Moose Lake Village
710 South Kenwood Avenue, Moose Lake, MN 55767 · Carlton County · (218) 351-9401
60 certified beds, about 53 residents a day · Non profit - Corporation · Medicare and Medicaid since 1987
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 245491 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on July 9, 2026, inspectors cited 5 health deficiencies (the Minnesota average is 7.1, the national average 9.2).
None of its 14 health citations since November 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 4.64 hours per resident per day, against 4.19 across Minnesota and 3.86 nationally. Registered nurses accounted for 0.80 of those hours.
45.8% 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.
111/23
203/24
605/25
507/26
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 14 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
0K
0L
Actual harm
0G
0H
0I
Potential for more than minimal harm
9D
4E
1F
Potential for minimal harm
0A
0B
0C
July 9, 2026Standard inspection · 5 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 minimum dishwasher temperatures were attained during the rinse cycle for 1 of 1 dishwasher. This had the potential to affect all current residents, as well as staff or visitors, who ate food served from dishes and tableware that were cleaned in the dishwasher.
- E Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Inspectors wroteBased on observation, interview and document review the facility failed to ensure medication refrigerators were kept within the recommended temperature range for 1 of 2 medication refrigerators. This deficient practice had the potential to affect any resident who received medications stored in the refrigerator.
- E Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation, interview, and document review, the facility failed to ensure that all staff (including outside contracted staff) wear appropriate personnel protective equipment (PPE) and perform appropriate hand hygiene while completing wound care on a resident. This affected 1 of 1 (R60) residents reviewed for infection control. The facility also failed to change oxygen tubing timely to decrease the risk of infection for 1 of 1 (R37) reviewed for respiratory care. Findings Include: Wound Care: R60's quarterly Minimum Data Set (MDS) dated [DATE], indicated R60 had intact cognition. Diagnoses included peripheral vascular disease. Section M indicated R60 was at risk for pressure ulcers/injuries and had one stage two pressure ulcer that was not present on admission. R 60 also had one open lesion that was not a pressure ulcer, rash or cut. [...]
- D Allow residents to self-administer drugs if determined clinically appropriate.
Inspectors wroteBased on observation, interview, and document review the facility failed to complete a Self-Administration of Medication (SAM) assessment and acquire a physician order for self-administration for 1 of 1 resident (R72) who was observed to have medications left at bedside.
- D Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on interview and document review the facility failed to ensure orders for blood sugar readings were followed for 1 of 5 residents (R19) reviewed for unnecessary medications.
May 15, 2025Standard inspection · 6 citations
- E 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 hot water temperatures were at safe temperatures at point-of-use for 27 of 27 residents who resided on the 200 hallway and the specialty care unit. In addition, the facility failed to ensure staff provided adequate supervision for transfers and activities of daily living for 2 of 2 residents (R49 and R40) and the facility further failed to follow the care plan related to transferring for the prevention of falls for 3 of 5 (R49, R40, R44) residents at risk for falls.
- E Ensure each resident’s drug regimen must be free from unnecessary drugs.
Inspectors wroteBased on interview and document review, the facility failed to ensure medication orders for residents contained an indication for the medication for 3 of 5 (R19, R37, R49) residents reviewed for unnecessary medications.
- D Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.
Inspectors wroteBased on interview and document review, the facility failed to provide a financial statement to 1 of 2 residents (R4) who had requested to receive a quarterly statement of their personal funds account.
- 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 observation, interview, and record review the facility failed to identify and update the care plan with resident specific fall prevention interventions for 1 of 2 residents (R49) reviewed for multiple falls at the facility.
- D Provide care or services that was trauma informed and/or culturally competent.
Inspectors wroteBased on interview and document review, the facility failed to assess post-traumatic stress disorder (PTSD) symptoms and triggers and carry them forward to the care plan for 1 of 1 resident (R19) reviewed for trauma informed care.
- D Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on observation and interview the facility failed to utilize beard coverings in the kitchen to ensure sanitary conditions were maintained in food preparation areas. This deficient practice had the potential to impact all residents who received nourishment from the facility dietary services.
March 14, 2024Standard inspection · 2 citations
- D Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Inspectors wroteBased on interview and document review, the facility failed to ensure advanced directives for emergency care and treatment were accurately reflected in all areas of the medical chart to ensure resident wishes would be implemented correctly in an emergent situation for 1 of 24 residents (R106) reviewed for advanced directives.
- D Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Inspectors wroteBased on observation and interview, the facility failed to ensure eye drops were disposed of when they were past the 28 day post open date. This had potential to affect 2 of 16 residents who resided on 300 hallway.
November 9, 2023Complaint inspection · 1 citation
- D Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Inspectors wroteBased on interview and document review, the facility failed to notify the medical provider of high blood sugar levels for 2 of 3 residents (R2, R3) reviewed for change in condition.
