Not rated by CMS — ratings are suppressed for new or low-volume facilities.
Past the typical resurvey interval — a standard survey could occur at any time
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 Meramec Nursing during CMS and state inspections, most recent first.
Staff did not notify families or representatives after significant incidents, such as falls and altercations, involving residents with cognitive impairment and dementia. Despite facility policy requiring notification and documentation, nurse notes lacked evidence of communication, and staff interviews confirmed these notifications were not made or recorded.
The facility failed to manage and secure resident funds properly, resulting in the commingling of five residents' funds with the facility's operating funds. Monthly reconciliations were not completed for two months, and refunds were not issued within the required 30 days of discharge. The facility lacked written authorization to hold and commingle resident funds, and the Administrator acknowledged these deficiencies.
The facility failed to refund personal funds to three residents within 30 days of discharge, as required by its policies. The Accounts Receivable Employee did not review the Aging Report monthly, resulting in delayed refunds. The Administrator acknowledged responsibility for ensuring timely refunds, but the deficiency persisted.
The facility failed to provide the required Notice of Medicare Non-Coverage (NOMNC) for three residents discharged from Medicare Part A services before exhausting their benefit days. The Administrator, responsible for completing the NOMNCs after the departure of the Social Service Designee, did not issue the notices in a timely manner due to being overwhelmed with multiple roles, resulting in non-compliance with the facility's policy.
The facility failed to conduct required pre-employment background checks for three employees, including an LPN, a housekeeper, and a dietary aide, before their hire dates. The Administrator, responsible for these screenings, cited being overwhelmed with multiple roles as the reason for this oversight, which contravened the facility's policy to prevent hiring individuals with a history of abuse or neglect.
The facility failed to complete quarterly MDS assessments for four residents, as required by the RAI manual. The assessments, crucial for monitoring residents' cognitive and mood status, were either not assessed or left incomplete. The MDS coordinator, working night shifts, did not complete the assessments, and the SSD, responsible for resident interviews, failed to provide necessary information. The DON, instructed not to perform the SSD's duties, did not complete the assessments, and the Administrator was unaware of these deficiencies.
The facility staff failed to update care plans for residents, resulting in inaccurate documentation of ADL needs, pressure ulcer interventions, and dietary supplements. Two residents' care plans did not reflect their current need for assistance with transfers, while another resident's care plan lacked information on pressure ulcer prevention and treatment. Additionally, a resident with significant weight loss did not have their dietary supplement documented in the care plan, leading to missed supplementation during meals. The MDS Coordinator and DON acknowledged these oversights.
Facility staff failed to use mechanical lifts properly and did not secure hazardous materials, posing risks to residents. Two residents dependent on staff for transfers were moved with lifts not used according to policy, with the lift's legs closed instead of spread for stability. Additionally, razors and cleaning chemicals were left unsecured in an unattended shower room, accessible to residents, with no specific policy for their storage.
The facility failed to reconcile narcotics at shift change due to a lack of dual verification by licensed staff. The transition to a computer narcotic count system in June 2024 left some agency staff without access, leading to discrepancies in narcotic counts. Staff interviews confirmed that the proper procedure of dual verification was not consistently followed, as agency staff often could not participate in the narcotic count process.
Facility staff failed to implement Enhanced Barrier Precautions (EBP) and proper hand hygiene during care for residents with indwelling catheters. Observations showed staff did not wear gowns or change gloves as required, despite EBP signage and policy guidelines. Interviews revealed a lack of understanding and training among staff, with some unaware of the necessity for gowns during specific care activities. The Infection Preventionist, ADON, DON, and Administrator acknowledged the deficiencies, confirming staff had been educated on these protocols.
A facility failed to separate two residents after one tested positive for COVID-19, resulting in the other contracting the virus. Despite policy guidelines, the residents remained in the same room due to staff misunderstanding, leading to the spread of infection.
Facility staff failed to maintain mechanical lift slings in proper working condition, resulting in a resident suffering a large scalp laceration and subarachnoid bleed after a sling strap tore during a transfer. Staff were aware of the poor condition of the slings but used them anyway due to a lack of alternatives, and no routine checks were being conducted despite facility policy.
