SFF Candidate

Overview

Address
420 MARSHALL AVENUE, SAINT PAUL, MN 55102
Phone
6512242368
Certified beds
100
Avg daily residents
86 (86% of beds filled)
Ownership
For-profit corporation
Provider type
Medicare and Medicaid
Medicare/Medicaid since
1985-12-01
Setting
Urban
1 /5
CMS Overall Rating

CMS 5-Star Ratings

CMS rates every Medicare/Medicaid-certified nursing home on four domains. The Overall rating is driven primarily by Health Inspection results, then adjusted up or down by Staffing and Quality Measures.

Overall Rating
Composite of Health Inspection, Staffing, and Quality Measures.
1/5
Health Inspection
Based on the three most recent standard surveys, with more weight on recent results.
1/5
Staffing
Weighted combination of RN and total nurse staffing hours per resident per day, case-mix adjusted.
4/5
Quality Measures
15 resident-level quality measures split between long-stay and short-stay (post-acute) residents.
1/5
Quality Measures breakdown
Long-Stay Quality Measures 2/5
Short-Stay Quality Measures 1/5

Staffing & Workforce

Direct-care staffing is the strongest operational driver of quality in nursing homes. Values are hours per resident per day, derived from payroll-based journal (PBJ) submissions. "Case-mix" adjusts for resident acuity; "Adjusted" is the CMS rating-input value.

Role Reported Case-mix expected Adjusted Federal floor
Total nurse
All nursing staff combined: RN + LPN + Aide
4.61 5.22 3.41 ≥ 3.48
Registered Nurse (RN)
Licensed RN hours. Strongest driver of clinical outcomes.
1.68 0.91 1.24 ≥ 0.55
Licensed Practical Nurse (LPN)
LPN/LVN hours. Often handles medication administration.
0.64 1.16 0.48
Nurse aide
CNA hours. Bulk of direct resident care — bathing, feeding, mobility.
2.29 3.15 1.70
Licensed (RN + LPN)
Combined licensed nurse coverage.
2.32
Physical therapist
Rehabilitation therapist hours — important for post-acute / rehab admissions.
0.06

Federal minimums (phasing in under the CMS 2024 minimum staffing rule) shown for reference. RN: 0.55 hrs/resident/day. Total nurse: 3.48 hrs/resident/day.

Weekend staffing

Total nurse (weekend)
4.29
hrs / resident / day
RN (weekend)
1.41
hrs / resident / day
Total nurse (adjusted, weekend)
3.17
hrs / resident / day

Weekend under-staffing is a common quality-of-care concern — adverse events are more frequent when licensed coverage drops.

Staff turnover

Total nursing staff turnover
34.0%
annual
RN turnover
33.3%
annual
Administrators departed
0
last 12 months

Resident acuity

Nursing Case-Mix Index
1.85
higher acuity than avg
Case-Mix Index Ratio
1.34
facility / state ratio

Health Inspections

CMS weights three inspection cycles to compute the Health Inspection rating: the most recent (50%), the second most recent (33%), and the oldest (17%). Each standard-survey deficiency is assigned a score based on scope and severity; complaint-survey findings and revisit scores are added to produce the cycle total.

Cycle Date Total defs. Standard Complaint Deficiency score Revisits Total score
Cycle 1 (most recent) 2025-07-30 24 9 16 320 1 320
Cycle 2/3 (prior) 2024-05-23 23 12 12 242 1 242
Total weighted health score
300.5
lower is better

Deficiencies (63)

Individual survey findings. Scope/severity uses the CMS A–L matrix: letters further down the alphabet indicate greater harm and wider scope, up through J–L (immediate jeopardy).

