Compiled from official CMS federal data
St. Johnsbury Health & Rehab, Saint Johnsbury, VT — Violations & Inspection Reports
Does St. Johnsbury Health & Rehab have a federal violation or abuse history?
According to the public federal record on file with the Centers for Medicare & Medicaid Services (CMS), St. Johnsbury Health & Rehab (CCN 475019), in Saint Johnsbury, VT, has federal inspection findings. CMS currently displays its federal abuse icon for this facility — a flag CMS assigns under its own published methodology for abuse-related citations (deficiency tag F600 and related). CMS also lists the facility as a candidate for its Special Focus Facility program; a candidate is not on the active watch list.
In its current inspection cycle, CMS cited the facility for 25 deficiencies; the most severe is rated L, which CMS classifies as Immediate Jeopardy — its most serious level, for noncompliance it found likely to cause serious harm or death. Earlier-cycle citations appear in the dated timeline below as historical, not current. CMS has $314,323 in civil money penalties on file against the facility. This page restates the federal record and draws no conclusion of its own.
Abuse-, fall-, and care-related findings on the federal record
- 9 citations in CMS's "Freedom from Abuse, Neglect, and Exploitation" family (F600-series) — most recent Jul 2025.
- 5 citations for accident hazards or inadequate supervision (F689) — the deficiency family behind fall-related findings; most recent Jan 2026.
- 2 pressure-ulcer care citations (F686) — the consumer term is "bedsores"; most recent Jul 2025.
- 1 nutrition and hydration citation (F692) — the consumer terms are "malnutrition" and "dehydration"; most recent Aug 2023.
- 46 findings on file from complaint-triggered inspections.
Every figure above restates CMS’s own dated record; this page draws no conclusion of its own. Strict state filing deadlines can apply to nursing-home injury claims — a licensed attorney in your state can review this record.
FOR FAMILIES
What brings you to this record?
The Federal Record
CMS displays its federal abuse icon on this facility's official record.
Below is this facility's federal inspection record as on file with CMS.
Federal abuse icon on file
CMS displays this icon for facilities it has cited for resident abuse under its own published methodology — the government's own flag, restated here.
A candidate for the federal Special Focus Facility watch list
CMS lists this facility as a candidate for the Special Focus Facility program. It is not on the active watch list.
Scope & Severity — current cycle
CMS's own A–L scope/severity grid. Plotted cells mark this facility's most recent (current-cycle) citations.
Civil money penalties on file
$314,323
CMS also records 75 days of payment denial.
Have a lawyer review this record →
About this record: Federal nursing-home surveys are conducted on a recurring cycle by state survey agencies acting on CMS's behalf, and the figures on this page are compiled from CMS's published provider data, as on file with CMS; the federal record may understate what actually occurred, and inspection findings are point-in-time survey results, not a determination that any specific resident was harmed.
Deficiency timeline
Citations are listed by scope/severity (most severe first), not chronologically; each entry is labeled current-cycle or historical.
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Designate a physician to serve as medical director responsible for implementation of resident care policies and coordination of medical care in the facility.
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
57 more citations on file — Abuse & neglect 7 · Accidents & supervision 5 · Pressure ulcers 2 · Nutrition & hydration 1 · Medication & pharmacy 5 · Resident rights 6 · Other citations 28 (expand)
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
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.
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
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.
Ensure that residents are fully informed and understand their health status, care and treatments.
Provide and implement an infection prevention and control program.
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
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.
Ensure that residents are free from significant medication errors.
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Have a plan that describes the process for conducting QAPI and QAA activities.
Provide timely, quality laboratory services/tests to meet the needs of residents.
Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Obtain a doctor's order to admit a resident and ensure the resident is under a doctor's care.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Ensure that the resident and his/her doctor meet face-to-face at all required visits.
Ensure services provided by the nursing facility meet professional standards of quality.
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.
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Allow residents to self-administer drugs if determined clinically appropriate.
Designate a physician to serve as medical director responsible for implementation of resident care policies and coordination of medical care in the facility.
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Provide and implement an infection prevention and control program.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
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.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Provide care and assistance to perform activities of daily living for any resident who is unable.
Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.
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.
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Protect each resident from the wrongful use of the resident's belongings or money.
PASARR screening for Mental disorders or Intellectual Disabilities
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Protect each resident from the wrongful use of the resident's belongings or money.
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
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.
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Provide enough food/fluids to maintain a resident's health.
Overall CMS star rating
This facility: 1 · CMS state average: 2.8
Both figures as published by CMS.
You may be reading this record for the first time.
If something happened to someone you love at this facility, this federal record may be new to you today. The company that operates a nursing home, by contrast, is rarely seeing records like this for the first time — operators like these typically retain standing legal, risk, and insurance teams whose routine work includes records exactly like the one on this page. That is not a judgment of this facility; it is how the business is structured. Because strict time limits can apply, families often find it helps to have a qualified person review the record with them sooner rather than later.
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Federal record
St. Johnsbury Health & Rehab — Federal Record
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SECTION 7 — CASE CONTEXT
Add what you saw at St. Johnsbury Health & Rehab to this record
No call centers, no auctions. CareSentinel is an independent service that compiles the public CMS record and does not provide legal advice. The federal record is a point-in-time inspection record and may understate what actually occurred. CareSentinel is operated by Nodal Logics LLC.
Strict time limits can apply to taking legal action — consider consulting a qualified attorney promptly.
If you believe a resident is in immediate danger, call 911. Care concerns can also be reported at no cost to your state survey agency or the Long-Term Care Ombudsman program (ltcombudsman.org) — independent of any legal inquiry.
How to read this record
Making sense of a CMS inspection record
CMS scores every citation on a grid from A to L, combining how widespread a finding was with how serious it was. A–C is a deficiency CMS classifies as no harm; D–F as the potential for harm; G–I as actual harm that reached a resident; and J–L as immediate jeopardy, CMS’s most serious level. Later letters mark more serious findings.
Three questions to ask on a tour
- How is the home staffed on nights, weekends, and holidays?
- What happens when a resident’s condition changes suddenly?
- How, and how quickly, are families told about an incident?