Saint Paul, MN

The Emeralds at St Paul LLC

1-star overall rating with 1-star inspections with Special Focus status with $35,275 in total fines with 24 recent health deficiencies with 3 fire-safety deficiencies in the latest cycle

420 Marshall Avenue, Saint Paul, MN

(651) 224-2368

Compare this facility

Overall

1 / 5

CMS overall stars

Health inspections

1 / 5

Survey and complaint cycles

Staffing

4 / 5

RN + nurse staffing

Quality measures

1 / 5

Resident outcomes and process measures

Quick facts

Facility snapshot

Beds

100

Certified beds

Average residents

Average occupied residents

Ownership

For-Profit

Publicly displayed owner type

Chain

Monarch Healthcare Management

Operator or chain grouping

Approved since

1985-12-01

CMS approved date

Coverage

Medicare + Medicaid

Participation flags

Chain footprint

45 facilities

Chain averages 2 overall / 2 health / 3 staffing / 3 quality stars

Changed ownership

Within the last 12 months

Family council

Yes

Resident and family council reported

Sprinklers

Yes

Automatic sprinklers in all required areas

Staffing

Hours and turnover

RN hours / resident day

1.68

Registered nurse staffing · state 1.06 · national 0.68

LPN hours / resident day

0.64

Licensed practical nurse staffing · state 0.62 · national 0.87

Aide hours / resident day

2.29

Nurse aide staffing · state 2.56 · national 2.35

Total nurse hours

4.61

All reported nurse hours · state 4.23 · national 3.89

Licensed hours

2.32

RN + LPN hours · state 1.68 · national 1.54

Weekend hours

4.29

Weekend nurse staffing · state 3.68 · national 3.43

Weekend RN hours

1.41

Weekend registered nurse coverage · state 0.68 · national 0.47

Physical therapist

0.06

Reported PT staffing · state 0.08 · national 0.07

Adjusted RN hours

1.24

CMS adjusted RN staffing hours

Adjusted total hours

3.41

CMS adjusted total nurse staffing hours

Case-mix index

1.85

Higher values indicate more complex resident acuity

RN turnover

33%

Annual RN turnover · state 39% · national 45%

Total nurse turnover

34%

Annual nurse turnover · state 42% · national 46%

SNF VBP

Value-based purchasing

Program rank

3,708

Lower is better among SNFs in the FY 2026 VBP program.

Performance score

43.03

Composite VBP score used to determine payment impact.

Payment multiplier

0.9960

Above 1.000 increases Medicare payment; below 1.000 reduces it.

Program components

How the VBP score is built

Readmission

6.51

Baseline 19.80% · Performance 18.41% · Measure score 6.51 · Achievement 6.51 · Improvement 4.50

Healthcare-associated infections

3.32

Baseline 7.63% · Performance 6.84% · Measure score 3.32 · Achievement 3.32 · Improvement 2.49

Total nurse turnover

6.41

Performance 37.50% · Measure score 6.41 · Achievement 6.41 · This facility did not have sufficient data to calculate a baseline period measure result.

Adjusted total nurse staffing

0.98

Baseline 3.71 hours · Performance 3.36 hours · Measure score 0.98 · Achievement 0.98 · Improvement 0

