St Charles Health Campus

In the surveyor’s words

From the most serious findings on record at St Charles Health Campus, in the surveyor’s own words.

• Actual harm, isolatedF686Apr 25, 2025

  Based on interview and record review, the facility failed to ensure services were provided to prevent the development of pressure ulcers for 1 of 3 residents reviewed for pressure ulcers. The facility failed to obtain adequate physician orders or instructions following the removal of a non-removable brace, which resulted in the development of an unstageable pressure ulcer to the left heel (Wound 2). Following an assessment by a wound care clinic that indicated a newly developed unstageable pressure ulcer to the top of the left foot (Wound 3), the facility failed to assess the wound routinely or create a plan of care to address the wound. […]

• No harm, potential for more than minimal, patternF921Mar 7, 2023

  Based on observation, interview, and record review, the facility failed to ensure a safe, comfortable, and sanitary environment was maintained in 3 of 3 resident halls, 1 of 1 laundry rooms, and 1 of 1 common shower rooms. Resident room floors were sticky and debris was on the floor, resident items were uncovered and unlabeled in shared bathrooms, there was a strong urine odor in the bathroom, and vent covers were soiled in the shower room and laundry room. (100 Hall, 200 Hall, 300 Hall, Hall 200 Shower Room, Laundry room) Findings include: 1. During an interview on 2/27/23 at 11:29 A.M., room [ROOM NUMBER]'s family indicated the roommate was urinating on the bathroom floor and toilet seat. […]

• No harm, potential for more than minimal, isolatedF689Dec 12, 2024

  Based on interview and record review, the facility failed to ensure each resident received adequate supervision and assistance to prevent accidents for 1 of 3 residents reviewed for falls. New interventions were not placed following falls to prevent further falls for a cognitively impaired resident. (Resident G) Finding includes: On 12/11/24 at 1:57 P.M., Resident G's clinical record was reviewed. Diagnoses included, but were not limited to, left tibia shaft fracture, osteoporosis, and Alzheimer's disease. Resident G was admitted to the facility on [DATE] and discharged [DATE]. The most recent Admission MDS (Minimum Data Set) Assessment, dated 8/15/24, indicated a severe cognitive impairment and no behaviors. […]

• No harm, potential for more than minimal, isolatedF554Jun 19, 2024

  Based on observation, interview, and record review, the facility failed to ensure residents that were self administering medications were assessed for the capability to self administer medications for 1 of 15 residents observed during medication administration and 1 of 1 random observation with medications in their room. (Resident 39, Resident 12) Findings include: 1. On 6/17/24 at 11:03 A.M., while Registered Nurse (RN) 14 administered Azo Bladder Control 300 mg, 2 capsules, the following medications were observed sitting on the bedside table in Resident 39's room: - Albuterol sulfate (a medication used to treat Asthma and Chronic Obstructive Pulmonary Disease) inhaler- 1 puff by mouth every 2 hours as needed on the label - Fluticasone (a nose spray for allergies) -label faded and… […]

• No harm, potential for more than minimal, isolatedF582Jun 19, 2024

  Based on interview and record review, the facility failed to provide necessary documentation to ensure a resident or responsible party was issued a Skilled Nursing Facility Advanced Beneficiary Notice (SNFABN) and Notice of Medicare Non-Coverage (NOMNC) before the proposed end of services for 1 of 3 beneficiary notices reviewed. (Resident 46) Findings include: On 6/13/24 at 2:25 P.M., during review of the Medicare Part A discharge notices, Resident 46's notice stated the last day covered for Part A was 5/10/24 and indicated, Other .Facility initiated and family agreed duet [sic] to lack of progress/participation in therapy related to overall decline in condition. […]