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VERTICAL HEALTH SERVICES

Ownership rollup across 15 nursing homes in 3 states: Missouri, Tennessee, Washington. The "follow the money" view of an operator’s whole portfolio — the pattern a single facility page can’t show.

Insights

The chain’s homes average 1.9 of 5 stars on the CMS overall rating — about 0.7 stars below the ~2.7 average of the 3 states it operates in. A whole portfolio rating below its own states’ norm is a pattern worth researching, not a single-home fluke. It is improving: across the same 14 homes rated throughout, the average rose 0.79 stars between 2025-02 and 2026-06. We benchmark against its own states because CMS ranks the health-inspection star within each state, so a national comparison (national average ~3.0) partly measures where a chain operates rather than how it operates.

15
Homes in this chain
1,939
Certified beds129 per home on average
75%
Occupied1,448 residents a day across 1,939 beds
+0.79
Star changeacross the 14 homes rated throughout · 2025-02 to 2026-06
3
States covered
1.9
Average CMS rating~2.7 in its states · ~3.0 nationally

Where the rating comes from

The CMS overall star blends three different things. Split apart across the whole portfolio, they say different things about an operator: thin staffing is a budget decision made above the building, while a weak inspection score is what surveyors actually found inside it.

ComponentChain averageBasis
Health inspection2.3 of 515 rated homesstate surveyors’ findings, ranked within each state
Staffing1.7 of 515 rated homesfrom payroll (PBJ) hours
Quality measures3.3 of 515 rated homeslargely self-reported clinical data

Averaged across this chain’s rated homes. Health-inspection stars are assigned within each state’s own distribution, so for a chain spanning several states this component mixes distributions and is best read alongside each home’s actual citations.

Portfolio red flags

How many of this chain’s homes carry the most serious CMS markers. One flagged home can be local; a pattern across the portfolio is an operator-level signal worth researching.

6 with immediate-jeopardy citations3 with an abuse flag11 with federal fines

Follow the money — chain finances

Aggregated from each home’s CMS Medicare cost report (HCRIS). Related-party payments are dollars a home sends to landlords or management companies under common ownership — the main channel through which private-equity and REIT owners can pull money out of a home while its own books still show a thin margin.

$4.0M
Related-party expensesummed across 14 homes · FY2023 cost reports
5%
of operating expensegoes to related companies, across the 14 homes reporting both figures
-7.2%
Operating marginrevenue-weighted across 15 homes with a cost report
$1.3M
Total federal fines11 homes fined

Only homes with a cost report on file are included, so the related-party total is a floor. Cost reports are self-filed, unaudited, and a year or two behind.

Who pays — share of resident-days across this chain
Medicaid 73%Medicare 9%Other / private 19%

Weighted by each home’s average daily census, across the all 15 homes that report both a usable payer mix and a census. Homes whose cost report fails the same validity check the facility pages apply are left out of this figure entirely rather than counted as zero.

Every home in this chain

Lowest-rated first, so the homes most worth a closer look sit at the top. Each links to its full inspection, staffing, fines, and ownership record.

HomeCMS ratingFlags
Advanced Care Of St JosephSaint Joseph, MO 1 of 5$29,803 fined
Aegis Health And RehabilitationWildwood, MO 1 of 53 immediate-jeopardy $275,739 fined
Aspen Point Health And RehabilitationSaint Charles, MO 1 of 57 immediate-jeopardy $340,683 fined
Athene Nursing And RehabilitationTown and Country, MO 1 of 52 immediate-jeopardy Abuse flag $122,846 fined
Atrium Place Health And RehabilitationSaint Louis, MO 1 of 51 immediate-jeopardy $157,667 fined
Belleview Care CenterSaint Joseph, MO 1 of 5Abuse flag $31,330 fined
Chattanooga Health And Rehab CenterChattanooga, TN 1 of 5$6,509 fined
Alpine Breeze Health And WellnessRaytown, MO 2 of 51 immediate-jeopardy Abuse flag $35,683 fined
Aurora Health And RehabilitationRolla, MO 2 of 5$32,782 fined
Renton Health & RehabilitationRenton, WA 2 of 52 immediate-jeopardy $256,725 fined
Avalon View Health And WellnessLiberty, MO 3 of 5$14,267 fined
Lee's Summit PlaceLees Summit, MO 3 of 5
Agility Health And RehabilitationUniversity Place, WA 3 of 5
Valley View Skilled Nursing And RehabilitationRenton, WA 3 of 5
St Joseph ChateauSaint Joseph, MO 4 of 5
Read this as a floor, not a verdict. CMS chain and ownership data is known to under-report private-equity and REIT ties, and a low chain average can hide strong individual homes (or vice-versa). Use it to know which questions to ask — then read each home’s actual inspection record and confirm current ownership with your state licensing agency.

Source: CMS Provider Data Catalog (nursing-home ratings, deficiencies, penalties, and ownership) and the CMS Medicare cost report (HCRIS) for finances. Chain membership is as reported to CMS. CMS extracts retrieved 30 August 2026; CMS refreshes them monthly, so counts here are as of that date. Verify with the facility and your state regulator.