ElderGrade
C

64/100

Average

Nelson County Health System Care Center

108 E Nyhus Ave, Mcville, ND 58254

CMS 2/5 stars #2 of 3 in Nelson County (701) 322-4314
Certified beds
35
Occupancy
91%
Ownership
Government
Accepts
Medicare + Medicaid

What to ask about before you visit

These are findings in the public CMS record for this home. They are not our opinion — each one comes straight from a federal inspection or enforcement file.

  • Abuse icon on record

    CMS flags this facility for citations of abuse that caused harm, or potential for harm, to residents.

  • 1 citation(s) involving actual harm or immediate jeopardy

    Inspectors found violations at scope/severity G or above, meaning residents were harmed or placed in immediate jeopardy.

  • $36,855 in federal fines

    CMS has fined this facility across 1 penalty action(s).

How this grade was calculated

Every point is shown. Nothing is weighted behind the scenes — the full formula is on How we grade.

Inspection safety

26/30

Citations from state health inspections over the last three surveys, weighted by how much harm CMS says they caused.

  • -4 for 1 actual-harm citation(s) in the last 3 years

Staffing

22.5/30

Nursing hours per resident per day, adjusted for how sick the residents are, plus RN cover and weekend consistency.

  • 5.15 total nurse hours per resident per day (national median 3.77)
  • 0.7 RN hours per resident per day
  • Weekend staffing drops 15% against weekdays

Staff stability

9/15

How much of the nursing team leaves in a year. High turnover means a resident rarely sees the same face twice.

  • 51% of nursing staff left in the last year

Resident outcomes

2/15

The CMS quality-measure rating, built from resident outcomes like falls, pressure ulcers, infections and antipsychotic use.

  • 1 of 5 stars on the CMS quality-measure rating

Enforcement history

5/10

Fines and payment denials CMS has imposed. A denial of payment means CMS stopped paying for new admissions.

  • $36,855 in federal fines across 1 action(s)

Grade ceiling applied

  • Capped at 64 (grade C) — CMS abuse icon on record

Staffing, against the national average

Full detail

Hours of nursing care each resident receives per day. The marker on each bar is the national average.

Total nurse hours per resident per day 4.07 hrs
National average 3.86 hrs Better than average
Registered nurse (RN) hours 0.70 hrs
National average 0.69 hrs Better than average

RNs are the licence level most likely to catch a resident deteriorating.

Weekend nurse hours 3.45 hrs
National average 3.42 hrs Better than average

The shift most families visit, and the one thinned first.

Nursing staff turnover 51.20%
National average 45.80% Below average

The share of nursing staff who left over the last year.

Recent inspection findings

All 15 citations

Last standard health inspection: April 1, 2025 (1 year ago).

D Apr 29, 2026 F0600 From a complaint

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

No actual harm, potential for more than minimal harm

D Apr 29, 2026 F0610 From a complaint

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Respond appropriately to all alleged violations.

No actual harm, potential for more than minimal harm

D Jun 23, 2025 F0600 From a complaint

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

No actual harm, potential for more than minimal harm

D Apr 1, 2025 F0880

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

No actual harm, potential for more than minimal harm

G Nov 26, 2024 F0600 From a complaint

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Actual harm to a resident

D Nov 26, 2024 F0605 From a complaint

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.

No actual harm, potential for more than minimal harm

F Mar 21, 2024 F0851

Administration Deficiencies

Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.

No actual harm, potential for more than minimal harm

D Mar 21, 2024 F0657

Resident Assessment and Care Planning Deficiencies

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

No actual harm, potential for more than minimal harm

Who owns this home

Full record
Owner Type Role Since
SWENSON, CATHERINE Individual W-2 MANAGING EMPLOYEE
BERG, IVAN Individual CORPORATE DIRECTOR
JENSEN, BRANDON Individual CORPORATE DIRECTOR
LUNDEBY, BRANDON Individual CORPORATE DIRECTOR
OXTON, RANAE Individual CORPORATE DIRECTOR
STEIN, HEATHER Individual CORPORATE DIRECTOR
TWETE, ANGELA Individual CORPORATE DIRECTOR
TWETE, JUDITH Individual CORPORATE DIRECTOR
FORDE, STEVEN Individual OPERATIONAL/MANAGERIAL CONTROL
NELSON COUNTY HEALTH SYSTEM Organization 5% OR GREATER DIRECT OWNERSHIP INTEREST

What families say

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Common questions about Nelson County Health System Care Center

What is the ElderGrade for Nelson County Health System Care Center? +

Nelson County Health System Care Center holds an ElderGrade of C (64 out of 100), which we describe as "average". The grade combines its inspection citations, nurse staffing levels, staff turnover, resident outcomes and enforcement history from the federal CMS record.

How many nursing hours does each resident get at Nelson County Health System Care Center? +

Residents receive an average of 4.07 nursing hours per day across all nursing staff, against a national average of 3.86 hours.

Has Nelson County Health System Care Center been cited for harming residents? +

Yes. 1 of the 15 citations on record were scored at scope and severity G or above, meaning inspectors found actual harm to a resident or immediate jeopardy to resident safety.

Does Nelson County Health System Care Center accept Medicaid? +

Yes, Nelson County Health System Care Center is certified to accept Medicaid, which is the programme that pays for long-term custodial care once a resident meets their state's income and asset limits.