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Selling a skilled nursing facility in Missouri

What moves the price of a Missouri nursing home, how a sale runs from first call to change of ownership, and where to see the record for every Missouri building.

By Stan Klos III · Updated October 2026
Each point is one of Missouri's 487 certified skilled nursing facilities. See every one on SNFRadar ↗

Missouri at a glance

Missouri has 487 Medicare- and Medicaid-certified skilled nursing facilities with 50,043 certified beds, and on average 70.9% of those beds are occupied, below the national average of 80.3%.

487certified facilities
50,043certified beds
70.9%of beds occupied

Source: CMS Provider Information file, August 2026. The full Missouri picture, rates and every building are on SNFRadar, the market record we built and publish free.

What a buyer reads first in Missouri

The numbers a buyer pulls before the first call, for the typical Missouri building against the nation. Your own building's are on its SNFRadar page.

Missouri by the numbers
70.9%of beds occupiedU.S. 80.3%
69%Medicaid share of days, medianU.S. 66%
$271revenue per patient day, medianU.S. $373
3.2%net margin, medianU.S. 3.6%
3.43nurse hours per resident dayU.S. 3.86
0.46RN hours per resident dayU.S. 0.69
56.0%nurse turnover in a yearU.S. 45.8%
27%rated 4 or 5 starsU.S. 40%
53%rated 1 or 2 starsU.S. 41%

Sources: CMS Provider Information file, August 2026 (occupancy, staffing, turnover, star ratings: averages across certified buildings); Medicare cost reports (full-year filings), as SNFRadar compares them (medians, the same figures each building's SNFRadar page is compared against).

What moves value in Missouri

Occupancy. 70.9% of Missouri's certified beds are occupied, below the national 80.3%. With empty beds common, buyers pay for a building that fills its own and discount one that cannot say why it does not.

Payer mix and the Medicaid rate. Medicaid pays for 69% of resident days in the median Missouri building, close to the national 66%. Small shifts between Medicaid and Medicare census move value, which is why buyers ask for census by payer, month by month. Missouri's Medicaid rate files are on SNFRadar.

Revenue and margin. Net patient revenue runs $271 per patient day in the median Missouri filing, below the national $373, and the median net margin is 3.2%, close to the national 3.6%. Value turns on whether your building beats its state's median, not on the state.

Staffing. Missouri's buildings average 3.43 nurse staffing hours per resident per day, fewer than the national 3.86, and nurse turnover runs 56.0% a year against 45.8%. Buyers treat agency use and turnover as a cost they will inherit, so a stable staff is worth showing early.

Inspection record. 27% of Missouri buildings are rated four or five stars by Medicare and 53% one or two, against 40% and 41% nationally. With low ratings common here, a clean inspection record stands out, and buyers pay for it.

Size and ownership type. The average Missouri building has 103 certified beds, against 107 nationally. 80% are for-profit, 16% non-profit and 5% government, and 70% are part of a chain.

Where the beds are

Missouri's largest counties by certified beds. Each opens that county's buildings on SNFRadar.

CountyFacilitiesCertified beds
St. Louis699,380
Jackson394,605
Greene212,321
St. Louis City131,664
St. Charles151,484
All 113 Missouri counties

How a sale works

  1. A first call. What you want from the sale, and when. No listing, no blast.
  2. A value from the record. Your building's own numbers and the trades around it. How valuation works
  3. Vetted buyers under confidentiality, bidding against each other, not against you.
  4. Letter of intent, then the purchase agreement and the operations transfer agreement. The full process
  5. Change of ownership. Missouri's licensure filings plus Medicare and Medicaid, timed so billing does not stop. CHOW and Medicaid

Our recent closings

One shot deal · Seven states · November 2025

One shot deal: $545 million.

A 5,000-bed skilled nursing portfolio across seven states in the Midwest and Southeast, sold for approximately $545 million.

Read the deal sheet

All five closings, with the press coverage they drew.

Questions owners ask

How many nursing homes are in Missouri?

Missouri has 487 Medicare- and Medicaid-certified skilled nursing facilities with 50,043 certified beds, according to the CMS Provider Information file (August 2026).

What is the average occupancy of Missouri nursing homes?

On average 70.9% of certified beds in Missouri are occupied, below the national average of 80.3% (CMS Provider Information, August 2026).

Do you work with sellers in Missouri?

Yes. We advise skilled nursing sellers nationwide; our published closings so far are in Ohio, Mississippi, North Carolina and a seven-state portfolio across the Midwest and Southeast.

How much of Missouri's nursing home care does Medicaid pay for?

In the median Missouri building, Medicaid pays for 69% of resident days, against 66% nationally (Medicare cost reports (full-year filings), as SNFRadar compares them). That share is why Missouri's Medicaid rate method decides so much of a building's value.

Are Missouri nursing homes profitable?

The median Missouri building that filed a full-year Medicare cost report shows a net margin of 3.2%, against 3.6% nationally. Margins vary widely from building to building; each building's own filing is on its SNFRadar page.

Is the first conversation confidential?

Yes. Nothing about you or your building goes to a buyer without your say.

Do you represent buyers?

No. We represent sellers. Buyers can share their acquisition criteria with us so we know who to call when a building fits; that does not make us their broker.