SNF QRP

Medicare quality reporting measures

Measure	Facility	National	Note
Potentially preventable 30-day readmission	10.36%	10.72% 0.4 pts better	No Different than the National Rate · Eligible stays 38 · Observed rate 13.16% · Lower 95% interval 6.62%
Discharge to community	42.13%	50.57% 8.4 pts worse	No Different than the National Rate · Eligible stays 30 · Observed rate 23.33% · Lower 95% interval 25.9%
Medicare spending per beneficiary	1.01	1.02 About the same
Drug regimen review with follow-up	51.52%	95.27% 43.7 pts worse	Numerator 17 · Denominator 33
Falls with major injury	0%	0.77% 0.8 pts better	Numerator 0 · Denominator 33
Discharge self-care score	50%	53.69% 3.7 pts worse	Numerator 11 · Denominator 22
Discharge mobility score	27.27%	50.94% 23.7 pts worse	Numerator 6 · Denominator 22
Pressure ulcers or injuries, new or worsened	6.06%	2.29% 3.8 pts worse	Numerator 2 · Denominator 33 · Adjusted rate 5.81%
Healthcare-associated infections requiring hospitalization	6.84%	7.12% 0.3 pts better	No Different than the National Rate · Eligible stays 31 · Observed rate 9.68% · Lower 95% interval 4.14%
Staff COVID-19 vaccination coverage	85.42%	8.2% 77.2 pts better	Numerator 123 · Denominator 144
Staff flu vaccination coverage	26.32%	42% 15.7 pts worse	Numerator 40 · Denominator 152
Discharge function score	50%	56.45% 6.5 pts worse	Numerator 11 · Denominator 22
Transfer of health information to provider	Not Available	95.95%	Numerator Not Available · Denominator 8 · Too few residents or stays to report publicly.
Transfer of health information to patient	Not Available	96.28%	Numerator Not Available · Denominator 8 · Too few residents or stays to report publicly.
Resident COVID-19 vaccinations up to date	Not Available	25.2%	Numerator Not Available · Denominator 11 · Too few residents or stays to report publicly.