56 D/E/F Actual harm — potential for minor
1 G/H/I Actual harm
6 J/K/L Immediate jeopardy
Tag Description Scope/Severity Survey date Corrected
0578 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 2025-07-30 2025-08-20
0605 Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. D 2025-07-30 2025-08-20
0677 Provide care and assistance to perform activities of daily living for any resident who is unable. D 2025-07-30 2025-08-20
0688 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 2025-07-30 2025-08-20
0699 Provide care or services that was trauma informed and/or culturally competent. D 2025-07-30 2025-08-20
0742 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. D 2025-07-30 2025-08-20
0812 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. E 2025-07-30 2025-08-20
0880 Provide and implement an infection prevention and control program. D 2025-07-30 2025-08-20
0558 Reasonably accommodate the needs and preferences of each resident. D 2025-07-30 2025-08-20
0656 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. D 2025-07-14 2025-08-08
0686 Provide appropriate pressure ulcer care and prevent new ulcers from developing. G 2025-07-14 2025-08-08
0842 Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. D 2025-07-14 2025-08-08
0609 Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. D 2025-06-25 2025-07-28
0610 Respond appropriately to all alleged violations. D 2025-06-25 2025-07-28
0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. J 2025-06-25 2025-06-14
0641 Ensure each resident receives an accurate assessment. D 2025-05-05 2025-05-22
0686 Provide appropriate pressure ulcer care and prevent new ulcers from developing. J 2025-05-05 2025-05-20
0697 Provide safe, appropriate pain management for a resident who requires such services. J 2025-05-05 2025-05-20
0700 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. D 2025-05-05 2025-05-22
0849 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. J 2025-05-05 2025-05-20
0909 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. D 2025-05-05 2025-05-22
0609 Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. D 2025-04-23 2025-04-25
0610 Respond appropriately to all alleged violations. D 2025-04-23 2025-04-25
0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. D 2025-04-23 2025-04-25
0726 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. E 2025-01-29 2025-03-01
0600 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. D 2025-01-14 2025-02-14
0656 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. D 2025-01-14 2025-02-14
0755 Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. D 2024-11-14 2024-12-15
0585 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. D 2024-09-18 2024-10-18
0609 Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. D 2024-07-30 2024-08-19
0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. J 2024-07-30 2024-08-19
0695 Provide safe and appropriate respiratory care for a resident when needed. J 2024-07-19 2024-08-19
0838 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. E 2024-07-19 2024-08-19
0554 Allow residents to self-administer drugs if determined clinically appropriate. D 2024-05-23 2024-06-30
0580 Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. D 2024-05-23 2024-06-30
0656 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. D 2024-05-23 2024-06-30
0658 Ensure services provided by the nursing facility meet professional standards of quality. D 2024-05-23 2024-06-30
0679 Provide activities to meet all resident's needs. D 2024-05-23 2024-06-30
0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. D 2024-05-23 2024-06-30
0693 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 2024-05-23 2024-06-30
0696 Provide appropriate care/assistance for a resident with a prosthesis. D 2024-05-23 2024-06-30
0758 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 2024-05-23 2024-06-30
0880 Provide and implement an infection prevention and control program. D 2024-05-23 2024-06-30
0883 Develop and implement policies and procedures for flu and pneumonia vaccinations. D 2024-05-23 2024-06-30
0584 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. D 2024-05-23 2024-06-30
0609 Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. D 2023-10-27 2023-11-16
0554 Allow residents to self-administer drugs if determined clinically appropriate. D 2023-04-27 2023-06-07
0580 Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. D 2023-04-27 2023-06-07
0584 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. D 2023-04-27 2023-06-07
0640 Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. D 2023-04-27 2023-06-07

Showing 50 most recent of 63. See the All Data CSV for the full list.

Penalties (5)

Fines issued
3
last 3 years
Total fines
$35,275
Payment denials
2
Date Type Fine amount
2024-07-19 Fine $8,021
2024-07-19 Fine $13,627
2024-07-19 Fine $13,627
2025-06-25 Payment Denial
2025-04-23 Payment Denial

Source: CMS Nursing Home Penalties.

Financial Health (FY 2023)

Payer mix (share of resident days)

Medicare 3.7% Medicaid 83.1% Other 13.2%

Operating performance

Operating Margin
-2.2%
Total Margin
1.3%
Occupancy Rate
80.2%
Cost per Resident Day
$33

Revenue & costs

Net Patient Revenue
$13.7M
Total Costs
$1.0M
Net Income
$189K

Balance sheet

Total Assets
$27.0M
Total Liabilities
$29.2M
Fund Balance
-$2.2M
Current Ratio
0.86

Source: CMS SNF Cost Report (FY 2023). Cost report data lags by ~2 years.

