Knute Nelson Care Center
420 12th Avenue East, Alexandria, MN 56308 · Douglas County · (320) 763-6653
83 certified beds, about 65 residents a day · Non profit - Corporation · Medicare and Medicaid since 1987
CMS high performing icon Certified for Medicaid Certified for Medicare
Overall
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
5 of 5
CMS Care Compare ratings, data as of September 1, 2026 · CCN 245435 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on May 13, 2026, inspectors cited 2 health deficiencies (the Minnesota average is 7.1, the national average 9.2).
None of its 12 health citations since September 2023 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 4.16 hours per resident per day, against 4.19 across Minnesota and 3.86 nationally. Registered nurses accounted for 1.01 of those hours.
29.1% of nursing staff left within the year CMS measured (Minnesota average 42.2%).
CMS links it to Vivie, an affiliated group of 5 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.
109/23
605/24
303/25
205/26
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 12 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
0K
0L
Actual harm
0G
0H
0I
Potential for more than minimal harm
7D
2E
1F
Potential for minimal harm
0A
0B
2C
May 13, 2026Standard inspection · 2 citations
- C Give residents a notice of rights, rules, services and charges.
Inspectors wroteBased on interview and record review the facility failed to ensure the resident bill of rights ([NAME]) were provided verbally and in writing for all the facility residents, this had the potential to affect all 63 residents in the facility. Findings Include:On 5/12/26 at 10:33 a.m., Resident Council Minutes Forms were reviewed for 2/24/26, 3/26/26, and 4/16/26. The minutes lacked documentation that the [NAME] were reviewed. On 5/12/26, at 11:15 a.m., seven residents (R61, R62, R35, R24, R21, R17, R18) were present at a resident council meeting held by surveyor. When questioned if the resident ([NAME]) had been reviewed, the residents present stated the rights had not been reviewed. R61 stated she thought [NAME] was given at time of admission, and they were posted in the facility. R62 indicated had been admitted years ago and was not coherent at that time. [...]
- C Post nurse staffing information every day.
Inspectors wroteBased on observation, record review, and interviews, the facility failed to ensure all required information was included daily on the facility staff posting. This had the potential to affect all 63 residents in the facility and their visitors who may wish to view the information.
March 5, 2025Standard inspection · 3 citations
- F Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on observation, interview, and document review, the facility failed to ensure food and beverages stored in the refrigerators, were labeled, dated and discarded properly. Further, the facility failed to maintain proper holding food temperatures during the noon meal on the Pines unit. This deficient practice had the potential to affect 59 residents who received food and beverages from the refrigerators.
- 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 interview and document review, the facility failed to notify the Long Term Care (LTC) ombudsman of a facility initiated transfer for 1 of 1 residents (R64) who was transferred to an acute care facility on an emergency basis reviewed for hospitalization.
- D Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Inspectors wroteBased on observation, interview and document review, the facility failed to ensure timely assistance with repositioning occurred for 1 of 5 residents (R2) with a current pressure ulcer and at risk for further development of pressure ulcers.
May 22, 2024Standard inspection, Complaint inspection · 6 citations
- E Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Inspectors wroteBased on observation, interview and document review, the facility failed to ensure food was served at a palatable and appetizing temperature for 4 of 4 residents (R 21, R29, R48 and R52) who resided on the Pines unit reviewed for food. This deficient practice had the potential to affect all 42 residents residing on this unit.
- E Develop and implement policies and procedures for flu and pneumonia vaccinations.
Inspectors wroteBased on interview and document review, the facility failed to ensure 4 of 5 residents (R6, R36, R41 and R44) received pneumococcal vaccinations based on shared clinical decision-making in accordance with the Center for Disease Control (CDC) recommendations reviewed for immunizations.
- D Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Inspectors wroteBased on observation, interview and document review, the facility failed to comprehensively assess the use of a restrictive device as a potential restraint for 1 of 1 resident (R6) reviewed for restraints.
- D Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on observation, interview and document review, the facility failed to ensure physician orders were implemented to prevent potential fluid retention for 1 of 1 resident reviewed for quality of care.
- D Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Inspectors wroteBased on observation, interview and document review, the facility failed to ensure timely assistance with repositioning occurred for 1 of 5 residents (R6) with a history of pressure ulcers and at risk for further development of pressure ulcers.
- D 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 comprehensively assess smoking safety for 1 of 1 residents (R38) who currently smoked.
September 22, 2023Complaint inspection · 1 citation
- D Keep residents' personal and medical records private and confidential.
Inspectors wroteBased on observation, interview and document review, the facility failed to maintain personal privacy for 4 of 4 residents (R1, R4, R5, R6) who had video monitoring devices in their bedrooms as an intervention to prevent falls and elopement.
Fire safety inspections
21 fire safety citations on file: 5 on May 13, 2026, 9 on March 5, 2025, 7 on May 22, 2024.
Every fire safety citation21 citations
- F Have simulated fire drills held at unexpected times.
- F Have generator or other power source capable of supplying service within 10 seconds.
- F Ensure that testing and maintenance of electrical equipment is performed.
- E Ensure proper usage of power strips and extension cords.
- D Inspect, test, and maintain automatic sprinkler systems.
- F Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- E Install smoke barrier doors that can resist smoke for at least 20 minutes.
- E Ensure proper usage of power strips and extension cords.
- D Keep aisles, corridors, and exits free of obstruction in case of emergency.
- D Install a fire alarm system that can be heard throughout the facility.
- D Inspect, test, and maintain automatic sprinkler systems.
- D Install corridor and hallway doors that block smoke.
- D Have simulated fire drills held at unexpected times.
