Every Medicare-certified nursing home in North Dakota, graded on inspections, staffing, turnover
and enforcement history.
6 homes in the state sit in the federal Special Focus programme.
Bethany On 42Nd runs a tight ship on the clinical side. Its most recent inspection was in May 2025 and it holds a five-star health inspection rating, with eleven deficiencies on record and none at the harm or jeopardy level. Nurse staffing sits at 5.19 hours per resident day, roughly 35% above the national average, which is genuinely high. The caveats matter though: one deficiency was abuse-related, staff turnover is 59% against a national average of 45.8%, and weekend coverage drops about 8% below weekday levels. Quality measures land at three stars, middling. Strong inspection history and generous staffing, but the abuse finding and churn are worth asking about directly.
Prince of Peace Care Center in Ellendale is a 55-bed nonprofit home, and the numbers tell a mixed story. Nurse staffing sits at 3.45 hours per resident per day, about 11% under the national average, and weekends run roughly 12% thinner than weekdays. The bigger concern is turnover: 83.6% of staff leave each year, nearly double the national rate, which makes it hard to keep consistent caregivers. The quality measures look strong, but four deficiencies sit on the current record, two of them serious enough to involve harm or jeopardy. The last inspection was recent, in April 2026, so that picture is current.
Baptist Health & Rehab runs a solidly staffed building on paper, about 5.09 nurse hours per resident day, roughly a third more than the national average, and weekend coverage stays within about 9% of weekday levels, so care doesn't drop off as sharply as it does at many homes. The trouble sits elsewhere. State inspectors have logged 16 deficiencies on the current record, four of them serious enough to put residents in harm's way and two tied to abuse, with $35,323 in fines across three penalties. Staff turnover, at 49.3%, runs slightly above the national figure, and the most recent inspection dates to April 2025. That mix, strong hours, harder inspection history, is what holds the grade down.
Knife River Care Center runs on a paradox: the raw staffing number is genuinely strong, 4.91 nurse hours per resident day against a national average of 3.86, and that's what earns it the top marks from CMS on staffing. But look at what's happened around that number. Turnover sits at 54.5%, well above the national 45.8%, meaning the aides and nurses in the building are cycling through frequently. Weekend staffing drops about 16% below weekday levels, so the coverage families see on a Tuesday isn't what shows up on a Saturday. And the inspection record is the real concern: 22 deficiencies, including two at harm or jeopardy level and three tied to abuse, plus a $35,890 fine. Strong hours, unstable workforce, and a troubling compliance history.
Pembilier Nursing Center runs 31 certified beds in Walhalla under nonprofit corporate ownership, and its inspection record is the strongest part of the picture: a four-out-of-five health inspection rating and a survey completed in April 2026. Nine deficiencies sit on the current record, one serious enough to reach harm or jeopardy level, though none involve abuse. Staffing tells a more mixed story. At 3.77 nurse hours per resident day, the home sits just under the national average of 3.86, and weekend coverage drops roughly 16% below its own weekday staffing. Annual turnover of 46.9% edges past the national 45.8%. Small homes can absorb some of this, but thin weekend coverage is worth asking about directly.
Wishek Living Center runs on a nonprofit model with 43 certified beds, and its nurse staffing sits well above the national average. The tradeoff shows up in turnover: just over half the nursing staff leaves each year, notably higher than the national figure. Inspections in May 2025 turned up six deficiencies, two serious enough to involve harm or jeopardy, drawing two fines totaling $26,272. The quality measure score is weak, which is worth asking about directly.
Aneta Parkview runs 35 beds as a nonprofit, and its last state inspection came back clean enough for a top federal rating, four deficiencies on record, none causing harm or tied to abuse. Staffing is a different story. At 3.84 nurse hours per resident day, it sits just under the national average, but weekends drop roughly 20% below its own weekday coverage, and 57.5% annual turnover is well above the 45.8% national figure. That churn matters more in a small rural home, where replacing a nurse takes longer. Quality measures land mid-range. Solid care when inspectors look, thinner coverage when they don't.
