Above average — CMS composite of the measures below.
The next survey window likely opens around January 2027
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Minnesota Masonic Home Care Center during CMS and state inspections, most recent first.
Shower Room Not Maintained in a Clean, Sanitary Condition: Surveyors observed unidentified pink matter covering part of the D1 unit shower walls, with additional deposits on the shower brushes, handheld shower bag, and plumbing fixtures. An NA stated she used one of the brushes after giving a resident a shower, and the housekeeper confirmed the pink matter was present and said she had not cleaned the shower the day before. The IP stated the shower needed to be cleaned, and the administrator said the shower should be cleaned to provide a clean environment for residents.
Call Lights Not Kept Within Reach: Two residents were observed with call lights placed out of reach after care and transfers. One resident with severe cognitive impairment and multiple diagnoses had her call light left on a recliner behind her wheelchair, while another resident with moderate cognitive impairment had her call light left on the bedrail after a mechanical lift transfer. Staff acknowledged the call lights were not placed within reach, despite the stated expectation that residents’ call lights be accessible at all times.
A resident with dementia, severely impaired cognition, and dependence for most ADLs had a care plan that addressed resistance to care, medications, and delusional thoughts, but it did not include staff-identified behavioral de-escalation methods that were effective for her. Staff and progress notes showed that preferred snacks such as chocolate, coffee, or a banana, watching news or puppy videos, and being moved to a quiet area or her room helped calm her when she was yelling or screaming. The care plan and Kardex lacked these personalized interventions even though multiple staff members reported using them successfully.
Incomplete CPAP Orders and Settings Documentation: The facility failed to ensure CPAP orders included specific equipment settings and humidification as appropriate for 3 residents. A resident with OSA, oxygen dependence, and hospice services, another resident with impaired cognition and multiple chronic conditions, and a third resident with moderate cognitive impairment all had orders for CPAP at home settings or pre-programmed settings, but the records did not identify the actual settings. Staff stated they only cleaned, filled, or placed the machines and did not verify settings, and the DON stated the facility did not obtain specific CPAP settings from providers.
A resident with intact cognition reported that meals were often lukewarm. During breakfast tray service, an aide and an LPN verified that the milk was 51 degrees F and the oatmeal was 136 degrees F, below the stated acceptable temperatures. The dietary supervisor also stated the milk should have been colder and the oatmeal at least 140 degrees F.
A resident with a Foley catheter, chronic wound, and multiple medical conditions was on EBP with instructions to use gowns and gloves for high-contact care. During bowel incontinent care, two NAs wore gloves but not gowns, despite a posted EBP sign directing gown and glove use for hygiene and brief changes. One NA said she forgot the gown, and the other said she was rushing and did not use one.
A facility failed to consistently implement and accurately track care-planned interventions for a resident on hemodialysis with a fluid restriction. The resident, with moderate cognitive impairment and multiple medical conditions, was found with multiple cups of fluid in her room, and neither she nor her family knew how much fluid was being given or tracked. Interviews with staff revealed inconsistencies in fluid intake tracking, and a review of records showed missing or inaccurate data. The resident was later hospitalized and found to be dehydrated, underscoring the facility's failure to monitor fluid intake properly.
The facility failed to follow physician orders for a resident with a cervical collar and did not notify the provider of the resident's refusal to wear it. Additionally, the facility did not implement an individualized bowel management protocol for another resident, leading to delays in addressing constipation. Staff interviews revealed inconsistencies in following protocols, and the director of nursing acknowledged the deficiencies.
A resident with a complex medical history, including diabetes and peripheral vascular disease, developed a pressure ulcer on the left heel. The facility failed to consistently perform and document weekly wound assessments and measurements, missing several dates. The wound care nurse was responsible for these assessments, but due to an error in order entry and occasional lapses in documentation, the assessments were not completed as required. The facility's policy for weekly assessments and interdisciplinary collaboration was not consistently followed.
Shower Room Not Maintained in a Clean, Sanitary Condition
Penalty
Summary
The D1 unit shower room was not maintained in a clean, sanitary manner when surveyors observed unidentified pink matter covering about 25% of the shower walls. On 2/11/26 at 9:00 a.m., the pink matter was seen on the caulking lines and baseboard tiles of the white-tiled shower walls. The water knob/handle had white calcium-like deposits, and a chrome fixture had rust-colored spots and a rust-colored stain on the wall below it. Two long-handled plastic brushes were on the shower floor, and both had pink matter on the base of the bristles. A clear plastic bag knotted to the handheld shower head also had pink matter on both ends. During interview, a nursing assistant stated she had given a resident a shower at 8:00 a.m. and then returned to clean the shower chair using one of the white brushes on the shower floor. She verified there was pink matter on the shower walls and brushes and stated the housekeeper cleans the walls and floors. The housekeeper stated she cleaned the shower rooms every day, verified the pink matter on the walls and brushes, and said she sometimes used bleach to clean those areas; she also stated she had not cleaned the shower the day before. On 2/12/26, the shower walls had been cleaned but some pink matter remained near the floor, and the two brushes with pink matter were still leaning against the wall. The infection preventionist stated she was not sure what the pink matter was, but the shower needed to be cleaned and the brushes needed to be replaced. The administrator stated the shower should be cleaned to provide a clean environment for residents, and the facility policy required resident spaces to be cleaned and maintained to the highest standards of hygiene and comfort.