- D To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- F Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
- F Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- F To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- F Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- E Provide properly protected cooking facilities.
- D Inspect, test, and maintain automatic sprinkler systems.
- D Ensure proper usage of power strips and extension cords.
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) | 4.16 | 4.19 | 3.86 |
| Registered nurses | 1.01 | 1.06 | 0.69 |
| All nursing staff on weekends | 3.57 | 3.71 | 3.42 |
| Nurse aides | 2.29 | ||
| Licensed practical nurses | 0.86 | ||
| Nursing staff turnover (share who left in a year) | 29.1% | 42.2% | 45.8% |
| Registered nurse turnover | 18.8% | 38.6% | 42.9% |
| Administrators who left | 0 |
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 4.39 on weekdays and 3.57 on weekends, 19% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 0.0% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 4.02 in April to June 2025 to 4.16 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 | 4.16 | 1.01 | 4.39 | 3.57 | 0.0% | 0 of 90 | 65 |
| Oct to Dec 2025 | 4.47 | 1.09 | 4.72 | 3.83 | 0.0% | 0 of 92 | 60 |
| Jul to Sep 2025 | 4.13 | 1.01 | 4.37 | 3.53 | 0.0% | 0 of 92 | 64 |
| Apr to Jun 2025 | 4.02 | 0.84 | 4.27 | 3.41 | 0.0% | 0 of 91 | 66 |
| 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 | 15.9 | 18.2 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.0 | 1.9 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 2.3 | 2.6 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 1.2 | 4.0 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 3.0 | 1.9 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 21.5 | 20.5 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 4.4 | 5.2 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 8.1 | 17.1 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 15.6 | 23.5 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 14.1 | 14.8 | 12.0 |
Owners and operators
Legal business name: KNUTE NELSON. CMS links this home to Vivie, a group of 5 nursing homes averaging 3.4 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Vivie | 5% or greater direct ownership interest | Organization | 100% | 01/01/2024 |
| Anderson, Mark | W-2 managing employee | Individual | 08/01/2004 | |
| Gugisberg, Marnie | W-2 managing employee | Individual | 07/11/2005 | |
| Perry, Katie | W-2 managing employee | Individual | 07/24/2006 | |
| Urman, Angela | W-2 managing employee | Individual | 11/16/2010 | |
| Billberg, Greg | Corporate director | Individual | 03/01/2022 | |
| Carlson, Pamela | Corporate director | Individual | 02/15/2017 | |
| Coauette, Chad | Corporate director | Individual | 02/15/2017 | |
| Critz, Julie | Corporate director | Individual | 03/01/2020 | |
| Jodsaas, Vicki | Corporate director | Individual | 03/01/2021 | |
| Montgomery, Jeff | Corporate director | Individual | 02/15/2018 | |
| O'Kane, Sara | Corporate director | Individual | 03/01/2023 | |
| Steffl, Deena | Corporate director | Individual | 02/15/2016 | |
| Anderson, Mark | Corporate officer | Individual | 08/01/2004 | |
| Gugisberg, Marnie | Corporate officer | Individual | 07/11/2005 | |
| Hanson, Phillip | Corporate officer | Individual | 01/01/2024 | |
| Perry, Katie | Corporate officer | Individual | 02/01/2023 | |
| Semmer, Fred | Corporate officer | Individual | 01/01/2024 | |
| Urman, Angela | Corporate officer | Individual | 11/16/2010 | |
| Wolf, David | Corporate officer | Individual | 02/15/2015 |
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 4 problems in this area, most recently on March 5, 2025: "Provide appropriate pressure ulcer care and prevent new ulcers from developing."
- How do residents and families raise a complaint or grievance, and how fast is it answered?Inspectors cited 3 problems in this area, most recently on May 13, 2026: "Give residents a notice of rights, rules, services and charges."
- Can we see a week of menus and the kitchen, and how are special diets handled?Inspectors cited 2 problems in this area, most recently on March 5, 2025: "Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards."
- How many nurses and aides work each shift, nights and weekends included?Inspectors cited 1 problem in this area, most recently on May 13, 2026: "Post nurse staffing information every day."
- Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 3.57 hours per resident per day, below the Minnesota average of 3.71.
Other nursing homes nearby
- Bethany on the Lake LLC Alexandria, 0.8 mi · 3 of 5 stars · 10 citations
- Galeon Osakis, 10.2 mi · 5 of 5 stars · 5 citations
- Glenwood Village Care Center Glenwood, 16.3 mi · 2 of 5 stars · 24 citations
- Evansville Care Center Evansville, 18 mi · 5 of 5 stars · 8 citations
- St. Williams Living Center Parkers Prairie, 19.1 mi · 5 of 5 stars · 10 citations
- Minnewaska Community Health Services Starbuck, 19.9 mi · 2 of 5 stars · 18 citations
- Cura of Sauk Centre Sauk Centre, 22.1 mi · 3 of 5 stars · 13 citations
- Barrett Care Center Inc Barrett, 24.9 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 Knute Nelson Care Center's Medicare star rating?
- CMS rates Knute Nelson Care Center 5 out of 5 stars overall, with 5 for health inspections, 5 for staffing and 5 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did Knute Nelson Care Center get at its last inspection?
- 2 health deficiencies at the standard inspection on May 13, 2026. The Minnesota average is 7.1.
- Has Knute Nelson Care Center been fined?
- CMS lists no fines in the last three years.
- Does Knute Nelson 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 Knute Nelson Care Center?
- CMS lists 20 owners and managers, and links the home to Vivie. Legal business name: KNUTE NELSON.
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.