Failure to Notify Families and Representatives of Resident Incidents
Penalty
Summary
Facility staff failed to notify residents, their physicians, and family members or representatives of significant incidents, including falls and an altercation, as required by facility policy. For one resident with cognitive impairment and a diagnosis of dementia, multiple falls and an altercation with another resident were documented in the nurse notes without any evidence that the family or responsible party was informed. The facility's policy mandates notification of family or representatives for incidents such as accidents, injuries, or significant changes in condition, and requires documentation of such notifications in the resident record. However, review of the records showed repeated omissions of this documentation, and the resident's legal guardian confirmed not being informed about these events. Similarly, another resident with a history of stroke and dementia experienced multiple falls, but there was no documentation that the family or representative was notified, despite the presence of emergency contacts and a power of attorney on file. Interviews with nursing staff and the administrator confirmed that nurses are responsible for notifying families and documenting these notifications, but staff admitted to not completing these tasks due to being busy. The administrator was unaware that families were not being informed as required.
Improper Management of Resident Funds
Penalty
Summary
The facility failed to properly manage and secure the personal funds of five residents, leading to the commingling of these funds with the facility's operating funds. The facility's policies require that resident funds be maintained in a separate, collective interest-bearing account and reconciled monthly. However, the facility did not perform monthly reconciliations for March 2024 and June 2024, and the resident trust fund was not managed according to state and federal guidelines. The facility's Administrator acknowledged the lack of written authorization to hold and commingle resident funds with facility funds. Interviews with facility staff revealed that the Business Office Manager (BOM) and Accounts Receivable Employee were responsible for managing the resident trust and accounts receivable, respectively. The Accounts Receivable Employee, who took over the position in August 2024, admitted to not having completed the necessary research to determine which credits needed to be refunded. Additionally, refunds were not issued within the required 30 days of discharge. The Administrator confirmed that resident funds should be returned within this timeframe, but this was not occurring, indicating a systemic issue in the management of resident funds.
Failure to Timely Refund Resident Funds Post-Discharge
Penalty
Summary
The facility staff failed to provide timely refunds of personal funds to residents from the facility operating account within 30 days of discharge for three out of five sampled residents. The facility's policies, including the Resident Funds policy and the Facility Resident Trust Fund Policy, require that refund check requests for discharged or expired residents be completed within five business days of discharge, and the balance of the resident's personal funds should be refunded by the end of the month following the month of discharge. However, the facility's Account Receivable (AR) Aging report showed that three residents had credit balances that were not refunded within the required timeframe. Interviews with facility staff revealed that the Business Office Manager (BOM) and the Accounts Receivable Employee were responsible for managing the accounts and ensuring timely refunds. The Administrator acknowledged that it was ultimately their responsibility to ensure refunds were issued timely. Despite this, the Accounts Receivable Employee admitted that the Aging Report was not being reviewed monthly as required, and refunds were not being issued within 30 days of discharge. This inaction led to the deficiency, as the facility did not comply with its own policies and state regulations regarding the timely refund of resident funds.
Failure to Provide Notice of Medicare Non-Coverage
Penalty
Summary
The facility failed to provide the appropriate Center for Medicare and Medicaid Services (CMS) Notice of Medicare Non-Coverage (NOMNC) for three residents who were discharged from Medicare Part A services before their benefit days were exhausted. The facility's policy requires that a NOMNC form be issued to residents or their representatives when Medicare-covered services are ending, regardless of whether the resident is leaving or staying at the facility. This notice should be provided within 48 hours of the last anticipated covered day to allow residents or their representatives to make informed decisions about assuming financial responsibility for continued services. However, the medical records of the three residents did not contain the required NOMNC forms. The deficiency was attributed to the facility's failure to complete the NOMNCs in a timely manner. The Administrator acknowledged that the previous Social Service Designee left the facility in June 2024, and since then, the Administrator had been responsible for ensuring the NOMNCs were completed. However, the Administrator admitted to not starting the completion of these notices until November 2024, due to being overwhelmed with multiple roles within the facility. As a result, the NOMNCs were not issued and signed by the residents or their responsible parties at least 48 hours prior to the last covered date of Medicare Part A services, as required by the facility's policy.
Failure to Conduct Pre-Employment Background Checks
Penalty
Summary
The facility failed to adhere to its policy on conducting pre-employment background checks, resulting in the hiring of three employees without completing necessary screenings. The policy, revised in December 2023, mandates that background checks, licensure verification, and criminal conviction record checks be conducted on all applicants. However, the facility did not check the Employee Disqualification List (EDL), criminal background check (CBC), Family Care Safety Registry (FCSR), and Nurse Aide (NA) Registry for three employees before their hire dates. Specifically, the Dietary Aide (DA) X was hired and began working before the FCSR and CBC were requested and received. Similarly, Housekeeper W was hired and started working without a CBC or NA Registry verification, and LPN V was hired without documentation of FCSR or CBC checks. During an interview, the Administrator admitted responsibility for completing pre-employment screenings since June 2024 but acknowledged that screenings were either late or not completed due to being overwhelmed with multiple job roles following a change in facility ownership. This oversight led to the employment of individuals without the necessary background checks, contrary to the facility's policy, which aims to prevent the hiring of individuals with a history of abuse, neglect, or misappropriation of property.