Quality measures

Resident outcomes and process scores

Measure	Facility	State	National	Note
Number of hospitalizations per 1000 long-stay resident days	2.4	1.7 0.7 pts worse	1.9 0.5 pts worse	Long Stay · 20240701-20250630 · Adjusted 2.4 · Observed 4.4 · Expected 3.5 · Used in QM five-star
Number of outpatient emergency department visits per 1000 long-stay resident days	1.4	2.0 0.6 pts better	1.8 0.4 pts better	Long Stay · 20240701-20250630 · Adjusted 1.4 · Observed 2.2 · Expected 2.6 · Used in QM five-star
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine	90.4%	97.3% 6.9 pts worse	93.4% 3 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 93.7% · Q2 91.5% · Q3 89.7% · Q4 86.7% · 4Q avg 90.4%
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine	94.3%	96.1% 1.8 pts worse	95.5% 1.2 pts worse	Long Stay · 2024Q3-2025Q2 · 4Q avg 94.3%
Percentage of long-stay residents experiencing one or more falls with major injury	0.0%	3.9% 3.9 pts better	3.3% 3.3 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star
Percentage of long-stay residents who have depressive symptoms	1.7%	4.3% 2.6 pts better	11.4% 9.7 pts better	Long Stay · 2024Q4-2025Q3 · Q1 3.4% · Q2 0.0% · Q3 0.0% · Q4 3.3% · 4Q avg 1.7%
Percentage of long-stay residents who lose too much weight	5.2%	4.1% 1.1 pts worse	5.4% 0.2 pts better	Long Stay · 2024Q4-2025Q3 · Q1 5.5% · Q2 4.0% · Q3 3.0% · Q4 8.2% · 4Q avg 5.2%
Percentage of long-stay residents who received an antianxiety or hypnotic medication	17.1%	12.4% 4.7 pts worse	19.6% 2.5 pts better	Long Stay · 2024Q4-2025Q3 · Q1 17.3% · Q2 17.1% · Q3 14.5% · Q4 19.2% · 4Q avg 17.1%
Percentage of long-stay residents who received an antipsychotic medication	18.1%	17.5% 0.6 pts worse	16.7% 1.4 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 12.8% · Q2 10.0% · Q3 25.0% · Q4 25.0% · 4Q avg 18.1% · Used in QM five-star
Percentage of long-stay residents who were physically restrained	0.0%	0.1% 0.1 pts better	0.1% 0.1 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0%
Percentage of long-stay residents whose ability to walk independently worsened	23.5%	22.5% 1 pts worse	16.3% 7.2 pts worse	Long Stay · 2024Q4-2025Q3 · Q2 26.1% · 4Q avg 23.5% · Used in QM five-star
Percentage of long-stay residents whose need for help with daily activities has increased	13.2%	18.6% 5.4 pts better	14.9% 1.7 pts better	Long Stay · 2024Q4-2025Q3 · Q1 22.9% · Q2 10.2% · Q3 7.0% · Q4 12.2% · 4Q avg 13.2% · Used in QM five-star
Percentage of long-stay residents with a catheter inserted and left in their bladder	7.0%	2.3% 4.7 pts worse	1.0% 6 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 10.0% · Q2 6.7% · Q3 7.0% · Q4 4.2% · 4Q avg 7.0% · Used in QM five-star
Percentage of long-stay residents with a urinary tract infection	1.3%	2.6% 1.3 pts better	1.7% 0.4 pts better	Long Stay · 2024Q4-2025Q3 · Q1 1.3% · Q2 2.4% · Q3 1.3% · Q4 0.0% · 4Q avg 1.3% · Used in QM five-star
Percentage of long-stay residents with new or worsened bowel or bladder incontinence	21.7%	24.8% 3.1 pts better	19.8% 1.9 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 21.4% · Q2 16.8% · Q3 31.7% · Q4 16.8% · 4Q avg 21.7%
Percentage of long-stay residents with pressure ulcers	11.1%	5.4% 5.7 pts worse	5.1% 6 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 9.4% · Q2 13.6% · Q3 11.1% · Q4 10.1% · 4Q avg 11.1% · Used in QM five-star
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine	71.0%	88.6% 17.6 pts worse	81.7% 10.7 pts worse	Short Stay · 2024Q4-2025Q3 · Q1 91.2% · Q2 71.9% · Q3 65.6% · Q4 58.2% · 4Q avg 71.0%
Percentage of short-stay residents who had an outpatient emergency department visit	14.7%	14.0% 0.7 pts worse	12.0% 2.7 pts worse	Short Stay · 20240701-20250630 · Adjusted 14.7% · Observed 20.7% · Expected 15.7% · Used in QM five-star
Percentage of short-stay residents who newly received an antipsychotic medication	1.6%	1.9% 0.3 pts better	1.6% About the same	Short Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 3.6% · Q4 2.6% · 4Q avg 1.6% · Used in QM five-star
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine	66.7%	82.7% 16 pts worse	79.7% 13 pts worse	Short Stay · 2024Q3-2025Q2 · 4Q avg 66.7%
Percentage of short-stay residents who were rehospitalized after a nursing home admission	28.1%	23.1% 5 pts worse	23.9% 4.2 pts worse	Short Stay · 20240701-20250630 · Adjusted 28.1% · Observed 37.9% · Expected 32.2% · Used in QM five-star

Survey summary

Recent inspection cycles

Cycle 1 Health 2025-07-30 · Fire 2025-07-30

24 health deficiencies

Top issue: Quality of Life and Care (10 deficiencies)

3 fire-safety deficiencies

Top issue: Smoke (2 deficiencies)

Cycle 2 Health 2024-05-23 · Fire 2024-05-23

21 health deficiencies

Top issue: Quality of Life and Care (6 deficiencies)

4 fire-safety deficiencies

Top issue: Egress (2 deficiencies)

Cycle 3 Health 2023-04-27 · Fire 2023-04-27

18 health deficiencies

Top issue: Quality of Life and Care (5 deficiencies)

0 fire-safety deficiencies

No concentrated fire-safety issue counts in this cycle.

Fire safety

Fire-safety citations

F · Potential for more than minimal harm 2025-07-30

K225 · Egress Deficiencies

Fire Safety

Have stairways and smokeproof enclosures used as exits that meet safety requirements.

Corrected 2025-08-21

F · Potential for more than minimal harm 2025-07-30

K324 · Smoke Deficiencies

Fire Safety

Provide properly protected cooking facilities.

Corrected 2025-08-21

F · Potential for more than minimal harm 2025-07-30

K363 · Smoke Deficiencies

Fire Safety

Install corridor and hallway doors that block smoke.

