St Johns Place
Inspection Findings
F-Tag F0585
F 0585 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some
FORM CMS-2567 (02/99) Previous Versions Obsolete
and the residents cannot sleep;-Dietary: The residents are receiving food they are not supposed to eat and some foods are salty;-Laundry: The residents are not getting their clothes back. Review of the Resident Council Minutes, dated 6/25/24 at 10:30 A.M., showed the following:-Old Business: The residents are not getting the correct medications. The call lights are being answered in a timely manner. The night shift staff are not nice and they are loud and the residents are being kept up at night. The resident are not getting their clothes returned to them. The residents are not being listened to and the problems are not being taken care of promptly.-There was not documentation of resolution for these grievances or concerns.-Nursing:
The night shift is loud and they use profanity and are keeping the residents from sleeping;-Laundry: Some residents are still missing their clothes. During an interview on 8/13/25 at 12:09 P.M., the Activity Director (AD) said he/she oversees the resident council meeting and the meetings are held once a month. The residents have not had the meeting for the month of August. The AD said in the meetings, the residents discuss the previous minutes and discuss current concerns and grievances regarding each department.
The AD said he/she will write down the concerns and grievances and give them to the Director of Nursing (DON) for her review. The AD said he/she would like a resolution before the next meeting. The AD has been with the facility since January, 2025 and has not gotten a resolution for any of the grievances or concerns.
He/She did not know if the grievances or concerns had been addressed. Review of Resident #4's quarterly Minimum Data Set (MDS), a federally mandated assessment instrument completed by facility staff, dated 5/23/25, showed the following:-Moderate Cognitive Impairment;-No moods or behaviors;-Independent with most activities of daily living;-Diagnoses of high blood pressure and high cholesterol. During an interview on 8/13/25 at 1:26 P.M., the resident said he/she is the resident council president. The resident said in the meetings, concerns include people missing clothes and the night staff talking and laughing loud. The resident said nothing has been done about these concerns and it makes the residents feel terrible. During
an interview on 8/13/25 at 1:55 P.M., the DON said she has been coming in (the facility) in the middle of the night and has seen the concerns. The DON said some staff have been terminated and some staff were talked to by the CNA Supervisor about being loud. During an interview on 8/21/25 at 11:39 A.M., the Administrative Assistant (AA) said he/she expected the policies to be followed. The residents are able to file
a grievance or concerns anonymously. The AA said resident council meeting is not for grievances. The meetings are for concerns of the residents. If the residents have a grievance, it must be filed with the Grievance Officer, which is the Social Services Designee. The AA said they do address all grievances and concerns, they just do not document all the resolutions.
Event ID:
Facility ID:
If continuation sheet
ST JOHNS PLACE in SAINT LOUIS, 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 SAINT LOUIS, 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 JOHNS PLACE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.