Benedictine Living Center Of Garrison runs 52 certified beds as a church-affiliated nonprofit, and its staffing sits about 18% under the national average, 3.18 nurse hours per resident day against 3.86 nationally, with weekends roughly 7% thinner than weekdays. Turnover lands at 36.4%, better than the 45.8% national figure, so the people who stay tend to stay. The tradeoff shows up in its record: 14 deficiencies, including one at the harm level and two abuse-related, plus a single $8,278 fine, with the most recent inspection dated July 22, 2025. Its three CMS star ratings, health inspection, quality measures, and staffing, all sit at the middle.
Bethel Lutheran runs a strong staffing operation on paper, 4.81 nurse hours per resident day, roughly a quarter above the national average, which helps explain its four-star staffing rating. But that margin thins on weekends, when coverage drops about 18% below the home's own weekday level, and the workforce itself is churning: 63% annual turnover against a national average near 46%. The inspection record is the bigger concern. Twenty-five deficiencies, including two at the harm or jeopardy level and four tied to abuse, with the most recent inspection in April 2026. Federal inspectors rated the health inspection side 2 out of 5. Plenty of hands on deck most weekdays, just not always the same hands, and not always enough of them.
Trinity Homes runs on 4.24 nurse hours per resident day, roughly 10% above the national average, and weekends dip only slightly from weekdays, the kind of staffing pattern that usually shows up in the 4/5 staffing rating. The trouble sits elsewhere. Inspectors have cited 34 deficiencies, six of them at the level where a resident was actually harmed or put in jeopardy, and five tied to abuse. Three fines total $75,611. Staff turnover is 57.3% against a national 45.8%, so a lot of that good coverage is delivered by people still learning the building. The state last inspected in August 2025, and the health inspection rating sits at 1 out of 5. Good staffing can't outweigh what those inspections found.
Tioga Medical Center's long-term care unit runs on unusually thin margins of people, not hours. The raw staffing number looks generous, 5.95 nurse hours per resident day against a national average around 3.86, but that figure masks a workforce cycling out fast enough to matter: 65.5% annual turnover, well above the 45.8% national rate. Weekend coverage drops roughly 11% below weekday levels, and the quality measure score sits at 1 out of 5 stars despite the 4-star staffing rating. Sixteen deficiencies are on the current record, including one at the harm level and two tied to abuse, with a single $11,408 fine. The last inspection was March 2025. A nonprofit with 30 beds can be a close-knit place; this one's numbers suggest watching staff consistency closely.
Good Samaritan Society - Lakota runs 38 beds in a small Nelson County town, and the nursing hours tell a mixed story: 3.83 per resident day, just under the national figure, with weekends dropping about 24% below the home's own weekday staffing. Staff turnover is 44.7%, roughly in line with the national average, so retention isn't the problem here. The inspection record is. Twenty-seven deficiencies, two of them at harm or jeopardy level, plus two fines totaling $74,283, and a quality measure rating of 1 out of 5. The most recent inspection was June 2025, so the record is current. Nothing suggests abuse. But a home with this many cited problems and quality scores this low is one to visit unannounced and ask hard questions about.
St Rose Care Center runs 36 beds in Lamoure under nonprofit ownership, and the numbers that stand out most are about people. Nurse staffing sits at 3.36 hours per resident day, roughly 13 percent under the national average, and it thins out further on weekends. The bigger concern is turnover: 82.1 percent of staff leave each year, against a national average near 46 percent. That kind of churn means residents see a rotating cast of caregivers, which matters more in a small home where everyone knows everyone. The 13 deficiencies on record include none at the harm level and none related to abuse, and the last inspection was in April 2026.
