St Francois Manor
Inspection Findings
F-Tag F0580
F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
interview and record review, the facility failed to notify a resident's physician or guardian after a change in
the resident's condition for one resident (Resident #1) out of three sampled residents. The facility census was 89. Review of the facility's policy titled, Condition Change, Resident, undated, showed:- The purpose of
these guidelines is to observe, record, and report any condition change to the attending physician so that proper treatment can be implemented;- Notify resident's responsible party, notify physician of condition change, need for treatment orders, and/or medication order. 1. Review of Resident #1's admission Minimum Data Set (MDS - a federally mandated assessment instrument completed by the facility), dated 08/28/25, showed:- admission to the facility on [DATE REDACTED];- Diagnoses of cerebral palsy (a congenital disorder of movement, muscle tone, or posture), seizure disorder (uncontrolled jerking, loss of consciousness, blank stares, or other symptoms caused by abnormal electrical activity in the brain), anxiety disorder (intense, excessive, and persistent worry and fear about everyday situations), and mental disorder (a wide range of conditions that affect mood, thinking, and behavior);- Cognition severely impaired;- The resident with a legal guardian. Review of the resident's Progress Notes, dated 08/22/25, showed:- At 5:02 A.M., the resident pulled out his/her urinary catheter (a flexible tube inserted into the bladder to drain urine) with the balloon still inflated and blood was on the bed mat;- No documentation the urinary catheter was re-inserted;- No documentation the physician was notified of the urinary catheter removal;- No documentation the guardian was notified of the change in the resident's condition. During an interview on 09/29/25 at 2:33 P.M., the Director of Nursing (DON) said she would expect staff to contact the physician and guardian if there was a change in the resident's condition. Complaint #2616588
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date
these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE
TITLE
(X6) DATE
FORM CMS-2567 (02/99) Previous Versions Obsolete
Facility ID:
If continuation sheet
Event ID:
Printed: 04/13/2026 Form Approved OMB No. 0938-0391
Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
11/17/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
St Francois Manor
1180 Old Jackson Road Farmington, MO 63640
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F-Tag F0684
F 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
#1. The staff only documented bowel movements. During an interview on 09/25/25 at 4:35 P.M., the Administrator said she would expect staff to follow physician orders and for orders to be complete. She would expect follow up appointments to be scheduled. During an interview on 09/29/25 at 2:33 P.M., the Director of Nursing (DON) said she would expect staff to follow physician orders. She did not know why the resident's catheter was not reinserted after it was pulled out. She would expect urine output to be monitored for a resident with an order for straight catheterization as needed. Complaint #2616588
Event ID:
Facility ID:
If continuation sheet
ST FRANCOIS MANOR in FARMINGTON, MO inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
Frequently Asked Questions
- What is an F-tag violation?
- F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
- Were these violations corrected?
- Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
- How often do nursing home inspections happen?
- CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
- What should families do about these violations?
- Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in FARMINGTON, MO, (5) Report new concerns to state authorities.
- Where can I see the full inspection report?
- Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from ST FRANCOIS MANOR or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.