First Care Living Center
900 Hilligoss Boulevard Southeast, Fosston, MN 56542 · Polk County · (218) 435-1133
36 certified beds, about 26 residents a day · Non profit - Corporation · Medicare and Medicaid since 1988
Inside a hospital Certified for Medicaid Certified for Medicare
Overall
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
3 of 5
CMS Care Compare ratings, data as of September 1, 2026 · CCN 245512 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on May 28, 2026, inspectors cited 4 health deficiencies (the Minnesota average is 7.1, the national average 9.2).
Of 13 health citations since April 2024, 1 was rated as actual harm or immediate jeopardy to residents (1 immediate jeopardy).
CMS lists 1 fine totaling $14,433 in the last three years; the largest was $14,433, and the latest is dated April 26, 2024.
Nurses and nurse aides worked 5.35 hours per resident per day, against 4.19 across Minnesota and 3.86 nationally. Registered nurses accounted for 1.55 of those hours.
41.7% of nursing staff left within the year CMS measured (Minnesota average 42.2%).
CMS links it to Essentia Health, an affiliated group of 6 nursing homes.
Health inspections
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
104/24
206/24
607/25
405/26
Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit
Where its citations fall on CMS's grid
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 13 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
1J
0K
0L
Actual harm
0G
0H
0I
Potential for more than minimal harm
12D
0E
0F
Potential for minimal harm
0A
0B
0C
May 28, 2026Standard inspection · 4 citations
- D 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.
Inspectors wroteBased on interview and document review, the facility failed to investigate, document, and track resolution of a resident grievance regarding another resident (R8) entering their room and going through their belongings for 1 of 1 resident (R22) reviewed for grievances.
- D Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
Inspectors wroteBased on observation, interview and document review, the facility failed to assess and evaluate wandering behaviors, including entering other residents' rooms and going through personal belongings, for 1 of 3 residents (R8) reviewed for behavioral symptoms.
- D Develop and implement policies and procedures for flu and pneumonia vaccinations.
Inspectors wroteBased on interview and document review, the facility failed to assess pneumococcal immunization status, provide education, and document discussion and offering of pneumococcal vaccination in accordance with current CDC recommendations for 2 of 5 residents (R20, R27) reviewed for immunizations.
- D Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
Inspectors wroteBased on interview and document review, the facility failed to assess COVID-19 vaccination status and ensure current CDC-recommended COVID-19 vaccination was offered and documented for 2 of 5 residents (R20, R27) reviewed for immunizations.
July 30, 2025Standard inspection · 6 citations
- D Assess the resident when there is a significant change in condition
Inspectors wroteBased on observation, interview and document review, the facility failed to complete a significant change in status assessment (SCSA) when two or more areas of change in resident status were identified on the Minimum Data Set (MDS) for 1 of 5 residents (R2) reviewed for activities of daily living (ADLs).
- D Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Inspectors wroteBased on interview and document review, the facility failed to revise the care plan to remove restorative nursing ambulation program from the care plan for 1 of 4 resident (R15) reviewed for restorative nurse services.
- D Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.
Inspectors wroteBased on observation, interview and document review, the facility failed to comprehensively assess for a decline in activities in daily living (ADL) and ensure a referral from physical therapy for the decline in ADL's was acted upon for for 1 of 5 residents (R2) reviewed for ADL's
- D 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.
Inspectors wroteBased on interview and document review, the facility failed to ensure range of motion (ROM) was completed in accordance as care planned from therapy recommendations to prevent the loss of mobility for 1 of 3 residents (R17) reviewed for restorative nursing services.
- D Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Inspectors wroteBased on observation, interview and document review, the facility failed to provide medications as ordered for 1 of 5 residents (R11) reviewed for medication management.
- D Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation, interview and document review, the facility failed to ensure enhanced barrier precautions (EBP) were implemented in accordance with Centers for Disease Control (CDC) recommendations during personal care for 1 of 1 residents (R11) reviewed who had a catheter.
June 6, 2024Standard inspection · 2 citations
- D Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Inspectors wroteBased on observation, interview and document review, the facility failed to perform routine monitoring of a wound to promote healing for 1 of 2 residents (R9) reviewed for wound care.
- D Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation, interview and document review, the facility failed to perform hand hygiene for 2 of 5 residents (R20, R29) observed for activities of daily living (ADL's); the facility failed to implement Enhanced Barrier Precautions for 1 of 2 (R9) residents reviewed for pressure ulcers.
