Nursing Care Index

Estates Of Spanish Lake, The

Saint Louis, St. Louis County, Missouri · CCN 265776 · For-profit (LLC) · not part of a chain

CMS rates Estates Of Spanish Lake, The 1 of 5 overall as of August 2026. 150 certified beds, 140 residents a day on average. 66 citations on record from the current inspection cycles, 2 at immediate jeopardy; 2 fines totalling $57,868 and 2 payment denials.

CMS’s ratings

The Five-Star Quality Rating System, as CMS publishes it. Where CMS gives no rating, the reason CMS gives is printed instead.

Overall★☆☆☆☆ 1 of 5
Health inspections★☆☆☆☆ 1 of 5
Staffing★☆☆☆☆ 1 of 5
Quality measures★★★★☆ 4 of 5
Quality: long-stay / short-stay4 / — of 5

Staffing

Total nurse staffing2.30468 hours per resident per day
Registered nurses0.05024 hours per resident per day
Weekend total2.00282 hours per resident per day
Nursing staff turnover68.8%
Administrators who left2

Citations from health inspections

Each is a finding by a state surveyor on the date shown, in CMS’s words. The severity is CMS’s scope-and-severity grid, spelled out: harm on the left, how widespread on the right.

SurveyFindingSeverityStatus
2025-07-17
complaint survey
Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning Deficiencies · tag F0658
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-08-20
2025-04-25 Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Nursing and Physician Services Deficiencies · tag F0727
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2025-06-05
2025-04-25 Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Resident Rights Deficiencies · tag F0623
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-06-05
2025-04-25
complaint survey
Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents.
Quality of Life and Care Deficiencies · tag F0741
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-06-05
2025-04-25 Provide medically-related social services to help each resident achieve the highest possible quality of life.
Quality of Life and Care Deficiencies · tag F0745
E No actual harm, with potential for more than minimal harm; pattern Past Non-Compliance
2025-04-14
2025-04-25 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.
Pharmacy Service Deficiencies · tag F0761
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-06-05
2025-04-25 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.
Resident Rights Deficiencies · tag F0578
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-05
2025-04-25 Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Resident Rights Deficiencies · tag F0582
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-05
2025-04-25 Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Resident Rights Deficiencies · tag F0584
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-10
2025-04-25
complaint survey
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0609
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-05
2025-04-25 PASARR screening for Mental disorders or Intellectual Disabilities
Resident Assessment and Care Planning Deficiencies · tag F0645
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-05
2025-04-25 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · tag F0656
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-05
2025-04-25
complaint survey
Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning Deficiencies · tag F0658
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-05
2025-04-25 Provide safe, appropriate dialysis care/services for a resident who requires such services.
Quality of Life and Care Deficiencies · tag F0698
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-05
2025-04-25
complaint survey
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies · tag F0842
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-05
2024-10-10
complaint survey
Respond appropriately to all alleged violations.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0610
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-11-22
2024-09-17
complaint survey
Make sure that a working call system is available in each resident's bathroom and bathing area.
Environmental Deficiencies · tag F0919
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-10-09
2024-09-17
complaint survey
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · tag F0684
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-10-09
2024-09-17
complaint survey
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies · tag F0686
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-10-09
2024-09-17
complaint survey
Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services.
Quality of Life and Care Deficiencies · tag F0691
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-10-09
2024-01-25 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
J Immediate jeopardy to resident health or safety; isolated Deficient, Provider has date of correction
2024-03-08
2024-01-25
complaint survey
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0600
G Actual harm that is not immediate jeopardy; isolated Deficient, Provider has date of correction
2024-03-08
2024-01-25 Post a list of names, addresses, and telephone numbers of all pertinent State agencies and advocacy groups and a statement that the resident may file a complaint with the State Survey Agency.
Resident Rights Deficiencies · tag F0575
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-03-08
2024-01-25 Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Nursing and Physician Services Deficiencies · tag F0727
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-03-08
2024-01-25 Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Administration Deficiencies · tag F0868
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-03-08
2024-01-25 Honor the resident's right to organize and participate in resident/family groups in the facility.
Resident Rights Deficiencies · tag F0565
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-03-08
2024-01-25 Honor the resident's right to manage his or her financial affairs.
Resident Rights Deficiencies · tag F0567
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-03-08
2024-01-25 Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Resident Rights Deficiencies · tag F0584
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-03-08
2024-01-25
complaint survey
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Resident Rights Deficiencies · tag F0585
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-03-08
2024-01-25 Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0607
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-03-08
2024-01-25
complaint survey
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0609
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-03-08
2024-01-25
complaint survey
Respond appropriately to all alleged violations.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0610
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-03-08
2024-01-25 PASARR screening for Mental disorders or Intellectual Disabilities
Resident Assessment and Care Planning Deficiencies · tag F0645
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-03-08
2024-01-25 Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder.
Quality of Life and Care Deficiencies · tag F0742
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-03-08
2024-01-25 Allow residents to self-administer drugs if determined clinically appropriate.
Resident Rights Deficiencies · tag F0554
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-03-08
2024-01-25 Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
Resident Rights Deficiencies · tag F0569
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-03-08
2024-01-25 Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Resident Rights Deficiencies · tag F0623
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-03-08
2024-01-25 Assess the resident when there is a significant change in condition
Resident Assessment and Care Planning Deficiencies · tag F0637
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-03-08
2024-01-25 Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Resident Assessment and Care Planning Deficiencies · tag F0644
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-03-08
2024-01-25 Provide safe, appropriate dialysis care/services for a resident who requires such services.
Quality of Life and Care Deficiencies · tag F0698
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-03-08
2024-01-25 Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Pharmacy Service Deficiencies · tag F0756
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-03-08
2024-01-25 Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse.
Administration Deficiencies · tag F0847
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-03-08
2023-10-17
complaint survey
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0600
D No actual harm, with potential for more than minimal harm; isolated Past Non-Compliance
2023-09-22
2023-10-17
complaint survey
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0609
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-11-08
2023-10-17
complaint survey
Respond appropriately to all alleged violations.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0610
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-11-08
2023-08-24
complaint survey
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Resident Rights Deficiencies · tag F0584
K Immediate jeopardy to resident health or safety; pattern Deficient, Provider has date of correction
2023-09-21
2023-08-24
complaint survey
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0609
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-11-08
2023-08-24
complaint survey
Respond appropriately to all alleged violations.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0610
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-11-08
2021-04-08 Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.
Resident Rights Deficiencies · tag F0568
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2021-05-22
2021-04-08 Assure the security of all personal funds of residents deposited with the facility.
Resident Rights Deficiencies · tag F0570
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2021-05-22
2021-04-08 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · tag F0656
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2021-05-22
2021-04-08 Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning Deficiencies · tag F0658
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2021-05-22
2021-04-08 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.
Quality of Life and Care Deficiencies · tag F0688
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2021-05-22
2021-04-08 Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Quality of Life and Care Deficiencies · tag F0700
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2021-05-22
2021-04-08 Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Pharmacy Service Deficiencies · tag F0755
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2021-05-22
2021-04-08 Ensure medication error rates are not 5 percent or greater.
Pharmacy Service Deficiencies · tag F0759
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2021-05-22
2021-04-08 Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame.
Environmental Deficiencies · tag F0909
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2021-05-22
2021-04-08 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · tag F0550
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2021-05-22
2021-04-08 Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies · tag F0677
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2021-05-22
2021-04-08 Provide activities to meet all resident's needs.
Quality of Life and Care Deficiencies · tag F0679
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2021-05-22
2021-04-08 Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · tag F0684
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2021-05-22
2021-04-08 Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies · tag F0686
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2021-05-22
2021-04-08 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2021-05-22
2021-04-08 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.
Pharmacy Service Deficiencies · tag F0761
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2021-05-22
2021-04-08 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2021-05-22
2021-04-08 Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Resident Rights Deficiencies · tag F0623
C No actual harm, with potential for minimal harm; widespread Deficient, Provider has date of correction
2021-05-22

