01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-05-22 | 7 | 2026-05-22 | 4 |
| Cycle 2 | 2025-03-12 | 9 | 2025-03-12 | 10 |
| Cycle 3 | 2024-05-31 | 17 | 2024-05-31 | 9 |
CMS CCN 2455462026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Mission Nursing Home
3401 East Medicine Lake Boulevard · Plymouth, MN 55441 · Hennepin County
Certified beds70CMS provider file
Recent citation rows56current CMS citation release
Penalty rows1current 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
56 rows in the current release
2 rows carry G–L scope/severity codes; 0 carry J–L. 11 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-05-22 · 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 date of correction · 2026-06-302026-05-22 · 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 · 2026-06-302026-05-22 · 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 · 2026-06-302026-05-22 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2026-06-302026-05-22 · 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 · 2026-06-302026-05-22 · FIREK0712Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2026-06-302026-05-22 · 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 · 2026-06-302026-03-05 · HEALTHF0849Severity D · isolated; potential for more than minimal harm
Administration Deficiencies
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
Correction field: Deficient, Provider has date of correction · 2026-03-26 · complaint2026-02-25 · HEALTHF0600Severity G · isolated actual harm
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: Past Non-Compliance · 2026-02-19 · complaint2026-02-11 · 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 · 2026-03-04 · complaint2026-01-08 · HEALTHF0729Severity E · pattern; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Verify that a nurse aide has been trained; and if they haven't worked as a nurse aide for 2 years, receive retraining.
Correction field: Deficient, Provider has date of correction · 2026-01-23 · complaint2025-07-03 · 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 date of correction · 2025-08-18 · complaint2025-07-03 · HEALTHF0760Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2025-08-18 · complaint2025-07-03 · 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 · 2025-08-18 · 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 · 2025-05-09 · complaint2025-04-10 · 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 · 2025-05-09 · complaint2025-04-10 · HEALTHF0697Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Provide safe, appropriate pain management for a resident who requires such services.
Correction field: Past Non-Compliance · 2025-04-03 · complaint2025-03-12 · HEALTHF0645Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
Correction field: Deficient, Provider has date of correction · 2025-04-182025-03-12 · HEALTHF0689Severity E · pattern; 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 · 2025-04-182025-03-12 · HEALTHF0867Severity F · widespread; potential for more than minimal harm
Administration Deficiencies
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Correction field: Deficient, Provider has date of correction · 2025-04-182025-03-12 · 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 · 2025-03-212025-03-12 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2025-03-212025-03-12 · FIREK0347Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Properly provide smoke detection systems in areas open to corridors.
Correction field: Deficient, Provider has date of correction · 2025-04-302025-03-12 · FIREK0353Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2025-04-3003 / 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 |
|---|---|---|---|
| 2026-02-11 | Fine | $14,015 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- MISSIONS, INC PROGRAMSOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 04/17/1975
- MISSIONS, INC PROGRAMSOrganization · 5% OR GREATER SECURITY INTERESTNOT APPLICABLE · since 04/17/1975
- AURAND, CLAUDIAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/01/2021
- BARKER, JOELIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/01/2021
- BILLY, STACEYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/01/2021
- BOBO, CYNTHIAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/01/2023
- DANIELS, KATHRYNIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2022
- DETERMAN, TERESAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/01/2022
- FALLON, TAMARAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/01/2021
- KIWUS, KELLYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/01/2023
- MANNIX, PETERIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/01/2023
- MEYER, ELLENIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/01/2022
- MONCRIEF, WILLIAMIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2022
- NETTLES, ANDREAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/01/2023
- SENKBEIL, MARYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/01/2020
- SONNTAG, ROBERTIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2010
- SPAULDING, WENDYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/01/2023
- WHITMAN, ANDREWIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/01/2020
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 hours1.09per resident day
RN hours0.32per resident day
Weekend nurse hours1.07per resident day
Staff turnover24.0%CMS reported field
06 / LOCAL RECORDS
Open the Plymouth ledger →