Cottages of Lake St Louis

In the surveyor’s words

From the most serious findings on record at Cottages of Lake St Louis, in the surveyor’s own words.

• Immediate jeopardy, isolatedF678Mar 29, 2022

  Based on interview and record review, the facility failed to initiate cardiopulmonary resuscitation (CPR, a procedure to support and maintain breathing and circulation for a person who has stopped breathing and/or whose heart has stopped) for one resident (Resident #1) identified as having a full code status (CPR required in the event of cardiac or respiratory arrest). Staff found the resident unresponsive and without a pulse or respirations on [DATE] and failed to initiate CPR and call 911. The resident expired at the facility. The facility census was 52. On [DATE] at 1:30 P.M., the administrator was notified of the past non-compliance immediate jeopardy (IJ) which occurred on [DATE]. On [DATE], the facility recognized the staff's failure. […]

• Actual harm, isolatedF686Oct 12, 2023

  Based on observations, interviews, record review, and facility policy review, the facility failed to conduct timely identification, assessment, and treatment of a wound for two of five residents (Residents (R) 47 and 43) reviewed for pressure sores out of a total sample of 21 residents resulting in the progression of the wound to advanced stages (stage IV - a deep wound reaching the muscles, ligaments, or bones which can cause pain, infection, invasive surgeries, or even death; or unstageable - a term that refers to an ulcer that has full thickness tissue loss but is covered by extensive necrotic (dead) tissue). […]

• Actual harm, isolatedF689Mar 29, 2022

  Based on observation, record review, and interview, the facility failed to monitor the effectiveness of current fall interventions and failed to modify the interventions as necessary to prevent further falls and injury for one resident (Resident #20), in a review of 20 residents, who had a history of falling and was identified as a high risk for falls. Resident #20 fell and required 54 stitches to his/her left arm. The facility census was 51. Review of the facility Fall - Clinical Protocol policy, revised October 2010, showed the following: -Assessment and Recognition: -The nurse shall assess and document/report the following: a. vital signs; b. recent injury, especially fracture or head injury; c. […]

• No harm, potential for more than minimal, widespreadF880Jul 24, 2025

  Based on observation, interview, and record review, the facility failed to follow current infection control standards for seven residents (Residents #3, #28, #31, #49, #76, #81, and #84), in a review of 18 sampled residents. The facility failed to follow infection control practices while performing blood glucose monitoring (a procedure where a drop of blood is obtained to test the amount of sugar in the blood) for three residents (Residents #81, #76 and #49) and one additional resident (Resident #84), when staff failed to appropriately sanitize the glucometer (a machine that tests a drop of blood for the amount of sugar it contains) after use and use a barrier to protect against contamination. […]

• No harm, potential for more than minimal, widespreadF812Oct 12, 2023

  Based on observations, record review, staff interviews, and policy review, the facility failed to ensure thawed foods were properly labeled and/or dated as required, failed to ensure the high-temperature dishwasher was monitored for effective sanitation, and failed to ensure food temperatures were properly monitored during meal preparation and service for 48 census residents who received meals from the individual kitchens in six of six cottages. These failures had the potential to lead to food-borne illness among all facility residents. Findings include: 1. Observations during the tour of the kitchen in [NAME] cottage on [DATE] at 10:00 AM revealed: -Five chocolate and two vanilla 4-ounce (oz.) Mighty Shakes thawed in the refrigerator. -The cartons documented, Store frozen. […]