LAKE MINNETONKA SHORES
4527 SHORELINE DRIVE
SPRING PARK, MN, 55384
9524714001
CCN: 245210
5
Overall4
Health5
Staffing3
QualitySpecial FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
| Name | Role | % |
|---|---|---|
| PRESBYTERIAN HOMES HOUSING AND ASSISTED LIVING, INC. | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% |
| NORTHEAST BANK | 5% OR GREATER MORTGAGE INTEREST | NOT APPLICABLE |
| NORTHEAST BANK | 5% OR GREATER SECURITY INTEREST | NOT APPLICABLE |
| FLETCHER, JONATHAN | CORPORATE DIRECTOR | NOT APPLICABLE |
| MEYER, MARK | CORPORATE DIRECTOR | NOT APPLICABLE |
| PEDERSON, MARK | CORPORATE DIRECTOR | NOT APPLICABLE |
| FLETCHER, JONATHAN | CORPORATE OFFICER | NOT APPLICABLE |
| MEYER, MARK | CORPORATE OFFICER | NOT APPLICABLE |
| PHS MANAGEMENT, LLC | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| MIELKE, JOHN | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| SOKOLOSKI, SHAYLEE | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| PRESBYTERIAN HOMES HOUSING AND ASSISTED LIVING, INC. | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
Penalties (1)
| Date | Type | Amount |
|---|---|---|
| 2024-04-25 | Fine | $9K |
Health Deficiencies (9)
2024-04-25 · Health
D
F883 · Infection Control Deficiencies
Develop and implement policies and procedures for flu and pneumonia vaccinations.
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
F
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
F761 · Pharmacy Service Deficiencies
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.
C
F732 · Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
J
F578 · Resident Rights Deficiencies
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.
2023-08-24 · Health
D
F677 · Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
F657 · 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.
D
F583 · Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day3.68
4.31
RN Hrs/Resident/Day0.54
1.27
LPN Hrs/Resident/Day0.81
0.46
CNA Hrs/Resident/Day2.33
2.58
PT Hrs/Resident/Day0.12
0.21
Data as of 2026-03-01