Corrected 2025-08-21

F · Potential for more than minimal harm 2024-05-23

K225 · Egress Deficiencies

Fire Safety

Have stairways and smokeproof enclosures used as exits that meet safety requirements.

Corrected 2024-06-30

F · Potential for more than minimal harm 2024-05-23

K293 · Egress Deficiencies

Fire Safety

Have properly located and lighted "Exit" signs.

Corrected 2024-06-30

F · Potential for more than minimal harm 2024-05-23

K351 · Smoke Deficiencies

Fire Safety

Install an approved automatic sprinkler system.

Corrected 2024-06-30

F · Potential for more than minimal harm 2024-05-23

K712 · Miscellaneous Deficiencies

Fire Safety

Have simulated fire drills held at unexpected times.

Corrected 2024-06-30

Inspection history

Recent health citations

E · Potential for more than minimal harm 2025-07-30

F812 · Nutrition and Dietary Deficiencies

Health

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Corrected 2025-08-20

D · Potential for more than minimal harm 2025-07-30

F558 · Resident Rights Deficiencies

Health

Reasonably accommodate the needs and preferences of each resident.

Corrected 2025-08-20

D · Potential for more than minimal harm 2025-07-30

F578 · Resident Rights Deficiencies

Health

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.

Corrected 2025-08-20

D · Potential for more than minimal harm 2025-07-30

F605 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.

Corrected 2025-08-20

D · Potential for more than minimal harm 2025-07-30

F677 · Quality of Life and Care Deficiencies

Health

Provide care and assistance to perform activities of daily living for any resident who is unable.

Corrected 2025-08-20

D · Potential for more than minimal harm 2025-07-30

F688 · Quality of Life and Care Deficiencies

Health

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.

Corrected 2025-08-20

D · Potential for more than minimal harm 2025-07-30

F699 · Quality of Life and Care Deficiencies

Health

Provide care or services that was trauma informed and/or culturally competent.

Corrected 2025-08-20

D · Potential for more than minimal harm 2025-07-30

F742 · Quality of Life and Care Deficiencies

Health

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.

Corrected 2025-08-20

D · Potential for more than minimal harm 2025-07-30

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2025-08-20

G · Actual harm 2025-07-14

F686 · Quality of Life and Care Deficiencies

Health

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

Corrected 2025-08-08

D · Potential for more than minimal harm 2025-07-14

F656 · Resident Assessment and Care Planning Deficiencies

Health

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Corrected 2025-08-08

D · Potential for more than minimal harm 2025-07-14

F842 · Resident Assessment and Care Planning Deficiencies

Health

Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Corrected 2025-08-08

J · Immediate jeopardy 2025-06-25

F689 · Quality of Life and Care Deficiencies

Health

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Corrected 2025-06-14

D · Potential for more than minimal harm 2025-06-25

F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Corrected 2025-07-28

D · Potential for more than minimal harm 2025-06-25

F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Respond appropriately to all alleged violations.

Corrected 2025-07-28

J · Immediate jeopardy 2025-05-05

F686 · Quality of Life and Care Deficiencies

Health

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

Corrected 2025-05-20

J · Immediate jeopardy 2025-05-05

F697 · Quality of Life and Care Deficiencies

Health

Provide safe, appropriate pain management for a resident who requires such services.

Corrected 2025-05-20

J · Immediate jeopardy 2025-05-05

F849 · Administration Deficiencies

Health

Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.

Corrected 2025-05-20

D · Potential for more than minimal harm 2025-05-05

F641 · Resident Assessment and Care Planning Deficiencies

Health

Ensure each resident receives an accurate assessment.

Corrected 2025-05-22

D · Potential for more than minimal harm 2025-05-05

F700 · Quality of Life and Care Deficiencies

Health

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.

Corrected 2025-05-22

D · Potential for more than minimal harm 2025-05-05

F909 · Environmental Deficiencies

Health

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.

