St Augustine Health and Rehabilitation Center
51 Sunrise Blvd, Saint Augustine, FL 32084 · St. Johns County · 120 certified beds · avg 112 residents/day · certified since Sep 1, 1977
Abuse citation flag (CMS)
Part of chain: NHS MANAGEMENT (43 facilities, chain avg rating 2.9★)
The abuse flag means inspectors cited this facility for abuse that caused harm to a resident within the past year, or potential for harm in each of the last two years. Source: CMS.
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★☆☆☆☆1/5 · CMS overall rating: 1/5
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.
Most serious findings (actual harm or immediate jeopardy)
▲ Immediate jeopardy, one-off · Mar 5, 2026 · F-0600 · triggered by a complaint
The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors.
Why it matters: Abuse and neglect cause direct physical and emotional harm and are among the most serious failures a nursing home can have.
Severity (J): Inspectors found a situation that put a resident's life or safety in immediate danger, affecting one or a few residents. The facility must fix it immediately — these citations often come with large fines.
Corrected: Mar 26, 2026 (Deficient, Provider has date of correction)
▲ Immediate jeopardy, one-off · Mar 5, 2026 · F-0689 · triggered by a complaint
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.
Severity (J): Inspectors found a situation that put a resident's life or safety in immediate danger, affecting one or a few residents. The facility must fix it immediately — these citations often come with large fines.
Corrected: Mar 26, 2026 (Deficient, Provider has date of correction)
All citations in the current public record (16)
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.
| Date | Severity | What the facility was cited for |
|---|---|---|
| May 21, 2026 | F · Potential for harm, facility-wide | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| May 21, 2026 | E · Potential for harm, repeated | The facility did not provide required paperwork or notices about a resident's needs, their right to appeal a transfer or discharge, or the facility's bed-hold policy (how long a bed is saved during a hospital stay). |
| May 21, 2026 | D · Potential for harm, one-off | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. |
| Mar 5, 2026 | ▲ J · Immediate jeopardy, one-off | The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint |
| Mar 5, 2026 | ▲ J · Immediate jeopardy, one-off | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint |
| Sep 12, 2024 | F · Potential for harm, facility-wide | The facility did not keep all essential equipment working safely — things like heating and cooling systems, kitchen equipment, and medical devices. |
| Sep 12, 2024 | E · Potential for harm, repeated | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. |
| Sep 12, 2024 | E · Potential for harm, repeated | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Sep 12, 2024 | D · Potential for harm, one-off | The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. |
| Sep 12, 2024 | D · Potential for harm, one-off | The facility did not provide the care needed to maintain or improve residents' movement and flexibility — such as range-of-motion exercises — leading to avoidable decline. |
| Sep 12, 2024 | D · Potential for harm, one-off | The facility did not have a policy covering how food brought in by family and visitors is used and stored safely. |
| Sep 12, 2024 | D · Potential for harm, one-off | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Oct 13, 2022 | D · Potential for harm, one-off | The facility did not give residents proper notice about what Medicare or Medicaid covers, or about charges the resident might owe for services that aren't covered. |
| Oct 13, 2022 | D · Potential for harm, one-off | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. |
| Oct 13, 2022 | D · Potential for harm, one-off | The facility did not properly complete the required screening (called PASARR) that identifies whether a person entering a nursing home has a mental illness or intellectual disability and needs specialized services. |
| Oct 13, 2022 | D · Potential for harm, one-off | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
Inspection trend by year
Citations from standard inspections decreased between the last two inspection cycles (7 → 3).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2022 | 4 | 0 | D |
| 2024 | 7 | 0 | F |
| 2026 | 5 | 2 | J ▲ |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
Fines and enforcement (last 3 years)
1 fine totaling $26,685.
| Date | Type | Amount / length |
|---|---|---|
| Mar 5, 2026 | Fine | $26,685 |
Nurse staffing (from payroll records, adjusted for how much care residents need)
| Measure | This facility | Florida avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 4.54 | 4.03 | 3.95 | top 15% in Florida; top 22% in the U.S. |
| Registered Nurse hours | 0.56 | 0.76 | 0.69 | bottom 31% in Florida; bottom 46% in the U.S. |
| Weekend total nurse staffing | 4.05 | 3.68 | 3.50 | top 17% in Florida; top 21% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.30 | 0.53 | 0.48 | bottom 21% in Florida; bottom 31% in the U.S. |
| Total nursing staff turnover (%) | 32.4 | 41.4 | 45.8 | top 27% in Florida; top 19% in the U.S. |
| RN turnover (%) | 14.3 | 46.0 | 42.9 | top 4% in Florida; top 7% in the U.S. |
Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 3.89, RN 0.48, weekend 3.47. Staffing rating: 4/5.