Good Samaritan Society - Park River runs 44 certified beds as a nonprofit, and its last inspection was in August 2025. The staffing picture is mixed: 3.02 nurse hours per resident day sits roughly 22% under the national average of 3.86, and weekends dip about 17% below the home's own weekday coverage. Turnover runs 47.4%, slightly above the national 45.8%. On the record: 29 deficiencies, none at harm or jeopardy level, though one is abuse-related, plus a single $42,181 fine. Federal ratings put staffing at 4 of 5 stars but inspections and quality measures at 2 each. The takeaway: adequate hands on weekdays, thinner on weekends, with inspection findings that warrant a closer look.
Four Seasons Health Care in Forman runs 25 beds under nonprofit ownership, and its last inspection on February 19, 2026 turned up 29 deficiencies, two of them serious enough to cause harm or put residents in immediate jeopardy, plus one tied to abuse. The staffing picture is thin even by rural North Dakota standards, and three fines totaling $115,484 have accumulated on the current record. What keeps the quality measure rating afloat is clinical performance on paper, things like hospitalization and medication metrics, but strong outcomes data can't offset a building where the hands-on care and the oversight have both raised red flags. If you're considering this one, ask directly what changed after February.
Western Horizons Care Center has 31 certified beds and runs on 4.75 nurse staffing hours per resident day, about 23% above the national average of 3.86, a real point in its favor, though weekend coverage drops roughly 15% below its own weekday level. The staffing star rating sits at 3/5, but the clinical and inspection record is where things get serious: 35 deficiencies on the current record, including 5 at the harm or jeopardy level and 3 abuse-related, plus three CMS fines totaling $62,703. The most recent inspection was September 4, 2025. It's a nonprofit corporation, and the quality measure rating comes in at 1/5. Stronger-than-average staffing is not offsetting the harm-level findings and fine history here.
The county-owned home in Mcville runs 35 beds and staffs above the national average, 4.07 nurse hours per resident day versus 3.86, which is the strongest thing in its file. But that staffing thins out on weekends, dropping roughly 15% below its own weekday level, and turnover sits at 51.2% against a national 45.8%, so the people providing that care keep changing. The inspection record is the real concern: 15 deficiencies, six tied to abuse and one serious enough to put a resident in harm's way, plus a $36,855 fine. The most recent inspection was April 2025. Good daily coverage, a troubling paper trail.
Smp Health - St Raphael runs a church-affiliated nonprofit home with 170 certified beds in Valley City, and its nurse staffing sits at 4.71 hours per resident day, roughly 22% above the national average of 3.86. That staffing cushion shows up in its five-star CMS staffing rating, and turnover runs lower than average too, at 38.5% against 45.8% nationally, though weekend coverage dips about 11% below its own weekday level. The inspection record is solid but not spotless: nine deficiencies, one serious enough to reach harm or jeopardy level, and none tied to abuse. A recent September 2025 inspection and a four-star health inspection rating back that up, while quality measures land at three stars.
Dunseith Com Nursing Home runs on unusually heavy staffing, 5.50 nurse hours per resident day, roughly 42% above the national average, and that's the strongest thing in its file, reflected in a full five stars from CMS on staffing. The problems sit elsewhere. Inspectors have cited 31 deficiencies, three of them at the level where a resident was actually harmed or put in jeopardy, plus four tied to abuse; the health inspection rating is one star, and two fines total $92,954. Weekend coverage dips about 9% below weekday levels, and turnover runs 56.4% against a national 45.8%. City-owned, 30 beds, inspected most recently in May 2025. Plenty of hands, but the record shows they haven't always kept residents safe.
Ave Maria sits in Jamestown with 100 certified beds and a nonprofit owner, and its staffing is the standout: 4.98 nurse hours per resident day, roughly 29% above the national average, with turnover at 37% versus 45.8% nationally. Weekend coverage dips about 16% below its own weekday level, so the weekday-to-Saturday drop is worth asking about. The inspection record is where the concern lives, 11 deficiencies, 2 at harm or jeopardy level, 5 tied to abuse, and a $6,788 fine, with a 2/5 health inspection rating and 2/5 quality measures. The most recent inspection was December 11, 2025, so the record is current. Ask directly how those abuse-related deficiencies were resolved and what weekend staffing looks like now.