Moose Lake Village
710 SOUTH KENWOOD AVENUE
MOOSE LAKE, MN, 55767
2183519400
CCN: 245491
4
Overall4
Health4
Staffing3
QualitySpecial FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
| Name | Role | % |
|---|---|---|
| CASSIA | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% |
| YOUNGQUIST, KATHRYN | CORPORATE DIRECTOR | NOT APPLICABLE |
| DAHL, ROBERT | CORPORATE DIRECTOR | NOT APPLICABLE |
| KERN, MATTHEW | CORPORATE DIRECTOR | NOT APPLICABLE |
| STADTHERR, SEELOCHANI | CORPORATE DIRECTOR | NOT APPLICABLE |
| MACKAY, MARSHALL | CORPORATE OFFICER | NOT APPLICABLE |
| RAMSDALE, SCOTT | CORPORATE OFFICER | NOT APPLICABLE |
| WILKERSON, GARY | CORPORATE OFFICER | NOT APPLICABLE |
| NYE, GERALD | CORPORATE OFFICER | NOT APPLICABLE |
| PARKS, CHARLES | CORPORATE OFFICER | NOT APPLICABLE |
| CASSIA | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| SMITH, SHAWNA | W-2 MANAGING EMPLOYEE | NOT APPLICABLE |
Health Deficiencies (13)
2025-05-15 · Health
D
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.
E
F757 · Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
D
F699 · Quality of Life and Care Deficiencies
Provide care or services that was trauma informed and/or culturally competent.
E
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
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
F568 · Resident Rights Deficiencies
Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.
2024-03-14 · Health
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.
D
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.
2023-11-09 · Health
D
F580 · Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
2023-05-12 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
F690 · Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
F656 · Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day3.68
4.78
RN Hrs/Resident/Day0.54
0.72
LPN Hrs/Resident/Day0.81
0.57
CNA Hrs/Resident/Day2.33
3.48
PT Hrs/Resident/Day0.12
0.03
Data as of 2026-03-01