Fines and payment denials

DatePenaltyAmount
2024-01-25Payment denial for 9 days from 2024-02-28
2024-01-25Fine$32,771
2023-08-24Payment denial for 40 days from 2023-09-29
2023-08-24Fine$25,097

Who owns and runs it

Every owner, officer and manager CMS lists, as filed. These are the names in CMS’s ownership record; anyone named in the ownership record can ask about it on the about page.

NameRoleShareSince
Medallion Healthcare Systems LLC
Organization
adp of the snf2014-09-10
Rosenberg, Zev
Individual
5% or greater direct ownership interest60%2014-09-10
Gao, Shawn
Individual
adp of the snf2019-05-01
Hawkins, Katrina
Individual
adp of the snf2025-02-04
Rosenberg, Zev
Individual
adp of the snf2014-09-10
Spector, Tuviyah
Individual
adp of the snf2014-09-10
Spector, Tuviyah
Individual
direct ownership interest2014-09-10
Gao, Shawn
Individual
operational/managerial control2019-05-01
Hawkins, Katrina
Individual
operational/managerial control2025-02-04
Rosenberg, Zev
Individual
operational/managerial control2014-09-10
Spector, Tuviyah
Individual
operational/managerial control2014-09-10

What changed

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Source: Centers for Medicare & Medicaid Services, Provider Data Catalog (public domain), files dated 2026-08-01. Ratings are CMS’s; citations are state surveyors’ findings; nothing here is estimated or a recommendation. Every nursing home in St. Louis County.