Ownership & Corporate Structure

Chain: MONARCH HEALTHCARE MANAGEMENT

Chain ID
361
Facilities in chain
45
Legal business name
THE EMERALDS AT ST PAUL, LLC
Chain-average star ratings (for peer context)
Overall
2.3
Health
2.3
Staffing
3.3
QM
3.0

Owner / manager organizations (6)

Organization Role Association
JCA HOLDINGS LLC 5% OR GREATER DIRECT OWNERSHIP INTEREST since 02/01/2019
NIJ LLC 5% OR GREATER DIRECT OWNERSHIP INTEREST since 02/01/2019
SPARTAN HEALTHCARE LLC 5% OR GREATER DIRECT OWNERSHIP INTEREST since 02/01/2019
WBS HOLDINGS LLC 5% OR GREATER DIRECT OWNERSHIP INTEREST since 02/01/2019
YAZOMA HOLDINGS, LLC 5% OR GREATER DIRECT OWNERSHIP INTEREST since 02/01/2019
MONARCH HEALTHCARE OPERATING VIII LLC OPERATIONAL/MANAGERIAL CONTROL since 02/01/2019

Owner / manager individuals (9)

Name Role Association
AREM, JEFFREY 5% OR GREATER INDIRECT OWNERSHIP INTEREST since 02/01/2019
HALPERT, MARC 5% OR GREATER INDIRECT OWNERSHIP INTEREST since 02/01/2019
JAFFA, NOAM 5% OR GREATER INDIRECT OWNERSHIP INTEREST since 02/01/2019
LEGUM, JOSHUA 5% OR GREATER INDIRECT OWNERSHIP INTEREST since 02/01/2019
JAFFA, NOAM CORPORATE DIRECTOR since 02/01/2019
HALPERT, MARC CORPORATE OFFICER since 02/01/2019
STERN, WILLIAM CORPORATE OFFICER since 02/01/2019
LEGUM, JOSHUA CONTRACTED MANAGING EMPLOYEE since 02/01/2019
STERN, WILLIAM 5% OR GREATER MORTGAGE INTEREST since 02/01/2019

Source: CMS Nursing Home Ownership. Percent ownership is rarely disclosed — CMS only requires it for specific roles.

Facility Features

CCRC
No
Hospital-based
No
Resident / family council
Both
Sprinkler systems
Yes
Special focus status
SFF Candidate
Abuse citation flag
No
Methodology & sources

Full methodology →

All Data

Every labeled field shipped for this facility by CMS. No national median or percentile context is available for SNFs in the current release.

