leadership changed
  • Occupancy94 certified beds · ~81 residents a day86%Above 76% of peersMO avg 72%

Fines & penalties

Roughly the past three years

Enforcement summary

  • $66,640In fines
  • 1Fine
  • 0Payment denials
  • $37,310MO avg in fines
Above only 19% of peersFewer fines than 19% of rated homes in Missouri

Actions on record

  1. Jul 12, 2024Civil money penalty$66,640

Ownership

As filed with CMS

Structure

Ownership type
For profit - Limited Liability company
Chain
Independent
Certification
Medicare and Medicaid
Location type
Urban
Ownership change
None in the last 12 months

People and entities on file

Direct owners (5%+)
  • Zev Rosenberg
  • Tuviyah Spector
Operational or managerial control
  • Elaine Fleetwood
  • Shawn Gao

Person Organization

Sources & notes

Public data, updated quarterly

Data sources

  • CMS Care Compare · Provider InformationStar ratings, staffing hours, turnover, penalties and flags · processed February 2026.
  • CMS Health CitationsEvery deficiency from the last three inspection cycles, with scope, severity and inspection cycle.
  • CMS Penalties and Ownership filesCivil money penalties, payment denials, and the owners and managers on file.

Notes

  • CMS Certification Number 265712 · 2115 KAPPEL DRIVE, SAINT LOUIS, MO, 63136.
  • Percentiles compare this facility with every rated nursing home in Missouri and St. Louis County. Turnover and fines are inverted so a high percentile is always good.
  • This is an informational summary of public data, not medical, legal, or placement advice. Facilities cannot pay to change it; a facility that believes a record is wrong can dispute it with CMS.

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