Estates of St. Louis: Hepatitis C Testing Failures - MO
The complaint inspection at The Estates of St. Louis, completed in September 2025, found that the facility failed to act on a referral from the resident's previous facility to send them to a hepatitis clinic. Staff also did not check the blood levels the attending ARNP had ordered. The resident's labs were never drawn.
The director of nursing said she was unaware nurses had skipped the progress notes, ignored the care plan, and never ordered the labs after the ARNP rounded. She said all nursing staff were supposed to review notes, care plans, and orders daily for their assigned residents, but she could not explain how the previous administration had handled lab ordering, or how the last director of nursing and assistant director had reviewed ARNP and physician notes.
What she described instead was a system with no standard procedure. Every ARNP and physician operated differently, she said. Some gave verbal orders to the nurse on the floor. Some entered orders themselves. The facility had no consistent process to make sure any of it got done.
The director said she ran a 24-hour report each morning that listed all orders and notes entered into the electronic medical record. She used it to confirm orders were completed. But the hepatitis C labs were never entered as an order, so they never appeared on her report. Nobody caught the gap.
She was also unaware that in July 2023, the CDC updated its guidance to recommend automatic HCV RNA testing on all HCV antibody-reactive samples, a change designed to reduce the number of patient visits required and increase the number of people actually diagnosed and treated. Nearly two years after that guidance was issued, the director of nursing at The Estates of St. Louis had not heard of it.
The resident's hepatitis C went unmonitored. The clinic referral sat unaddressed. And the nurses responsible for catching both said they didn't know it was their job.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Estates of St Louis, LLC, The from 2025-09-03 including all violations, facility responses, and corrective action plans.
Download the official CMS inspection PDF from Medicare.gov
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: September 19, 2026 · Our methodology
ESTATES OF ST LOUIS, LLC, THE in SAINT LOUIS, MO was cited for violations during a health inspection on September 3, 2025.
The complaint inspection at The Estates of St.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.