April 26, 2024Complaint inspection · 1 citation
- J Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased on observation, interview and document review the facility failed to ensure safe transfer while utilizing a mechanical lift for 1 of 3 residents (R1) reviewed for accidents. This resulted in an immediate jeopardy (IJ) for R1. The immediate jeopardy began on [DATE], when R1 fell while being transferred in a full body mechanical lift that tipped over during provision of care. The facility failed to identify if the staff were correctly using the lift per manufacturer recommendation when the incident occurred. Additional transfer observations identified manufacturer's guidelines were not followed for safe use. The IJ was identified on [DATE]. The administrator and director of nursing (DON) were notified of the immediate jeopardy at 5:05 p.m. on [DATE]. [...]
Fire safety inspections
17 fire safety citations on file: 6 on May 28, 2026, 10 on July 30, 2025, 1 on June 6, 2024.
Every fire safety citation17 citations
- F Have corridors or aisles that are unobstructed and are at least 8 feet in width.
- F To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- E Install emergency lighting that can last at least 1 1/2 hours.
- D Provide properly protected cooking facilities.
- D Properly select, install, inspect, or maintain portable fire extinguishes.
- D Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- F Have simulated fire drills held at unexpected times.
- F Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- F Have generator or other power source capable of supplying service within 10 seconds.
- E Have approved installation, maintenance and testing program for fire alarm systems.
- E Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- D Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- D Provide properly protected cooking facilities.
- D Properly select, install, inspect, or maintain portable fire extinguishes.
- D Install corridor and hallway doors that block smoke.
- D Ensure proper usage of power strips and extension cords.
- D Have enough space near smoke barriers to protect residents.
Fines and payment denials
| Date | Penalty | Amount or length |
|---|---|---|
| April 26, 2024 | Fine | $14,433 |
A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.
Staffing
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Minnesota | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 5.35 | 4.19 | 3.86 |
| Registered nurses | 1.55 | 1.06 | 0.69 |
| All nursing staff on weekends | 4.45 | 3.71 | 3.42 |
| Nurse aides | 2.98 | ||
| Licensed practical nurses | 0.82 | ||
| Nursing staff turnover (share who left in a year) | 41.7% | 42.2% | 45.8% |
| Registered nurse turnover | 20.0% | 38.6% | 42.9% |
| Administrators who left | not reported |
CMS expects 3.41 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Staffing by quarter, from daily payroll records
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 5.72 on weekdays and 4.45 on weekends, 22% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 7.6% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 6.60 in April to June 2025 to 5.35 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 5.35 | 1.55 | 5.72 | 4.45 | 7.6% | 0 of 90 | 26 |
| Oct to Dec 2025 | 5.26 | 1.48 | 5.71 | 4.11 | 0.0% | 0 of 92 | 28 |
| Jul to Sep 2025 | 6.12 | 1.66 | 6.72 | 4.57 | 0.0% | 0 of 92 | 26 |
| Apr to Jun 2025 | 6.60 | 1.72 | 7.14 | 5.25 | 0.0% | 0 of 91 | 25 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Minnesota, Jan to Mar 2026 | 4.19 | 1.05 | 4.38 | 3.73 | 5.2% | 0.8% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Quality measures
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Minnesota | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 20.9 | 18.2 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 3.8 | 1.9 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 2.0 | 2.6 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 2.0 | 4.0 | 3.2 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 15.1 | 20.5 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 5.8 | 5.2 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 16.3 | 17.1 | 15.4 |
Owners and operators
Legal business name: FIRST CARE MEDICAL SERVICES. CMS links this home to Essentia Health, a group of 6 nursing homes averaging 4.3 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Christensen, James | Corporate director | Individual | 01/01/2020 | |
| Haugen, Joel | Corporate director | Individual | 01/01/2017 | |
| Heilman, Tim | Corporate director | Individual | 01/01/2020 | |
| Horn, Beverly | Corporate director | Individual | 01/01/2017 | |
| Jackson, Aarick | Corporate director | Individual | 01/01/2020 | |
