Gundersen St. Elizabeth's Care Center
1200 Fifth Grant Boulevard West, Wabasha, MN 55981 · Wabasha County · (651) 565-4581
100 certified beds, about 79 residents a day · Non profit - Corporation · Medicare and Medicaid since 1986
CMS high performing icon Inside a hospital Certified for Medicaid Certified for Medicare
Overall
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
2 of 5
CMS Care Compare ratings, data as of September 1, 2026 · CCN 245487 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on June 10, 2026, inspectors cited 1 health deficiency (the Minnesota average is 7.1, the national average 9.2).
None of its 8 health citations since April 2024 was rated as actual harm or immediate jeopardy.
CMS lists no fines against this home in the last three years.
Nurses and nurse aides worked 4.19 hours per resident per day, against 4.19 across Minnesota and 3.86 nationally. Registered nurses accounted for 0.69 of those hours.
27.6% of nursing staff left within the year CMS measured (Minnesota average 42.2%).
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.
204/24
505/25
106/26
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 8 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
0K
0L
Actual harm
0G
0H
0I
Potential for more than minimal harm
4D
2E
0F
Potential for minimal harm
0A
0B
2C
June 10, 2026Standard inspection · 1 citation · risk-based survey (a shorter visit CMS gives only to higher performing homes)
- 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 followed for 1 of 1 resident (R54) reviewed for transmission-based precautions. Findings Include: R54's comprehensive Minimum Data Set (MDS) dated [DATE] indicated R54 had moderate cognitive impairment, used a walker for mobility, required substantial/maximal assistance for toileting, partial/moderate assistance for transferring from bed to chair. R54's diagnosis included kidney disease requiring a urinary catheter (flexible, hollow tube inserted into the bladder to drain urine when a person cannot urinate naturally). During an observation on 6/9/26 at 10:59 a.m., director of nursing (DON) entered R54's room to assist with transferring him to a chair so he can eat lunch. [...]
May 21, 2025Standard inspection, Complaint inspection · 5 citations
- E Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Inspectors wroteBased on observation, interview, and document review, the facility failed to develop and implement a system to ensure ongoing, adequate monitoring for side effects with consumed psychotropic medications to promote continuity of care for 3 of 5 residents (R39, R56, R9); and failed to ensure the use of as-needed (i.e., PRN) psychotropic medication was limited to 14-days or extended to a certain date with supporting rationale provided by the medical provider for 1 of 5 residents (R31) reviewed for unnecessary medication use.
- E 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.
Inspectors wroteBased on observation, interview, and document review, the facility failed to ensure alternatives (i.e., small grab bar, positioning devices) were offered, attempted and recorded in the medical record prior to the use of bilateral one-half (1/2) side rails for 4 of 4 residents (R122, R45, R56, R222) observed to have side rails attached to their bed.
- D Provide care or services that was trauma informed and/or culturally competent.
Inspectors wroteBased on interview, observation, and record review the facility failed to identify and document the trauma-related history, post-traumatic stress disorder (PTSD), known triggers and lacked a system or process for completing trauma assessments for 1 of 1 residents (R59) with a known history of PTSD.
- D 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.
Inspectors wroteBased on observation, interview, and document review, the facility failed to ensure direct-care staff were trained and competent in the daily use of resident' medical equipment to ensure safety and reduce the risk of complication (i.e., device failure) for 1 of 1 resident (R53) who used a bed-side continuous positive airway pressure (i.e., CPAP) machine.
- C 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.
Inspectors wroteBased on observation, interview, and document review, the facility failed to develop and implement a preventative, regular maintenance program of resident' beds and side rails to ensure safety and reduce the risk of complication (i.e., bed malfunction, entrapment) for 3 of 3 residents (R122, R45, R222) reviewed who used side rails on their bed. However, the lack of a program had potential to affect all 75 residents residing at either campus.
April 4, 2024Standard inspection · 2 citations
- D Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Inspectors wroteBased on record review, and interview the facility failed to ensure a written notification of transfer and/or discharge was sent to the office of the Ombudsman for 1 of 1 (R45) residents reviewed for hospitalization.
- C Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Inspectors wroteBased on record review, and interview the facility failed to provide a written notification/copy of a bed hold for 1 of 1 (R45) residents reviewed for hospitalization.
Fire safety inspections
15 fire safety citations on file: 1 on June 10, 2026, 6 on May 21, 2025, 8 on April 4, 2024.
Every fire safety citation15 citations
- D Inspect, test, and maintain automatic sprinkler systems.
- F Provide properly protected cooking facilities.
- F Inspect, test, and maintain automatic sprinkler systems.
- F Have generator or other power source capable of supplying service within 10 seconds.
- E Install smoke barrier doors that can resist smoke for at least 20 minutes.
- C Provide family notifications of emergency plan.
- C Have simulated fire drills held at unexpected times.
- F Have exits that are accessible at all times.
- F Provide properly protected cooking facilities.
- F Have approved installation, maintenance and testing program for fire alarm systems.
- F Inspect, test, and maintain automatic sprinkler systems.
- F Install smoke barrier doors that can resist smoke for at least 20 minutes.
- F Have proper medical gas storage and administration areas.
- C Follow proper procedures when the fire alarm was out of service for more than 4 hours.
