Thief River Care Center
2001 Eastwood Drive · Thief River Falls, MN · 56701 · 2186838100
70 certified beds Non profit - Corporation Chain: St. Francis Health Services
Why this verdict
- Inspectors found immediate jeopardy — danger of serious harm or death — in the most recent cycle (1 citation).
- Inspection record is far worse than the national median (deficiency count and severity).
- Inspection results have improved across recent cycles.
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Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.
Red flags
1 immediate-jeopardy citation in the most recent inspection cycle
Immediate jeopardy is the most serious finding an inspector can make: a situation likely to cause serious injury, harm, or death.
1 abuse-related citation at the actual-harm level
Inspectors cited failures in the abuse-prevention rules (F600–F610) that resulted in actual harm to a resident.
Medicare/Medicaid payments were denied
CMS refused payment for new admissions for a period — one of its strongest enforcement tools.
If someone you love was harmed at a facility with findings like these, you have options — read this.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 1 of 5 Inspections: 1 of 5 Staffing: 4 of 5 Quality measures: 2 of 5
| Total nurse hours / resident-day | 3.60 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 1.04 | 0.55–0.75 |
| Weekend hours / resident-day | 3.16 | ≈ weekday level |
| Nursing turnover / year | 48% | median 45% |
| Fines (3-yr window) | 3 · $94,417 |
Inspection citations (29 in the current record)
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Potential for harm · E April 1, 2026
Ensure each resident receives an accurate assessment.
Corrected May 6, 2026 · Resident Assessment and Care Planning
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Potential for harm · D April 1, 2026
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected May 5, 2026 · Quality of Life and Care
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Potential for harm · D April 1, 2026
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected May 5, 2026 · Quality of Life and Care
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Potential for harm · D April 1, 2026
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Corrected May 5, 2026 · Quality of Life and Care
-
Potential for harm · D April 1, 2026 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected May 5, 2026 · Quality of Life and Care
-
Immediate jeopardy · J December 30, 2025 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected December 18, 2025 · Quality of Life and Care
-
Actual harm · G January 16, 2025 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected February 19, 2025 · Quality of Life and Care
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Potential for harm · D January 16, 2025
Reasonably accommodate the needs and preferences of each resident.
Corrected February 19, 2025 · Resident Rights
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Potential for harm · D January 16, 2025
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected March 14, 2025 · Resident Assessment and Care Planning
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Potential for harm · D January 16, 2025
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected February 19, 2025 · Quality of Life and Care
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Potential for harm · D January 16, 2025
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected February 19, 2025 · Quality of Life and Care
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Potential for harm · D January 16, 2025
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected February 19, 2025 · Quality of Life and Care
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Potential for harm · E January 16, 2025
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Corrected February 19, 2025 · Nutrition and Dietary
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Potential for harm · F January 16, 2025
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected February 19, 2025 · Nutrition and Dietary
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Potential for harm · F January 16, 2025
Provide and implement an infection prevention and control program.
Corrected March 14, 2025 · Infection Control
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Potential for harm · D May 2, 2024 · found via complaint
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected May 31, 2024 · Resident Rights
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Immediate jeopardy · J April 19, 2024 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected April 15, 2024 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D April 19, 2024 · found via complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected May 17, 2024 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D April 12, 2024 · found via complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected May 6, 2024 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D April 12, 2024 · found via complaint
Respond appropriately to all alleged violations.
Corrected May 6, 2024 · Freedom from Abuse, Neglect, and Exploitation
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Immediate jeopardy · J January 3, 2024 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected January 20, 2024 · Quality of Life and Care
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Potential for harm · D January 3, 2024 · found via complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected January 20, 2024 · Freedom from Abuse, Neglect, and Exploitation
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Immediate jeopardy · J November 1, 2023
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.
Corrected December 1, 2023 · Resident Rights
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Potential for harm · D November 1, 2023
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Corrected December 1, 2023 · Resident Rights
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Potential for harm · D November 1, 2023
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected December 1, 2023 · Quality of Life and Care
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| January 16, 2025 | Payment Denial | 23 days |
| April 12, 2024 | Fine | $19,800 |
| January 3, 2024 | Fine | $65,302 |
| November 1, 2023 | Fine | $9,315 |
| November 1, 2023 | Payment Denial | 2 days |
Better-scoring options nearby
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 245252 · certified since July 1, 1982. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.