| Lewandowski, Laurie | Corporate director | Individual | 01/01/2017 | |
| Mertz, Taylor | Corporate director | Individual | 05/17/2022 | |
| Smith, Benjamin | Corporate director | Individual | 05/17/2022 | |
| Arvin, Douglas | Corporate officer | Individual | 05/18/2023 | |
| Gefroh Ellison, Stefanie | Corporate officer | Individual | 08/12/2024 | |
| Hurley, Alan | Corporate officer | Individual | 05/18/2023 | |
| Watters, Michael | Corporate officer | Individual | 07/01/2023 | |
| Innovis Health LLC | Operational/managerial control | Organization | 01/01/2017 | |
| Arvin, Douglas | Operational/managerial control | Individual | 05/08/2023 | |
| Curtis, Michael | Operational/managerial control | Individual | 07/08/2024 | |
| Gupta, Parul | Operational/managerial control | Individual | 09/02/2025 | |
| Hurley, Alan | Operational/managerial control | Individual | 05/18/2023 | |
| Essentia Health | Adp of the SNF | Organization | 01/29/2025 | |
| Innovis Health LLC | Adp of the SNF | Organization | 01/29/2025 | |
| Arvin, Douglas | Adp of the SNF | Individual | 05/18/2023 | |
| Curtis, Michael | Adp of the SNF | Individual | 07/08/2024 | |
| Gupta, Parul | Adp of the SNF | Individual | 09/02/2025 | |
| Hurley, Alan | Adp of the SNF | Individual | 05/18/2023 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Questions to ask on a visit
Chosen from this home's own inspection record.
- How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 5 problems in this area, most recently on May 28, 2026: "Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia."
- What changed in infection control since the last inspection, and who on staff is the infection preventionist?Inspectors cited 4 problems in this area, most recently on May 28, 2026: "Develop and implement policies and procedures for flu and pneumonia vaccinations."
- When is the care plan meeting, and can family attend it?Inspectors cited 2 problems in this area, most recently on July 30, 2025: "Assess the resident when there is a significant change in condition"
- How do residents and families raise a complaint or grievance, and how fast is it answered?Inspectors cited 1 problem in this area, most recently on May 28, 2026: "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."
Other nursing homes nearby
- McIntosh Senior Living McIntosh, 8.2 mi · 5 of 5 stars · 2 citations
- Cornerstone Nsg & Rehab Center Bagley, 16.5 mi · 5 of 5 stars · 14 citations
- Mahnomen Health Center Mahnomen, 21.1 mi · 2 of 5 stars · 15 citations
Minnesota contacts for a concern about a nursing home
These are the official offices in Minnesota. NursingHomeClear cannot take or act on complaints.
- Inspections and complaints: Minnesota Department of Health, Health Regulation Division, the state agency that inspects nursing homes for CMS and takes complaints about care.
- State inspection reports: MDH Nursing and Boarding Care Home Survey and Complaint Inspection Findings, where Minnesota publishes its own records on licensed homes.
Common questions
- What is First Care Living Center's Medicare star rating?
- CMS rates First Care Living Center 4 out of 5 stars overall, with 3 for health inspections, 5 for staffing and 3 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did First Care Living Center get at its last inspection?
- 4 health deficiencies at the standard inspection on May 28, 2026. The Minnesota average is 7.1.
- Has First Care Living Center been fined?
- Yes. CMS lists 1 fine totaling $14,433 in the last three years.
- Does First Care Living Center accept Medicaid?
- It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
- Who owns First Care Living Center?
- CMS lists 23 owners and managers, and links the home to Essentia Health. Legal business name: FIRST CARE MEDICAL SERVICES.
Sources
- Ratings, staffing and fines: CMS Provider Information, released September 30, 2026, data as of September 1, 2026.
- Citations: CMS Health Deficiencies and Fire Safety Deficiencies.
- Owners: CMS Ownership. Penalties: CMS Penalties.
- Staffing by quarter: CMS Payroll Based Journal Daily Nurse Staffing, April 2025 to March 2026, summed by NursingHomeClear.
- Inspector summaries: CMS Full Statement of Deficiencies (CMS-2567 text), data as of September 1, 2026. Each quote is the part of the statement before the detailed findings.
- Inspection reports with the inspectors' full notes are on this home's Medicare.gov page.
- Something wrong on this page? Ask for a correction. We fix errors in our copy of the data; findings themselves can only be changed by CMS and the state.
- NursingHomeClear is independent and not affiliated with CMS, Medicare or any state agency. This page reports federal records; it does not rate, recommend or endorse any home, and it is not medical or legal advice.