01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-07-31 | 6 | 2025-07-31 | 1 |
| Cycle 2 | 2024-06-13 | 11 | 2024-06-13 | 2 |
| Cycle 3 | 2023-07-27 | 5 | 2023-07-27 | 4 |
CMS CCN 2452182026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Mayo Clinic Health System - Lake City
500 West Grant Street · Lake City, MN 55041 · Goodhue County
Certified beds90CMS provider file
Recent citation rows29current CMS citation release
Penalty rows2current 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
29 rows in the current release
3 rows carry G–L scope/severity codes; 1 carry J–L. 5 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-04-20 · HEALTHF0600Severity J · isolated immediate jeopardy
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Correction field: Deficient, Provider has date of correction · 2026-05-15 · complaint2026-04-20 · HEALTHF0609Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Deficient, Provider has date of correction · 2026-05-15 · complaint2026-04-20 · HEALTHF0610Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
Correction field: Deficient, Provider has date of correction · 2026-05-15 · complaint2026-04-20 · 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 · 2026-05-15 · complaint2025-12-04 · 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 · 2025-12-19 · complaint2025-07-31 · 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 · 2025-09-082025-07-31 · FIREK0920Severity E · pattern; 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 · 2025-09-082025-04-03 · HEALTHF0689Severity G · isolated actual 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 · 2025-05-01 · complaint2024-12-18 · HEALTHF0760Severity G · isolated actual harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Past Non-Compliance · 2024-12-10 · complaint2024-06-13 · HEALTHF0576Severity B · pattern; potential for minimal harm
Resident Rights Deficiencies
Ensure residents have reasonable access to and privacy in their use of communication methods.
Correction field: Deficient, Provider has date of correction · 2024-08-092024-06-13 · HEALTHF0582Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Correction field: Deficient, Provider has date of correction · 2024-08-092024-06-13 · 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 · 2024-08-092024-06-13 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2024-08-092024-06-13 · 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 · 2024-08-092024-06-13 · HEALTHF0740Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
Correction field: Deficient, Provider has date of correction · 2024-08-092024-06-13 · HEALTHF0744Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
Correction field: Deficient, Provider has date of correction · 2024-08-092024-06-13 · 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 · 2024-08-092024-06-13 · 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 · 2024-08-092024-06-13 · FIREK0324Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2024-07-312024-06-13 · FIREK0712Severity C · widespread; potential for minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2024-07-312023-11-06 · HEALTHF0552Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Ensure that residents are fully informed and understand their health status, care and treatments.
Correction field: Deficient, Provider has date of correction · 2023-11-27 · complaint2023-11-06 · HEALTHF0609Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Deficient, Provider has date of correction · 2023-11-27 · complaint2023-11-06 · HEALTHF0623Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Correction field: Deficient, Provider has date of correction · 2023-11-27 · complaint2023-11-06 · HEALTHF0625Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Correction field: Deficient, Provider has date of correction · 2023-11-27 · 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 |
|---|---|---|---|
| 2026-04-20 | Fine | $112,978 | 0 |
| 2025-04-03 | Fine | $32,139 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- ALIX, JAYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 04/24/1998
- ANIL, GOKHANIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2025
- ARCHER, LISAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2025
- BAICKER, KATHERINEIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 04/28/1998
- BAKER, DOUGLASIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 04/28/1998
- BARTLETT, BRIANIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2025
- BEAHRS, TAYLORIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2025
- BILICIC, GEORGEIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 04/28/1998
- BROWN, SALLYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 04/28/1998
- BURNS, URSULAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 04/28/1998
- CAINE, NATALIEIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 04/28/1998
- CALLSTROM, MATTHEWIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 04/28/1998
- COMFERE, NNEKAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 04/28/1998
- DAHLEN, DENNISIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 04/28/1998
- DAVIS, JEDIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 04/28/1998
- DAVIS, RICHARDIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 04/28/1998
- DIDEHBAN, ROSHANAKIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 04/28/1998
- DUNN, AJANIIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 04/28/1998
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 hours4.70per resident day
RN hours1.38per resident day
Weekend nurse hours4.30per resident day
Staff turnover44.4%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.