- C Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
Fines and payment denials
CMS lists no fines or payment denials against this home in the last three years. The national average is 0.9 fines per home.
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) | 4.19 | 4.19 | 3.86 |
| Registered nurses | 0.69 | 1.06 | 0.69 |
| All nursing staff on weekends | 3.80 | 3.71 | 3.42 |
| Nurse aides | 2.64 | ||
| Licensed practical nurses | 0.86 | ||
| Nursing staff turnover (share who left in a year) | 27.6% | 42.2% | 45.8% |
| Registered nurse turnover | 36.8% | 38.6% | 42.9% |
| Administrators who left | 0 |
CMS expects 3.03 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 4.35 on weekdays and 3.80 on weekends, 13% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 6.8% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 4.74 in April to June 2025 to 4.19 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 | 4.19 | 0.69 | 4.35 | 3.80 | 6.8% | 0 of 90 | 79 |
| Oct to Dec 2025 | 4.51 | 0.75 | 4.70 | 4.02 | 5.1% | 0 of 92 | 76 |
| Jul to Sep 2025 | 4.67 | 0.83 | 4.94 | 3.98 | 4.1% | 0 of 92 | 74 |
| Apr to Jun 2025 | 4.74 | 0.90 | 5.02 | 4.03 | 3.4% | 0 of 91 | 75 |
| 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 | 24.9 | 18.2 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 2.4 | 1.9 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 1.1 | 2.6 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 2.9 | 4.0 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.0 | 1.9 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 19.5 | 20.5 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 4.9 | 5.2 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 11.2 | 17.1 | 15.4 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.8 | 1.6 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.4 | 1.9 | 1.8 |
Owners and operators
Legal business name: SAINT ELIZABETHS HOSPITAL OF WABASHA INC.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Gundersen Lutheran Health System Inc | 5% or greater direct ownership interest | Organization | 100% | 08/01/2020 |
| Bellin Gundersen Health System Inc | 5% or greater indirect ownership interest | Organization | 100% | 11/30/2022 |
| Coenen, Daniel | Corporate director | Individual | 01/01/2024 | |
| Denk, Cindy | Corporate director | Individual | 10/01/2012 | |
| Durand, Emily | Corporate director | Individual | 01/01/2023 | |
| Ebersold, Michael | Corporate director | Individual | 07/01/2016 | |
| Fisch, Paul | Corporate director | Individual | 09/01/2020 | |
| Haas, Lloyd | Corporate director | Individual | 09/01/2020 | |
| McLellan, Paul | Corporate director | Individual | 01/01/2026 | |
| Vaplon, Richard | Corporate director | Individual | 01/01/2026 | |
| Youngbauer, Beverly | Corporate director | Individual | 01/01/2023 | |
| Petersen, Kristi | Corporate officer | Individual | 01/01/2025 | |
| Root, James | Corporate officer | Individual | 09/01/2020 | |
| Wolfe, John | Corporate officer | Individual | 01/01/1992 | |
| Bellin Gundersen Health System Inc | Operational/managerial control | Organization | 11/30/2022 | |
| Gundersen Lutheran Health System Inc | Operational/managerial control | Organization | 08/01/2020 | |
| Spano, Dennis | Operational/managerial control | Individual | 01/01/2025 | |
| Petersen, Kristi | Adp of the SNF | Individual | 03/03/2025 | |
| Spano, Dennis | Adp of the SNF | Individual | 03/03/2025 |
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 2 problems in this area, most recently on May 21, 2025: "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."
- How do residents and families raise a complaint or grievance, and how fast is it answered?Inspectors cited 2 problems in this area, most recently on April 4, 2024: "Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights."
- What changed in infection control since the last inspection, and who on staff is the infection preventionist?Inspectors cited 1 problem in this area, most recently on June 10, 2026: "Provide and implement an infection prevention and control program."
- How are allegations of abuse or neglect reported and investigated, and who tells the family?Inspectors cited 1 problem in this area, most recently on May 21, 2025: "Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function."
Other nursing homes nearby
- Mayo Clinic Health System - Lake City Lake City, 12.8 mi · 2 of 5 stars · 25 citations
- The Green Prairie Rehabilitation Center Plainview, 16.4 mi · 5 of 5 stars · 10 citations
- Plum City Care Ctr Plum City, 18.1 mi · 5 of 5 stars · 9 citations
- American Lutheran Home-Mondovi Mondovi, 22.8 mi · 5 of 5 stars · 7 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 Gundersen St. Elizabeth's Care Center's Medicare star rating?
- CMS rates Gundersen St. Elizabeth's Care Center 5 out of 5 stars overall, with 5 for health inspections, 5 for staffing and 2 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did Gundersen St. Elizabeth's Care Center get at its last inspection?
- 1 health deficiency at the standard inspection on June 10, 2026. The Minnesota average is 7.1.
- Has Gundersen St. Elizabeth's Care Center been fined?
- CMS lists no fines in the last three years.
- Does Gundersen St. Elizabeth's Care 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 Gundersen St. Elizabeth's Care Center?
- CMS lists 19 owners and managers. Legal business name: SAINT ELIZABETHS HOSPITAL OF WABASHA INC.
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.