Self-reported quality measures
Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.
Quality measures rating: 3/5 · long-stay residents: 4/5 · short-stay residents: 1/5
Who owns this facility
For profit - Limited Liability company
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Estes, James | Individual | 5% or Greater Direct Ownership Interest | 68% | 02/19/1999 |
| James N Estes Jr Family Dynasty Tr No 2 | Organization | 5% or Greater Direct Ownership Interest | 10% | 09/30/2019 |
| James Norman Estes Jr Tr | Organization | 5% or Greater Direct Ownership Interest | 6% | 06/30/2013 |
| Jennifer E Agee Family Dynasty Tr No 2 | Organization | 5% or Greater Direct Ownership Interest | 10% | 09/30/2019 |
| Jennifer Lee Estes Tr 031093 | Organization | 5% or Greater Direct Ownership Interest | 6% | 06/30/2013 |
| Estes, James | Individual | Corporate Officer | NOT APPLICABLE | 02/19/1999 |
| Hughes, Thomas | Individual | W-2 Managing Employee | NOT APPLICABLE | 09/17/2021 |
| Hughes, Thomas | Individual | Operational/Managerial Control | NOT APPLICABLE | 09/17/2021 |
| Long, Phillip | Individual | Corporate Officer | NOT APPLICABLE | 10/01/2019 |
| McVea, Cheri | Individual | Corporate Director | NOT APPLICABLE | 09/27/2021 |
| McVea, Cheri | Individual | Operational/Managerial Control | NOT APPLICABLE | 09/27/2021 |
| Rasco, Lynn | Individual | Corporate Director | NOT APPLICABLE | 07/01/2022 |
| Rasco, Lynn | Individual | Operational/Managerial Control | NOT APPLICABLE | 07/01/2022 |
| Regions Bank | Organization | 5% or Greater Security Interest | NOT APPLICABLE | 08/27/2013 |
| Schneider, Julie | Individual | Corporate Director | NOT APPLICABLE | 04/21/2023 |
| Schneider, Julie | Individual | Operational/Managerial Control | NOT APPLICABLE | 04/21/2023 |
| Toney, Darin | Individual | Corporate Director | NOT APPLICABLE | 04/15/2024 |
| Toney, Darin | Individual | Operational/Managerial Control | NOT APPLICABLE | 04/15/2024 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "Tell me about this abuse or neglect citation — what happened, and what specific changes did you make afterward?"
- "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
- "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
- "What written notices do we get before any transfer or discharge, and what is your bed-hold policy?"
- "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
- "How do you inspect and maintain essential equipment, and how quickly are repairs made?"
- "Can you show me how medications are stored and secured on the units, including controlled drugs?"
- "Can we tour the resident rooms, bathrooms, and common areas today, including areas not on the usual tour route?"
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the results and plan of correction from your most recent state inspection?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Ponce Therapy Care Center and Rehab, the | 0.7 mi | Saint Augustine, FL | ★★★★★ | 5/5 | |
| Lilac at Bayview, the | 1.6 mi | Saint Augustine, FL | ★★☆☆☆ | 2/5 | |
| Moultrie Creek Nursing and Rehab Center | 4.3 mi | Saint Augustine, FL | ★★★★★ | 5/5 | |
| Clyde E Lassen State Veterans Nursing Home | 10.1 mi | Saint Augustine, FL | ★★★★☆ | 5/5 | |
| Westminster St Augustine | 11.8 mi | Saint Augustine, FL | ★★★★★ | 5/5 |
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Facility data as of CMS processing date 2026-08-01. CCN 105315.