Not rated by CMS — ratings are suppressed for new or low-volume facilities.
A standard survey is most likely before around October 2026
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Cottages Of Lake St Louis during CMS and state inspections, most recent first.
A resident admitted with CHF and atrial fibrillation had multiple ordered medications, including metoprolol, aspirin, pregabalin, duloxetine, levothyroxine, midodrine, potassium chloride, pravastatin, trazodone, and acetaminophen, entered on the eMAR but not administered for evening and early-morning doses, which were marked as "9 (see progress note)" without any explanatory notes. Nursing staff acknowledged that medications ordered after the usual cutoff did not arrive, did not access the Stat-Safe, did not contact another nurse, pharmacy, the physician, the DON, or the family, and did not document reasons for the missed doses, despite facility policy requiring use of the E-Kit, pharmacy contact, provider notification, and documentation. The resident’s representative reported the resident missed medications and was unable to sleep, while leadership, the pharmacist, NP, and physician all confirmed they were not notified and that mechanisms existed to obtain or provide at least some of the missed medications, demonstrating a failure to follow physician orders and professional standards of medication management.
A deficiency was cited for not ensuring a resident's right to dignity, self-determination, communication, and the exercise of their rights was upheld.
Failure to Administer Ordered Medications and Follow Medication Access/Notification Protocols
Penalty
Summary
The deficiency involves the facility’s failure to follow professional standards of practice and physician orders for one resident, including not administering multiple ordered medications and not following facility policy when medications were unavailable. The resident was admitted with diagnoses including chronic diastolic congestive heart failure and atrial fibrillation, and had hospital discharge orders for several medications, such as metoprolol tartrate, aspirin, pregabalin, duloxetine, levothyroxine, midodrine, potassium chloride, pravastatin, trazodone, and acetaminophen. The facility’s nursing policy stated that if a medication was unavailable, staff were to check the Stat-Safe (E-Kit), contact the pharmacy for immediate delivery if not in the Stat-Safe, notify the physician when a dose was missed, escalate to the Medical Director and DON if the physician was unavailable, and document in the electronic health record. The facility did not provide additional policies for Medication Administration, Physician and Family Notification, or Following Physician Orders when requested. On the evening of admission, the resident’s medications were entered into the eMAR with start times beginning that night and the following morning. For each scheduled dose on the evening of admission and the early morning after admission, the eMAR showed a “9 (see progress note)” entry for pravastatin, trazodone, aspirin, duloxetine, metoprolol tartrate, potassium chloride, acetaminophen, midodrine, pregabalin, and levothyroxine, indicating the medications were not administered. There were no corresponding progress notes on those dates explaining why the medications were not given, despite the facility’s expectation that a “9” entry be accompanied by documentation of the reason and actions taken. The Stat-Safe list showed that at least metoprolol tartrate 25 mg and trazodone 50 mg were available in the emergency kit, but there was no documentation that these were accessed for the resident. Interviews confirmed that the medications were not administered and that required notifications and follow-up actions were not taken. The resident’s representative reported asking staff about the medications on the evening of admission and being reassured they would be given, but stated the resident missed evening/bedtime and early morning medications and was anxious and unable to sleep. LPN A, who worked the evening/night shifts, stated that orders entered after 5:00 P.M. would not be delivered in time for bedtime, that the medications did not arrive that evening, and that the nurse did not access the Stat-Safe or call another nurse to do so. LPN A acknowledged being aware of the missing doses, did not call the pharmacy or physician, was unaware of the option to request STAT medications from the pharmacy, and did not notify the DON. LPN A also noted the resident became more confused and had difficulty sleeping but attributed this to lack of sleep. RN B, who worked the following day, stated the medications arrived that morning, was aware the resident had not received medications including a sleeping medication, and acknowledged not notifying the physician or DON and not consistently documenting reasons for missed doses. The DON, Administrator, pharmacist, nurse practitioner, and physician each described expectations and available options (use of Stat-Safe, contacting pharmacy, obtaining over-the-counter medications, and notifying providers and family) that were not followed in this case, and confirmed they were not notified of the missed medications. The facility’s DON stated that if a “9” was charted on the eMAR, she expected a progress note explaining why the medication was not administered and that, in the absence of such a note, the medication was not given. She also stated she would expect staff to notify the family and physician of missing medications and that over-the-counter medications such as acetaminophen and aspirin could be obtained easily from a nearby pharmacy. The Administrator reported that if medications were unavailable, staff should pull from the Stat-Safe, ask the family to bring medications, or use another 24-hour pharmacy if the primary pharmacy could not deliver in a timely manner. The pharmacist confirmed the orders were received after hours and that an on-call pharmacist was available for STAT needs, and the nurse practitioner and physician both stated they were not notified of missing medications and that at least aspirin should have been available. These interviews and records collectively show that the facility did not administer ordered medications, did not use available mechanisms to obtain them, and did not document or notify providers and family as required by professional standards and facility policy. The deficiency is specifically that the facility failed to follow physician orders and administer medications as ordered, failed to follow its own policy for obtaining medications when unavailable, and failed to notify the physician and family and document missed doses for one resident. This included medications for heart failure, blood pressure, pain, insomnia, and blood clot prevention. The resident experienced restlessness and inability to sleep, and staff observed changes in orientation, but no timely provider notification or documentation of missed medications occurred. The facility’s own leadership and external providers confirmed that the expected processes for medication access, notification, and documentation were not followed in this case.
Failure to Honor Resident Rights
Penalty
Summary
A deficiency was identified regarding the failure to honor the resident's right to a dignified existence, self-determination, communication, and the exercise of their rights. The report notes that the facility did not ensure these resident rights were upheld, but does not provide specific details about the actions or inactions that led to this deficiency, nor does it mention any particular events or residents involved.
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Nursing homes near Lake Saint Louis
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Sunterra Springs Dardenne Prairie | 1.4 mi | — | 10 | 0 |
| Delmar Gardens Of O'fallon | 3.4 mi | — | 1 | 0 |
| Abbey Senior Health | 4.9 mi | — | 1 | 0 |
| Garden View Care Center | 5 mi | — | 2 | 0 |
| Lutheran Senior Services At Breeze Park | 7.5 mi | — | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release August 2026) and official state health department websites.