Corrected 2025-05-22

D · Potential for more than minimal harm 2025-04-23

F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Corrected 2025-04-25

D · Potential for more than minimal harm 2025-04-23

F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Respond appropriately to all alleged violations.

Corrected 2025-04-25

D · Potential for more than minimal harm 2025-04-23

F684 · Quality of Life and Care Deficiencies

Health

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Corrected 2025-04-25

E · Potential for more than minimal harm 2025-01-29

F726 · Nursing and Physician Services Deficiencies

Health

Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.

Corrected 2025-03-01

D · Potential for more than minimal harm 2025-01-14

F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Corrected 2025-02-14

D · Potential for more than minimal harm 2025-01-14

F656 · Resident Assessment and Care Planning Deficiencies

Health

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Corrected 2025-02-14

D · Potential for more than minimal harm 2024-11-14

F755 · Pharmacy Service Deficiencies

Health

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

Corrected 2024-12-15

D · Potential for more than minimal harm 2024-09-18

F585 · Resident Rights Deficiencies

Health

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.

Corrected 2024-10-18

J · Immediate jeopardy 2024-07-30

F689 · Quality of Life and Care Deficiencies

Health

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Corrected 2024-08-19

D · Potential for more than minimal harm 2024-07-30

F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Corrected 2024-08-19

J · Immediate jeopardy 2024-07-19

F695 · Quality of Life and Care Deficiencies

Health

Provide safe and appropriate respiratory care for a resident when needed.

Corrected 2024-08-19

E · Potential for more than minimal harm 2024-07-19

F838 · Administration Deficiencies

Health

Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.

Corrected 2024-08-19

D · Potential for more than minimal harm 2024-05-23

F554 · Resident Rights Deficiencies

Health

Allow residents to self-administer drugs if determined clinically appropriate.

Corrected 2024-06-30

D · Potential for more than minimal harm 2024-05-23

F580 · Resident Rights Deficiencies

Health

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

Corrected 2024-06-30

D · Potential for more than minimal harm 2024-05-23

F584 · Resident Rights Deficiencies

Health

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.

Corrected 2024-06-30

D · Potential for more than minimal harm 2024-05-23

F656 · Resident Assessment and Care Planning Deficiencies

Health

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Corrected 2024-06-30

D · Potential for more than minimal harm 2024-05-23

F658 · Resident Assessment and Care Planning Deficiencies

Health

Ensure services provided by the nursing facility meet professional standards of quality.

Corrected 2024-06-30

D · Potential for more than minimal harm 2024-05-23

F679 · Quality of Life and Care Deficiencies

Health

Provide activities to meet all resident's needs.

Corrected 2024-06-30

D · Potential for more than minimal harm 2024-05-23

F684 · Quality of Life and Care Deficiencies

Health

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Corrected 2024-06-30

D · Potential for more than minimal harm 2024-05-23

F693 · Quality of Life and Care Deficiencies

Health

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.

Corrected 2024-06-30

D · Potential for more than minimal harm 2024-05-23

F696 · Quality of Life and Care Deficiencies

Health

Provide appropriate care/assistance for a resident with a prosthesis.

Corrected 2024-06-30

D · Potential for more than minimal harm 2024-05-23

F758 · Pharmacy Service Deficiencies

Health

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.

Corrected 2024-06-30

D · Potential for more than minimal harm 2024-05-23

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2024-06-30

D · Potential for more than minimal harm 2024-05-23

F883 · Infection Control Deficiencies

Health

Develop and implement policies and procedures for flu and pneumonia vaccinations.

Corrected 2024-06-30

D · Potential for more than minimal harm 2023-10-27

F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Corrected 2023-11-16

E · Potential for more than minimal harm 2023-04-27

F684 · Quality of Life and Care Deficiencies

Health

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Corrected 2023-06-07

E · Potential for more than minimal harm 2023-04-27

F812 · Nutrition and Dietary Deficiencies

Health

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Corrected 2023-06-07

E · Potential for more than minimal harm 2023-04-27