Based on interview and document review, the facility failed to provide a disclosure of ownership form. This had potential to affect all 87 residents residing in the facility. Findings include: During the extended survey, on 8/9/21 through 8/13/21, the disclosure of information form was requested and not produced; multiple requests were made in writing and verbally on several different days. When interviewed on 8/10/21, in late afternoon, the administrator stated she was unsure of what the Disclosure of Ownership form was. …
F844 citations in Minnesota
Administration Deficiencies
Follow rules about disclosure of ownership requirements and tell the state agency about changes in ownership and/or administrative personnel.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2024
Minnesota cites F844 more often than its own record predicts
8.72 times the share F844 takes of citations nationally.
Of every deficiency written in Minnesota in 2024, this is the portion that was F844.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Minnesota surveyors wrote
F844 findings written in Minnesota, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
Based on interview and document review, the facility failed to ensure the State Agency (SA) was notified as required when the current director of nursing (DON) was hired for the position. This deficient practice had the potential to affect all 69 residents in the facility. Findings include: During the extended survey on 9/6//24, evidence was requested to demonstrate the SA had been notified when the DON was hired. On 9/6/24 at 5:22 p.m., the administrator confirmed the SA was not notified when the DON was hired.
What else Minnesota surveyors cite →
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