01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-07-07 | 2 | 2026-07-07 | 0 |
| Cycle 2 | 2025-07-09 | 3 | 2025-07-09 | 6 |
| Cycle 3 | 2024-07-17 | 9 | 2024-07-17 | 3 |
CMS CCN 2453072026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Cornerstone Nsg & Rehab Center
416 Seventh Street Northeast · Bagley, MN 56621 · Clearwater County
Certified beds47CMS provider file
Recent citation rows23current CMS citation release
Penalty rows0current 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
23 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 4 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-07-07 · HEALTHF0699Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care or services that was trauma informed and/or culturally competent.
Correction field: Deficient, Provider has date of correction · 2026-07-232025-09-26 · HEALTHF0686Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2025-12-17 · complaint2025-07-09 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2025-08-182025-07-09 · HEALTHF0812Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2025-08-182025-07-09 · 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 · 2025-08-252025-07-09 · FIREK0324Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2025-08-012025-07-09 · FIREK0353Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2025-08-082025-07-09 · FIREK0761Severity D · isolated; potential for more than minimal harm
Miscellaneous Deficiencies
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Correction field: Deficient, Provider has date of correction · 2025-08-112025-07-09 · FIREK0912Severity E · pattern; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have power receptacles that are properly grounded.
Correction field: Deficient, Provider has date of correction · 2025-08-112025-07-09 · FIREK0918Severity D · isolated; 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 · 2025-08-112025-07-09 · FIREK0920Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure proper usage of power strips and extension cords.
Correction field: Deficient, Provider has date of correction · 2025-08-112024-07-17 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2024-08-232024-07-17 · HEALTHF0686Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2024-08-232024-07-17 · 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 · 2024-08-232024-07-17 · HEALTHF0758Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Correction field: Deficient, Provider has date of correction · 2024-08-232024-07-17 · HEALTHF0761Severity E · pattern; 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 date of correction · 2024-08-232024-07-17 · 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 · 2024-08-232024-07-17 · HEALTHF0883Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Correction field: Deficient, Provider has date of correction · 2024-08-232024-07-17 · FIREK0321Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Correction field: Deficient, Provider has date of correction · 2024-08-232024-07-17 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2024-08-232024-07-17 · 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 · 2024-09-052024-04-16 · 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 · 2024-05-13 · complaint2023-09-20 · HEALTHF0626Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy.
Correction field: Deficient, Provider has date of correction · 2023-11-03 · complaint03 / 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 |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- POTVIN HOLDINGS INCORPORATEDOrganization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 10/31/2011
- POTVIN, ALLENIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 01/01/2020
- POTVIN, JUDITHIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 10/31/2011
- POTVIN, LANCEIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 01/01/2020
- SWANSON, KARIIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 01/01/2020
- DOLALIE, JENNIFERIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 01/01/2020
- DOLALIE, JENNIFERIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2020
- POTVIN, ALLENIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2020
- POTVIN, JUDITHIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2020
- POTVIN, LANCEIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2020
- SWANSON, KARIIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2020
- DOLALIE, JENNIFERIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2020
- POTVIN, ALLENIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/21/2007
- POTVIN, JUDITHIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/21/2007
- POTVIN, LANCEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2020
- SWANSON, KARIIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2020
- MORTENSEN, DAVIDIndividual · CORPORATE OFFICERNOT APPLICABLE · since 08/12/2013
- SWANSON, KARIIndividual · CORPORATE OFFICERNOT APPLICABLE · since 05/01/2021
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 hours4.79per resident day
RN hours1.05per resident day
Weekend nurse hours3.92per resident day
Staff turnover50.7%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.