Failure to Complete Quarterly MDS Assessments
Penalty
Summary
The facility staff failed to thoroughly complete the quarterly Minimum Data Set (MDS) assessments for four residents out of twelve sampled, as required by the Resident Assessment Instrument (RAI) manual. The RAI manual mandates that the quarterly assessment, a non-comprehensive assessment under the Omnibus Budget Reconciliation Act of 1987 (OBRA), be completed at least every 92 days to monitor critical indicators of gradual change in a resident's status. The deficiencies were noted in the cognitive and mood assessment sections of the MDS, where the resident interview portions were either not assessed or left blank, and the staff interview portions were also not completed. This failure to conduct structured cognitive interviews could lead to residents being mislabeled based on appearance or assumed diagnosis. The MDS coordinator, who has been in the position since May and works night shifts, did not complete the assessments, and the Director of Nursing (DON) was the backup person for completing MDS assessments. The Social Services Director (SSD) was supposed to complete the resident interview assessments but failed to do so. Consequently, when the MDS assessments were due, the necessary information was not available, leading to the assessments being coded as not assessed. The DON, instructed by corporate not to perform the SSD's job, did not complete the assessments. The Administrator, unaware of the incorrect completion of MDS assessments, stated that the DON, as the Registered Nurse, was responsible for checking the MDS input since the MDS Coordinator is a Licensed Practical Nurse.
Care Plan Deficiencies in LTC Facility
Penalty
Summary
The facility staff failed to review and revise the comprehensive care plans for several residents, leading to deficiencies in care. For two residents, the care plans did not accurately reflect their current needs for assistance with Activities of Daily Living (ADLs). One resident required a mechanical lift for transfers, but the care plan only indicated assistance from two staff members. Another resident's care plan inaccurately stated that they required assistance from one staff member for ADLs, while in reality, they needed assistance from two staff members and sometimes a mechanical lift. These discrepancies were acknowledged by the Certified Nurse Aides (CNAs), the Assistant Director of Nursing (ADON), the MDS Coordinator, and the Director of Nursing (DON), who all recognized that the care plans were not updated to reflect the residents' current needs. Additionally, the facility failed to update the care plan for a resident who developed a pressure ulcer. The resident's care plan did not include interventions for pressure ulcer prevention or treatment, despite the presence of a new unstageable pressure ulcer on the resident's heel. The MDS Coordinator, ADON, and DON all acknowledged that the care plan should have included information about the pressure ulcer and the necessary interventions, but it was not updated due to oversight and staffing issues. Furthermore, the care plan for a resident with significant weight loss did not include the prescribed dietary supplement. The resident was supposed to receive a house supplement at lunch, but this was not documented in the care plan, leading to the resident not receiving the supplement during observed meals. The CNAs, ADON, MDS Coordinator, and DON all admitted that the supplement should have been included in the care plan, but it was missed. The responsibility for updating the care plans was attributed to the MDS Coordinator and the DON, who acknowledged the oversight.
Improper Use of Mechanical Lifts and Unsecured Hazardous Materials
Penalty
Summary
The facility staff failed to ensure a safe environment for residents by not adhering to proper procedures for using mechanical lifts and by not securing hazardous materials. Two residents, who were dependent on staff for transfers, were observed being moved with mechanical lifts that were not used according to the facility's policy. The policy required the base of the lift to be spread to its widest position for stability during transfers, but staff were observed moving residents with the lift's legs closed, which could lead to instability and potential accidents. Interviews with staff revealed inconsistencies in understanding the correct procedure for using the lifts, with some staff members incorrectly believing the legs should be closed during certain parts of the transfer process. Additionally, the facility failed to store razors and hazardous chemicals securely, leaving them accessible to residents. Observations showed that razors and cleaning chemicals were left unsecured in an unattended shower room, with residents nearby. The facility lacked a specific policy for the storage of these items, and interviews with the Maintenance Director and Administrator indicated a lack of routine monitoring for the secure storage of sharps and chemicals. This oversight posed a risk, especially given the presence of at least one resident who was confused and wandered the facility.