Download CSV

Show 113 rows
Source Metric Value Raw key
Cost Report Cost per Resident Day ($) $33 metrics.cost_per_resident_day
Cost Report Current Ratio 0.86 metrics.current_ratio
Cost Report fiscal_year 2,023 fiscal_year
Cost Report Medicaid Day Share (%) 83.1% metrics.medicaid_day_share
Cost Report Medicare Day Share (%) 3.7% metrics.medicare_day_share
Cost Report Net Income ($) $189,398 metrics.net_income
Cost Report Net Patient Revenue ($) $13,741,532 metrics.net_patient_revenue
Cost Report Occupancy Rate (%) 80.2% metrics.occupancy_rate
Cost Report Operating Margin (%) -2.2% metrics.operating_margin
Cost Report Total Assets ($) $27,016,773 metrics.total_assets
Cost Report Total Costs ($) $1,030,244 metrics.total_costs
Cost Report Total Fund Balances ($) $-2,185,890 metrics.fund_balance
Cost Report Total Liabilities ($) $29,202,663 metrics.total_liabilities
Cost Report Total Margin (%) 1.3% metrics.total_margin
Provider Information Abuse Icon N Abuse Icon
Provider Information Adjusted LPN Staffing Hours per Resident per Day 0.47667 Adjusted LPN Staffing Hours per Resident per Day
Provider Information Adjusted Nurse Aide Staffing Hours per Resident per Day 1.69575 Adjusted Nurse Aide Staffing Hours per Resident per Day
Provider Information Adjusted RN Staffing Hours per Resident per Day 1.24123 Adjusted RN Staffing Hours per Resident per Day
Provider Information Adjusted Total Nurse Staffing Hours per Resident per Day 3.41365 Adjusted Total Nurse Staffing Hours per Resident per Day
Provider Information Adjusted Weekend Total Nurse Staffing Hours per Resident per Day 3.17238 Adjusted Weekend Total Nurse Staffing Hours per Resident per Day
Provider Information Administrator turnover footnote Administrator turnover footnote
Provider Information Automatic Sprinkler Systems in All Required Areas Yes Automatic Sprinkler Systems in All Required Areas
Provider Information Average Number of Residents per Day 86.4 Average Number of Residents per Day
Provider Information Average Number of Residents per Day Footnote Average Number of Residents per Day Footnote
Provider Information Case-Mix LPN Staffing Hours per Resident per Day 1.15821 Case-Mix LPN Staffing Hours per Resident per Day
Provider Information Case-Mix Nurse Aide Staffing Hours per Resident per Day 3.14775 Case-Mix Nurse Aide Staffing Hours per Resident per Day
Provider Information Case-Mix RN Staffing Hours per Resident per Day 0.91292 Case-Mix RN Staffing Hours per Resident per Day
Provider Information Case-Mix Total Nurse Staffing Hours per Resident per Day 5.21888 Case-Mix Total Nurse Staffing Hours per Resident per Day
Provider Information Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day 4.59990 Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day
Provider Information Chain Average Health Inspection Rating 2.3 Chain Average Health Inspection Rating
Provider Information Chain Average Overall 5-star Rating 2.3 Chain Average Overall 5-star Rating
Provider Information Chain Average QM Rating 3.0 Chain Average QM Rating
Provider Information Chain Average Staffing Rating 3.3 Chain Average Staffing Rating
Provider Information Chain ID 361 Chain ID
Provider Information Chain Name MONARCH HEALTHCARE MANAGEMENT Chain Name
Provider Information City/Town SAINT PAUL City/Town
Provider Information CMS Certification Number (CCN) 245295 CMS Certification Number (CCN)
Provider Information Continuing Care Retirement Community N Continuing Care Retirement Community
Provider Information County/Parish Ramsey County/Parish
Provider Information Date First Approved to Provide Medicare and Medicaid Services 1985-12-01 Date First Approved to Provide Medicare and Medicaid Services
Provider Information Geocoding Footnote Geocoding Footnote
Provider Information Health Inspection Rating 1 Health Inspection Rating
Provider Information Health Inspection Rating Footnote Health Inspection Rating Footnote
Provider Information Latitude 44.9486 Latitude
Provider Information Legal Business Name THE EMERALDS AT ST PAUL, LLC Legal Business Name
Provider Information Location 420 MARSHALL AVENUE,SAINT PAUL,MN,55102 Location
Provider Information Long-Stay QM Rating 2 Long-Stay QM Rating
Provider Information Long-Stay QM Rating Footnote Long-Stay QM Rating Footnote
Provider Information Longitude -93.118 Longitude
Provider Information Most Recent Health Inspection More Than 2 Years Ago N Most Recent Health Inspection More Than 2 Years Ago
Provider Information Number of administrators who have left the nursing home 0 Number of administrators who have left the nursing home
Provider Information Number of Certified Beds 100 Number of Certified Beds
Provider Information Number of Citations from Infection Control Inspections Number of Citations from Infection Control Inspections
Provider Information Number of Facilities in Chain 45 Number of Facilities in Chain
Provider Information Number of Fines 3 Number of Fines
Provider Information Number of Payment Denials 2 Number of Payment Denials
Provider Information Nursing Case-Mix Index 1.84882 Nursing Case-Mix Index
Provider Information Nursing Case-Mix Index Ratio 1.34201 Nursing Case-Mix Index Ratio
Provider Information Overall Rating 1 Overall Rating
