ST. PAUL — Federal officials identified 11 Minnesota nursing homes as being in violation of health and safety regulations, prompting tighter oversight of their practices.

The Minnesota homes are among a list of 400 nursing homes nationwide that the U.S. Senate Committee on Aging determined are in need of closer scrutiny.

The federal agency Centers for Medicare and Medicaid Services named the facilities, noting patterns of health and safety violations and a need for tighter oversight. Undignified living conditions, holes in walls and a resident found wandering outside confused were the violations federal officials found.

“We believe it is the tip of the iceberg,” said Kristine Sundberg of Elder Voice Family Advocates. “Light is being shed on it. Consumers are becoming more aware they don’t have to put up with such subpar care.”

The 11 facilities represent 3% of the state’s 375 nursing homes that serve about 40,000 residents. Nine of the listed facilities have not previously been publicly identified by CMS as having problems that would trigger tighter federal scrutiny.

U.S. Sens. Patrick Toomey and Bob Casey lead the Senate committee. They’ve been critical of federal regulators for not releasing more information about troubled skilled nursing care facilities.

After CMS agreed to provide the broader federal list, they praised the decision but urged the agency to continue to provide information to consumers about facilities that are not meeting the standards.

Monarch Healthcare Management took over operation of one of the named facilities — the Emeralds in St. Paul’s Cathedral Hill neighborhood — after a 2018 inspection found numerous violations, including poor upkeep of the interiors of residents’ rooms, improper labeling and storage of medications and residents who were able to leave the facility unattended.

“We came in there knowing there were a lot of changes that needed to be made,” said Marc Halpert, chief operating officer of Monarch, adding that he’s working to improve several troubled facilities including one in St. Louis Park that is also on the federal list.

Other facilities on the federal list had similar problems, according to recent health inspections. They include violations of residents’ rights to live with dignity and protecting them from abuse.