Inspection Report

Highland Chateau: Care Plan Failures Leave Resident Bedridden - MN

June 12, 2026

Saint Paul, MN

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Highland Chateau Health And Rehabilitation Center

The inspection, conducted December 30, 2025, found that staff knew the resident, identified in records as R1, had become noncompliant with getting out of bed. The assistant director of nursing, a licensed practical nurse identified as LPN-B, told inspectors she had tried to educate R1 about getting up but acknowledged she never wrote any of it down. "Documentation was something all the nurses at the facility were currently working on," she said.

LPN-B had worked at the facility for three months. She said she never contacted physical therapy, the nurse practitioner, the facility's pain clinic, or psychiatric services about the resident's refusal and physical decline. Her explanation: she believed the nurse practitioner already knew because staff discussed R1 in interdisciplinary team meetings, and the NP was sometimes in the room. Whether the NP acted on that information, the report does not say.

The care plan had not been updated to reflect R1's deteriorating condition. When inspectors asked about a home therapy order written by a provider on November 18, 2025, LPN-B said the facility must have missed it. The order had never been initiated.

The administrator told inspectors her expectation was that care plans would be updated whenever a comprehensive assessment changed. The facility's own written policy, revised in October 2025, required updates when a resident's condition changed significantly, when desired outcomes were not being met, and when a resident returned from a hospital stay. The policy also required that any refusal of treatment be documented in the clinical record.

R1's refusals were not documented. The therapy order sat unfilled for more than six weeks. And a woman who had once walked the facility on her own now required a machine to move her from a bed.

Full Inspection Report

The details above represent a summary of key findings. View the complete inspection report for Highland Chateau Health and Rehabilitation Center from 2025-12-30 including all violations, facility responses, and corrective action plans.

Download the official CMS inspection PDF from Medicare.gov

Additional Resources

Editorial Standards & Data Disclosure

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

Quick Answer

HIGHLAND CHATEAU HEALTH AND REHABILITATION CENTER in SAINT PAUL, MN was cited for violations during a health inspection on December 30, 2025.

The inspection, conducted December 30, 2025, found that staff knew the resident, identified in records as R1, had become noncompliant with getting out of bed.

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.

Frequently Asked Questions

What happened at HIGHLAND CHATEAU HEALTH AND REHABILITATION CENTER?

The inspection, conducted December 30, 2025, found that staff knew the resident, identified in records as R1, had become noncompliant with getting out of bed.

How serious are these violations?

Violation severity varies from minor documentation issues to serious safety concerns. Review the inspection report for specific deficiency codes and scope. All violations must be corrected within required timeframes and are subject to follow-up verification inspections.

What should families do?

Families should: (1) Ask facility administration about specific corrective actions taken, (2) Request to see the follow-up inspection report verifying corrections, (3) Check if this represents a pattern by reviewing prior inspection reports, (4) Compare this facility's ratings with other nursing homes in SAINT PAUL, MN, (5) Report any new concerns directly to state authorities.

Where can I see the full inspection report?

The complete inspection report is available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request a copy directly from HIGHLAND CHATEAU HEALTH AND REHABILITATION CENTER or from the state Department of Health. The report includes specific deficiency codes, facility responses, and correction timelines. This facility's federal provider number is 245028.

Has this facility had violations before?

To check HIGHLAND CHATEAU HEALTH AND REHABILITATION CENTER's history, visit Medicare.gov's Care Compare and review their inspection history, quality ratings, and staffing levels. Look for patterns of repeated violations, especially in critical areas like abuse prevention, medication management, infection control, and resident safety.