Provider Information Overall Rating Footnote Overall Rating Footnote
Provider Information Ownership Type For profit - Corporation Ownership Type
Provider Information Physical Therapist Staffing Footnote Physical Therapist Staffing Footnote
Provider Information Processing Date 2026-03-01 Processing Date
Provider Information Provider Address 420 MARSHALL AVENUE Provider Address
Provider Information Provider Changed Ownership in Last 12 Months N Provider Changed Ownership in Last 12 Months
Provider Information Provider Name The Emeralds at St Paul LLC Provider Name
Provider Information Provider Resides in Hospital N Provider Resides in Hospital
Provider Information Provider SSA County Code 610 Provider SSA County Code
Provider Information Provider Type Medicare and Medicaid Provider Type
Provider Information QM Rating 1 QM Rating
Provider Information QM Rating Footnote QM Rating Footnote
Provider Information Rating Cycle 1 Health Deficiency Score 320 Rating Cycle 1 Health Deficiency Score
Provider Information Rating Cycle 1 Health Revisit Score 0 Rating Cycle 1 Health Revisit Score
Provider Information Rating Cycle 1 Number of Complaint Health Deficiencies 16 Rating Cycle 1 Number of Complaint Health Deficiencies
Provider Information Rating Cycle 1 Number of Health Revisits 1 Rating Cycle 1 Number of Health Revisits
Provider Information Rating Cycle 1 Number of Standard Health Deficiencies 9 Rating Cycle 1 Number of Standard Health Deficiencies
Provider Information Rating Cycle 1 Standard Survey Health Date 2025-07-30 Rating Cycle 1 Standard Survey Health Date
Provider Information Rating Cycle 1 Total Health Score 320 Rating Cycle 1 Total Health Score
Provider Information Rating Cycle 1 Total Number of Health Deficiencies 24 Rating Cycle 1 Total Number of Health Deficiencies
Provider Information Rating Cycle 2 Number of Standard Health Deficiencies 12 Rating Cycle 2 Number of Standard Health Deficiencies
Provider Information Rating Cycle 2 Standard Health Survey Date 2024-05-23 Rating Cycle 2 Standard Health Survey Date
Provider Information Rating Cycle 2/3 Health Deficiency Score 242 Rating Cycle 2/3 Health Deficiency Score
Provider Information Rating Cycle 2/3 Health Revisit Score 0 Rating Cycle 2/3 Health Revisit Score
Provider Information Rating Cycle 2/3 Number of Complaint Health Deficiencies 12 Rating Cycle 2/3 Number of Complaint Health Deficiencies
Provider Information Rating Cycle 2/3 Number of Health Revisits 1 Rating Cycle 2/3 Number of Health Revisits
Provider Information Rating Cycle 2/3 Total Health Score 242 Rating Cycle 2/3 Total Health Score
Provider Information Rating Cycle 2/3 Total Number of Health Deficiencies 23 Rating Cycle 2/3 Total Number of Health Deficiencies
Provider Information Registered Nurse hours per resident per day on the weekend 1.41010 Registered Nurse hours per resident per day on the weekend
Provider Information Registered Nurse turnover 33.3 Registered Nurse turnover
Provider Information Registered Nurse turnover footnote Registered Nurse turnover footnote
Provider Information Reported Licensed Staffing Hours per Resident per Day 2.32212 Reported Licensed Staffing Hours per Resident per Day
Provider Information Reported LPN Staffing Hours per Resident per Day 0.64433 Reported LPN Staffing Hours per Resident per Day
Provider Information Reported Nurse Aide Staffing Hours per Resident per Day 2.29218 Reported Nurse Aide Staffing Hours per Resident per Day
Provider Information Reported Physical Therapist Staffing Hours per Resident Per Day 0.05875 Reported Physical Therapist Staffing Hours per Resident Per Day
Provider Information Reported RN Staffing Hours per Resident per Day 1.67779 Reported RN Staffing Hours per Resident per Day
Provider Information Reported Staffing Footnote Reported Staffing Footnote
Provider Information Reported Total Nurse Staffing Hours per Resident per Day 4.61429 Reported Total Nurse Staffing Hours per Resident per Day
Provider Information Short-Stay QM Rating 1 Short-Stay QM Rating
Provider Information Short-Stay QM Rating Footnote Short-Stay QM Rating Footnote
Provider Information Special Focus Status SFF Candidate Special Focus Status
Provider Information Staffing Rating 4 Staffing Rating
Provider Information Staffing Rating Footnote Staffing Rating Footnote
Provider Information State MN State
Provider Information Telephone Number 6512242368 Telephone Number
Provider Information Total Amount of Fines in Dollars 35275.00 Total Amount of Fines in Dollars
Provider Information Total number of nurse staff hours per resident per day on the weekend 4.28816 Total number of nurse staff hours per resident per day on the weekend
Provider Information Total Number of Penalties 5 Total Number of Penalties
Provider Information Total nursing staff turnover 34.0 Total nursing staff turnover
Provider Information Total nursing staff turnover footnote Total nursing staff turnover footnote
Provider Information Total Weighted Health Survey Score 300.500 Total Weighted Health Survey Score
Provider Information Urban Y Urban
Provider Information With a Resident and Family Council Both With a Resident and Family Council
Provider Information ZIP Code 55102 ZIP Code