Facility profile · CCN 425129
St Andrews Operator, Llc
41 federal citations on record , including 4 at the Immediate Jeopardy level, and 1 federal enforcement actions totaling $41,015.
Record summary
Federal record · Q1 202641
Total citations
24
Last 3 years
4
Actual harm+
1
Federal penalties
$41,015
Total fines
1
Overall ★ rating
Most common violation categories here
Most common F-tags at this facility
Citation history
41 on record| Survey | F-Tag | Violation | Severity | Source |
|---|---|---|---|---|
| Jul 17, 2025 | F880 | Provide and implement an infection prevention and control program. | F | Standard |
| Jul 17, 2025 | F867 | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | F | Standard |
| Jul 17, 2025 | F812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | Standard |
| Jul 17, 2025 | F761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | E | Standard |
| Jul 17, 2025 | F695 | Provide safe and appropriate respiratory care for a resident when needed. | D | Standard |
| Jul 17, 2025 | F693 | Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | D | Standard |
| Jul 17, 2025 | F655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | Standard |
| Jul 17, 2025 | F641 | Ensure each resident receives an accurate assessment. | D | Standard |
| Apr 29, 2025 | F689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | F | Complaint |
| Apr 29, 2025 | F609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | J | Complaint |
| Apr 29, 2025 | F607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | D | Complaint |
| Apr 29, 2025 | F605 | Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. | D | Complaint |
| Apr 29, 2025 | F600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | J | Complaint |
| Apr 29, 2025 | F550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | Complaint |
| Jan 24, 2024 | F880 | Provide and implement an infection prevention and control program. | D | Standard |
| Jan 24, 2024 | F804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | Standard |
| Jan 24, 2024 | F757 | Ensure each resident’s drug regimen must be free from unnecessary drugs. | D | Standard |
| Jan 24, 2024 | F698 | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | Standard |
| Jan 24, 2024 | F688 | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | D | Standard |
| Jan 24, 2024 | F677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | Standard |
| Jan 24, 2024 | F656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Standard |
| Jan 24, 2024 | F550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | Standard |
| Jul 12, 2023 | F755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | Complaint |
| Apr 28, 2023 | F686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | Complaint |
| Oct 28, 2021 | F919 | Make sure that a working call system is available in each resident's bathroom and bathing area. | D | Standard |
| Oct 28, 2021 | F842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | Standard |
| Oct 28, 2021 | F761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | Standard |
| Oct 28, 2021 | F760 | Ensure that residents are free from significant medication errors. | D | Standard |
| Oct 28, 2021 | F759 | Ensure medication error rates are not 5 percent or greater. | D | Standard |
| Oct 28, 2021 | F758 | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | D | Standard |
| Oct 28, 2021 | F692 | Provide enough food/fluids to maintain a resident's health. | D | Standard |
| Oct 28, 2021 | F689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | Standard |
| Oct 28, 2021 | F686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | Standard |
| Oct 28, 2021 | F656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Standard |
| Oct 28, 2021 | F645 | PASARR screening for Mental disorders or Intellectual Disabilities | D | Standard |
| Oct 28, 2021 | F610 | Respond appropriately to all alleged violations. | D | Standard |
| Oct 28, 2021 | F609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Standard |
| Oct 28, 2021 | F607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | D | Standard |
| Oct 28, 2021 | F600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | J | Standard |
| Oct 28, 2021 | F583 | Keep residents' personal and medical records private and confidential. | F | Standard |
| Oct 28, 2021 | F578 | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | D | Standard |
Federal enforcement history
Federal regulators have imposed 1 enforcement actions against this facility, including 1 civil money penalties totaling $41,015 .
| Date | Type | Fine | Payment denial |
|---|---|---|---|
| Apr 29, 2025 | Fine | $41,015 | — |
About this record
A citation is a finding by a state survey team working under federal contract. It is not a court
judgment. The description above is drawn verbatim from federal public datasets. Facilities have
the right to appeal findings through an Informal Dispute Resolution (IDR/IIDR) process.
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