Fire safety inspections
14 fire safety citations on file: 2 on July 9, 2026, 10 on May 15, 2025, 2 on March 14, 2024.
Every fire safety citation14 citations
- F Ensure that testing and maintenance of electrical equipment is performed.
- E Have restrictions on the use of highly flammable decorations.
- F Have approved installation, maintenance and testing program for fire alarm systems.
- F Inspect, test, and maintain automatic sprinkler systems.
- F Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- F Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
- F Have simulated fire drills held at unexpected times.
- F Have generator or other power source capable of supplying service within 10 seconds.
- E Install emergency lighting that can last at least 1 1/2 hours.
- E Have restrictions on the use of portable space heaters.
- D Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
- D Ensure proper usage of power strips and extension cords.
- F Inspect, test, and maintain automatic sprinkler systems.
- F Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
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) | 4.64 | 4.19 | 3.86 |
| Registered nurses | 0.80 | 1.06 | 0.69 |
| All nursing staff on weekends | 4.14 | 3.71 | 3.42 |
| Nurse aides | 3.23 | ||
| Licensed practical nurses | 0.61 | ||
| Nursing staff turnover (share who left in a year) | 45.8% | 42.2% | 45.8% |
| Registered nurse turnover | 30.0% | 38.6% | 42.9% |
| Administrators who left | 1 |
CMS expects 3.47 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 4.84 on weekdays and 4.14 on weekends, 14% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 2.3% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 4.91 in April to June 2025 to 4.64 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 | 4.64 | 0.80 | 4.84 | 4.14 | 2.3% | 2 of 90 | 53 |
| Oct to Dec 2025 | 4.56 | 0.81 | 4.72 | 4.15 | 3.0% | 0 of 92 | 54 |
| Jul to Sep 2025 | 4.78 | 0.72 | 5.01 | 4.19 | 2.6% | 0 of 92 | 53 |
| Apr to Jun 2025 | 4.91 | 0.73 | 5.06 | 4.54 | 3.8% | 0 of 91 | 50 |
| 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 | 23.1 | 18.2 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.8 | 1.9 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 1.2 | 2.6 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 0.0 | 4.0 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 2.5 | 1.9 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 35.5 | 20.5 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 12.0 | 5.2 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 30.9 | 17.1 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 13.2 | 23.5 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 17.0 | 14.8 | 12.0 |
Owners and operators
Legal business name: AUGUSTANA MERCY CARE CENTER LLC.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Cassia | 5% or greater direct ownership interest | Organization | 100% | 01/01/2018 |
| Smith, Shawna | W-2 managing employee | Individual | 01/01/2018 | |
| Dahl, Robert | Corporate director | Individual | 01/01/2018 | |
| Kern, Matthew | Corporate director | Individual | 01/01/2018 | |
| Stadtherr, Seelochani | Corporate director | Individual | 01/01/2018 | |
| Youngquist, Kathryn | Corporate director | Individual | 01/01/2018 | |
| Mackay, Marshall | Corporate officer | Individual | 01/01/2018 | |
| Nye, Gerald | Corporate officer | Individual | 01/01/2018 | |
| Parks, Charles | Corporate officer | Individual | 01/01/2018 | |
| Ramsdale, Scott | Corporate officer | Individual | 01/01/2018 | |
| Wilkerson, Gary | Corporate officer | Individual | 01/01/2018 | |
| Cassia | Operational/managerial control | Organization | 01/01/2018 |
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 residents and families raise a complaint or grievance, and how fast is it answered?Inspectors cited 4 problems in this area, most recently on July 9, 2026: "Allow residents to self-administer drugs if determined clinically appropriate."
- How are medications reviewed, and how often are antipsychotic or sedating drugs used?Inspectors cited 3 problems in this area, most recently on July 9, 2026: "Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs."
- How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 3 problems in this area, most recently on July 9, 2026: "Provide appropriate treatment and care according to orders, resident’s preferences and goals."
- 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 July 9, 2026: "Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards."
- How long has the current administrator been here?CMS counts 1 administrator who left in the period it measured.
Other nursing homes nearby
- Cura of Sandstone Sandstone, 22.2 mi · 1 of 5 stars · 27 citations
- Interfaith Care Center Carlton, 22.9 mi · 5 of 5 stars · 9 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 Moose Lake Village's Medicare star rating?
- CMS rates Moose Lake Village 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 Moose Lake Village get at its last inspection?
- 5 health deficiencies at the standard inspection on July 9, 2026. The Minnesota average is 7.1.
- Has Moose Lake Village been fined?
- CMS lists no fines in the last three years.
- Does Moose Lake Village 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 Moose Lake Village?
- CMS lists 12 owners and managers. Legal business name: AUGUSTANA MERCY CARE CENTER LLC.
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.