01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-06-12 | 11 | 2026-06-12 | 6 |
| Cycle 2 | 2025-04-10 | 5 | 2025-04-10 | 6 |
| Cycle 3 | 2024-02-09 | 23 | 2024-02-09 | 4 |
CMS CCN 2452002026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Birchwood Health Care Center
604 1St Street Ne · Forest Lake, MN 55025 · Washington County
Certified beds100CMS provider file
Recent citation rows55current CMS citation release
Penalty rows3current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
55 rows in the current release
4 rows carry G–L scope/severity codes; 2 carry J–L. 9 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-06-12 · HEALTHF0550Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Correction field: Deficient, Provider has plan of correction · 2026-07-282026-06-12 · HEALTHF0582Severity B · pattern; potential for minimal harm
Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Correction field: Deficient, Provider has plan of correction · 2026-07-282026-06-12 · HEALTHF0628Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Correction field: Deficient, Provider has plan of correction · 2026-07-282026-06-12 · HEALTHF0684Severity J · isolated immediate jeopardy
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has plan of correction · 2026-06-112026-06-12 · HEALTHF0698Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Correction field: Deficient, Provider has plan of correction · 2026-07-282026-06-12 · HEALTHF0761Severity D · isolated; potential for more than minimal harm
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.
Correction field: Deficient, Provider has plan of correction · 2026-07-282026-06-12 · HEALTHF0880Severity E · pattern; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has plan of correction · 2026-07-282026-06-12 · FIREK0222Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Correction field: Deficient, Provider has date of correction · 2026-07-302026-06-12 · FIREK0291Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Install emergency lighting that can last at least 1 1/2 hours.
Correction field: Deficient, Provider has date of correction · 2026-07-302026-06-12 · FIREK0311Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Have an enclosure around a vertical opening shaft.
Correction field: Deficient, Provider has date of correction · 2026-07-302026-06-12 · FIREK0363Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2026-07-302026-06-12 · FIREK0521Severity F · widespread; potential for more than minimal harm
Services Deficiencies
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Correction field: Deficient, Provider has date of correction · 2026-07-302026-06-12 · FIREK0918Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Correction field: Deficient, Provider has date of correction · 2026-07-302026-05-06 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2026-06-11 · complaint2025-12-19 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2026-01-23 · complaint2025-11-13 · HEALTHF0689Severity J · isolated immediate jeopardy
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Past Non-Compliance · 2025-11-09 · complaint2025-11-13 · HEALTHF0842Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2026-01-09 · complaint2025-04-10 · HEALTHF0558Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
Correction field: Deficient, Provider has date of correction · 2025-05-272025-04-10 · HEALTHF0677Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Correction field: Deficient, Provider has date of correction · 2025-05-27 · complaint2025-04-10 · HEALTHF0757Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Correction field: Deficient, Provider has date of correction · 2025-05-272025-04-10 · HEALTHF0803Severity D · isolated; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Correction field: Deficient, Provider has date of correction · 2025-05-272025-04-10 · HEALTHF0881Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Implement a program that monitors antibiotic use.
Correction field: Deficient, Provider has date of correction · 2025-05-272025-04-10 · FIREK0222Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Correction field: Deficient, Provider has date of correction · 2025-05-272025-04-10 · FIREK0291Severity D · isolated; potential for more than minimal harm
Egress Deficiencies
Install emergency lighting that can last at least 1 1/2 hours.
Correction field: Deficient, Provider has date of correction · 2025-05-2703 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2025-11-13 | Fine | $10,361 | 0 |
| 2024-02-09 | Fine | $29,234 | 0 |
| 2024-01-04 | Fine | $9,103 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- MARSHALL, SUSANIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 03/01/2007
- MARTIN, RICHARDIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 03/01/2007
- TOULOUSE, MOLLYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 04/30/2017
- LIFESPARK MANAGEMENT SERVICESOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/30/2020
- CHEBLI, YASSERIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/01/2022
- KING, RYANIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/01/2025
- MILLER, MEGANIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/01/2025
- AEGIS THERAPIES, INC.Organization · ADP OF THE SNFNOT APPLICABLE · since 01/01/2009
- GRAPE TREE MEDICAL STAFFING LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 12/01/2023
- LIFESPARK MANAGEMENT SERVICESOrganization · ADP OF THE SNFNOT APPLICABLE · since 07/09/2025
- LIFESPRK HOLDINGS, INC.Organization · ADP OF THE SNFNOT APPLICABLE · since 06/30/2020
- SENIOR CARE COMMUNITIESOrganization · ADP OF THE SNFNOT APPLICABLE · since 04/30/1999
- SHIFTSTER LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 12/01/2023
- TWSL. LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 06/30/2020
- CHEBLI, YASSERIndividual · ADP OF THE SNFNOT APPLICABLE · since 05/01/2022
- KING, RYANIndividual · ADP OF THE SNFNOT APPLICABLE · since 04/01/2025
- KRAMER, TRISHAIndividual · ADP OF THE SNFNOT APPLICABLE · since 05/20/2024
- MILLER, MEGANIndividual · ADP OF THE SNFNOT APPLICABLE · since 04/01/2025
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours3.86per resident day
RN hours0.78per resident day
Weekend nurse hours3.56per resident day
Staff turnover37.7%CMS reported field
06 / LOCAL RECORDS
Open the Minnesota ledger →Other published facilities nearby
No second facility in the same city met the directory rule.