01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-02-25 | 4 | 2026-02-25 | 1 |
| Cycle 2 | 2024-12-11 | 3 | 2024-12-11 | 2 |
| Cycle 3 | 2024-01-10 | 3 | 2024-01-10 | 3 |
CMS CCN 2455882026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
St Williams Living Center
212 West Soo Street, Box 30 · Parkers Prairie, MN 56361 · Otter Tail County
Certified beds53CMS provider file
Recent citation rows16current 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
16 rows in the current release
2 rows carry G–L scope/severity codes; 1 carry J–L. 3 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-02-25 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2026-03-202026-02-25 · 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 · 2026-02-252025-12-15 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2026-01-14 · complaint2025-12-15 · 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 · 2026-01-14 · complaint2025-12-15 · 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 · 2026-01-14 · complaint2025-04-17 · HEALTHF0700Severity J · isolated immediate jeopardy
Quality of Life and Care Deficiencies
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Correction field: Past Non-Compliance · 2025-04-11 · complaint2024-12-11 · 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 · 2025-01-092024-12-11 · HEALTHF0880Severity F · widespread; 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 · 2025-01-102024-12-11 · 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 · 2024-12-202024-12-11 · FIREK0374Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Correction field: Deficient, Provider has date of correction · 2024-12-232024-02-01 · 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: Past Non-Compliance · 2024-01-30 · complaint2024-01-10 · HEALTHF0585Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Correction field: Deficient, Provider has date of correction · 2024-02-132024-01-10 · 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 date of correction · 2024-02-132024-01-10 · FIREK0324Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2024-01-182024-01-10 · 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 · 2024-01-182024-01-10 · FIREK0753Severity D · isolated; potential for more than minimal harm
Miscellaneous Deficiencies
Have restrictions on the use of highly flammable decorations.
Correction field: Deficient, Provider has date of correction · 2024-01-1803 / 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 |
|---|---|---|---|
| 2025-04-17 | Fine | $14,901 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- MIDWEST BANKOrganization · 5% OR GREATER MORTGAGE INTERESTNOT APPLICABLE · since 04/29/2005
- DORN, VIOLAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/12/2012
- HAGGENMILLER, JEROMEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 09/01/2022
- HINRICHS, ROSEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 09/01/2018
- HOFFMAN, SCOTTIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 09/01/2022
- JAKUBIEC, DAWNIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/02/2012
- THEIS, JEREMYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2023
- VASKE, DAVIDIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 08/01/2023
- BITZAN, MARLENEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/21/2013
- KELLY, TIMOTHYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/01/2013
- SUNDBY, SCOTTIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 02/16/2015
- BITZAN, MARLENEIndividual · ADP OF THE SNFNOT APPLICABLE · since 05/21/2013
- KELLY, TIMOTHYIndividual · ADP OF THE SNFNOT APPLICABLE · since 12/06/2024
- SUNDBY, SCOTTIndividual · ADP OF THE SNFNOT APPLICABLE · since 07/15/2025
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 hours5.15per resident day
RN hours1.01per resident day
Weekend nurse hours4.50per resident day
Staff turnover29.9%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.