01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-06-05 | 10 | 2025-06-05 | 2 |
| Cycle 2 | 2024-04-25 | 9 | 2024-04-25 | 3 |
| Cycle 3 | 2023-07-27 | 7 | 2023-07-27 | 3 |
CMS CCN 2454712026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
The Waterview Shores Llc
402 - 13Th Avenue · Two Harbors, MN 55616 · Lake County
Certified beds44CMS provider file
Recent citation rows34current 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
34 rows in the current release
2 rows carry G–L scope/severity codes; 1 carry J–L. 6 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-05-04 · HEALTHF0755Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Correction field: Deficient, Provider has date of correction · 2026-05-01 · complaint2026-05-04 · HEALTHF0760Severity J · isolated immediate jeopardy
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2026-05-01 · complaint2025-09-11 · HEALTHF0656Severity G · isolated actual 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: Past Non-Compliance · 2025-08-29 · complaint2025-08-22 · HEALTHF0550Severity E · pattern; 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 · 2025-09-18 · complaint2025-06-05 · 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 · 2025-07-032025-06-05 · 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 · 2025-07-032025-06-05 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2025-07-032025-06-05 · HEALTHF0812Severity F · widespread; 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 · 2025-07-032025-06-05 · HEALTHF0851Severity F · widespread; potential for more than minimal harm
Administration Deficiencies
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
Correction field: Deficient, Provider has date of correction · 2025-07-032025-06-05 · 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 · 2025-07-032025-06-05 · 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 · 2025-07-142025-06-05 · FIREK0511Severity D · isolated; potential for more than minimal harm
Services Deficiencies
Have properly installed electrical wiring and gas equipment.
Correction field: Deficient, Provider has date of correction · 2025-07-142024-11-06 · 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 · 2024-12-02 · complaint2024-11-06 · 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 · 2024-12-02 · complaint2024-04-25 · HEALTHF0554Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Allow residents to self-administer drugs if determined clinically appropriate.
Correction field: Deficient, Provider has date of correction · 2024-05-212024-04-25 · HEALTHF0583Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
Correction field: Deficient, Provider has date of correction · 2024-05-212024-04-25 · 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 · 2024-05-212024-04-25 · 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 · 2024-05-212024-04-25 · HEALTHF0759Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
Correction field: Deficient, Provider has date of correction · 2024-05-212024-04-25 · 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 · 2024-05-212024-04-25 · HEALTHF0919Severity D · isolated; potential for more than minimal harm
Environmental Deficiencies
Make sure that a working call system is available in each resident's bathroom and bathing area.
Correction field: Deficient, Provider has date of correction · 2024-05-212024-04-25 · 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 · 2024-05-212024-04-25 · FIREK0363Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2024-05-212024-04-25 · 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 · 2024-05-2103 / 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 |
|---|---|---|---|
| 2026-05-04 | Fine | $334,488 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- NIJ LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST10% · since 06/01/2019
- SPARTAN HEALTHCARE LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST30% · since 06/01/2019
- WBS HOLDINGS LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST20% · since 06/01/2019
- YAZOMA HOLDINGS, LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST30% · since 06/01/2019
- JCA HOLDINGS LLCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTEREST10% · since 06/01/2019
- HALPERT, MARCIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST30% · since 06/01/2019
- JAFFA, NOAMIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST10% · since 06/01/2019
- LEGUM, JOSHUAIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST30% · since 06/01/2019
- STERN, WILLIAMIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST20% · since 06/01/2019
- LEGUM, JOSHUAIndividual · CONTRACTED MANAGING EMPLOYEENOT APPLICABLE · since 06/01/2019
- JAFFA, NOAMIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/01/2019
- HALPERT, MARCIndividual · CORPORATE OFFICERNOT APPLICABLE · since 06/01/2019
- STERN, WILLIAMIndividual · CORPORATE OFFICERNOT APPLICABLE · since 06/01/2019
- MONARCH HEALTHCARE OPERATING VIII LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/01/2019
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 hours3.32per resident day
RN hours0.74per resident day
Weekend nurse hours2.91per resident day
Staff turnover64.4%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.