Failure to Reconcile Narcotics at Shift Change
Penalty
Summary
The facility failed to reconcile narcotics at the change of shift when the medication cart changed from one staff member to another for four of four medication carts. The facility's policy requires that all controlled substances be accounted for with safeguards in place to prevent loss, diversion, or accidental exposure. However, the review of the facility's narcotic count sheets for both liquid and pill forms from November 1 to November 21, 2024, revealed that they did not contain the required two licensed staff signatures for narcotic counts at shift change. Interviews with various staff members, including LPNs, CMTs, and the Assistant Director of Nursing, confirmed that the proper procedure involves two licensed staff members counting narcotics together, but this was not consistently followed due to some agency staff not having access to the computer narcotic count system. The facility transitioned from a paper narcotic count log to a computer system in June 2024, following a change in ownership. However, not all agency staff were granted access to this new system, leading to discrepancies in narcotic counts. Staff interviews revealed that agency staff often could not participate in the narcotic count process, and some staff members resorted to comparing computer counts with the remaining amounts in the cards without the required dual verification. The Director of Nursing and the Administrator acknowledged the issue, noting that the lack of access for agency staff to the computer system hindered the proper execution of narcotic counts, which should involve both the off-going and on-coming licensed staff members signing off to ensure accuracy.
Failure to Implement Enhanced Barrier Precautions and Hand Hygiene
Penalty
Summary
The facility staff failed to implement Enhanced Barrier Precautions (EBP) to prevent the spread of infection during care for two residents. Observations revealed that staff did not wear gowns while providing perineal care to residents with indwelling catheters, despite EBP signage indicating the need for gowns and gloves during high-contact activities. Interviews with staff members indicated a lack of understanding and training regarding EBP requirements, with some staff unaware of the necessity to wear gowns during specific care activities. Additionally, the facility staff did not adhere to proper hand hygiene protocols during incontinence care for two residents. Observations showed that staff members failed to change gloves and perform hand hygiene when transitioning from dirty to clean tasks. Interviews with the involved staff confirmed their awareness of the hand hygiene policy but admitted to lapses due to nervousness or being 'in the zone.' The Infection Preventionist (IP), Assistant Director of Nursing (ADON), Director of Nursing (DON), and Administrator acknowledged the deficiencies in EBP and hand hygiene practices. They confirmed that staff had been educated on these protocols but could not explain why the guidelines were not followed during the observed incidents. The facility's policies on EBP and hand hygiene were reviewed, highlighting the expectations for staff to wear appropriate personal protective equipment and perform hand hygiene as required.
Failure to Separate Residents Leads to COVID-19 Spread
Penalty
Summary
The facility staff failed to maintain an effective infection prevention and control program, leading to the spread of COVID-19 between two residents. On August 7, 2024, one resident tested positive for COVID-19, while their roommate tested negative. Despite the negative test result, the facility did not separate the residents, leaving them in the same room. This action was contrary to the facility's COVID-19 Action Plan and the Interim Infection Prevention and Control Recommendations, which state that a resident with suspected or confirmed SARS-CoV-2 infection should be placed in a single-person room. As a result, the resident who initially tested negative developed symptoms and tested positive for COVID-19 on August 10, 2024. Interviews with facility staff revealed a misunderstanding of the infection control policy. The administrator and the Assistant Director of Nursing (ADON)/Infection Preventionist believed that a resident who tested negative could remain in the same room with a positive roommate due to prior exposure. This misunderstanding led to the failure to separate the residents, contributing to the spread of the virus. The ADON admitted to finding the facility's policy confusing and acknowledged that the residents did not wear masks while sharing the room, only having a curtain pulled between them. The administrator later recognized the error in policy interpretation, acknowledging that the negative-testing resident should have been moved to another room.
Failure to Maintain Mechanical Lift Slings Leads to Resident Injury
Penalty
Summary
Facility staff failed to maintain mechanical lift slings in proper working condition, resulting in a serious accident involving a resident. The resident, who was totally dependent on staff for transfers and diagnosed with dementia, suffered a large scalp laceration and subarachnoid bleed after the sling strap tore during a transfer. The incident occurred because the sling used had broken and frayed loops, and there were no other slings available in good condition. Staff had not been routinely checking the condition of the slings before use, despite the facility's policy requiring such inspections. Interviews with staff revealed that they were aware of the poor condition of the slings but used them anyway due to a lack of alternatives. The administrator admitted that no one had been assigned to check the slings routinely, and the DON confirmed that staff were not routinely checking the slings' condition prior to the accident. The facility's policy directed staff to inspect slings before each use, but this was not being followed, leading to the resident's fall and subsequent injuries.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Sullivan
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Life Care Center Of Sullivan | 0.9 mi | — | 1 | 0 |
| Cuba Manor Inc | 15.2 mi | — | 0 | 0 |
| St Clair Nursing Center | 15.2 mi | — | 1 | 0 |
| Steelville Senior Living | 18.7 mi | — | 2 | 0 |
| Sunset Health Care Center | 19.6 mi | — | 0 | 0 |
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