Call Lights Not Kept Within Residents’ Reach
Penalty
Summary
The facility failed to accommodate resident needs by not ensuring call lights were within reach for 2 residents reviewed for call light access. One resident had severe cognitive impairment, Parkinson’s disease, dementia, left shoulder pain, dysphagia, atherosclerosis, muscle weakness, and tremors, and her care plan directed staff to keep the call light within reach and encourage her to use it for assistance. During multiple observations, she was sitting in her wheelchair in front of the TV while her call light was placed on a recliner chair behind her wheelchair and out of reach. A nursing assistant confirmed the call light was out of reach and stated the resident would not be able to reach it. The second resident had moderate cognitive impairment and required assistance of two staff for transfers using a mechanical lift. During observation, after being transferred from bed to wheelchair, both aides left the room with the resident’s call light wrapped around the bedrail of the bed, out of reach and sight of the resident. The resident stated she could use the call light to ask for help but did not know where it was. Later, a nursing assistant stated he had forgotten to place the call light within reach. The nurse manager and DON stated the expectation was that call lights be in reach for residents at all times.
Care Plan Missing Effective Behavioral De-escalation Interventions
Penalty
Summary
The facility failed to revise A resident’s care plan to include the specific behavioral de-escalation methods staff found effective for her dementia-related behaviors. The resident’s quarterly MDS indicated severely impaired cognition, a diagnosis of dementia, and dependence on staff for most ADLs. Her care plan identified that she was resistant to care and medications and had delusional thoughts at times, with interventions focused on keeping her routine consistent, offering choices, cueing and reorienting her, and allowing her to sit at her own table outside the dining room to reduce overstimulation and anxiety. The care plan and Kardex did not include personalized interventions that staff reported were effective when the resident was yelling, screaming, or resistant to care, including watching the news or videos of puppies, receiving preferred snacks such as chocolate, coffee, or a banana, and being taken to her room or another quiet place to calm down. Progress notes documented multiple episodes in which the resident was screaming or yelling and then calmed after being offered chocolate or snacks. During observation, the resident was heard yelling from her room, and staff entered and offered her chocolate; she was not heard yelling during the interaction. Staff interviews confirmed that these individualized approaches were used and were effective. A NA stated that when the resident was having behaviors or resisting care, she would not be forced, would be given coffee, a banana, or chocolate, and then reapproached, which generally worked. An LPN stated that taking the resident away from others, having her watch the news and puppy videos, and offering food items she liked helped calm her down. Another LPN stated that talking about puppies and the resident’s daughter and moving her to a quiet spot such as her room helped when she had behaviors. The DON stated that nurse managers oversaw updating the care plan with personalized interventions and acknowledged that the care plan should include resident-specific preferences and interventions.
Incomplete CPAP Orders and Settings Documentation
Penalty
Summary
The facility failed to ensure residents using CPAP machines had appropriate orders that included equipment settings and humidification as appropriate for 3 of 3 residents reviewed for respiratory equipment. R1 had diagnoses including heart failure, kidney disease, obstructive sleep apnea, oxygen dependence, and was receiving hospice services. R1's physician order directed CPAP at home settings at bedtime and off in the morning, and the care plan identified CPAP on pre-programmed settings when sleeping, but the medical record did not identify any CPAP settings. During observation and interview, R1 stated the CPAP machine being used by the facility was from home and that he was not aware the facility had asked for or programmed it. An LPN stated staff only unplugged the machine, washed it, and put fresh water in the reservoir, and would not know if there was a problem unless it alarmed or did not turn on. R91 had impaired cognition, required assistance with all ADLs, and had diagnoses including diabetes, kidney disease, OSA, and morbid obesity. R91's order also directed CPAP at home settings at bedtime and off in the morning, while the care plan referenced pre-programmed settings, but no specific settings were documented. R150 had moderate cognitive impairment, required substantial to maximum assistance with bathing and dressing, and partial to moderate assistance with personal hygiene; the diagnosis list included OSA. R150's order directed CPAP at home setting at bedtime and off in the morning, and the care plan also referenced preprogrammed settings, but staff interviews showed they relied on resident or family-managed machines and did not monitor to ensure the machines were set at the correct settings. The DON stated the facility did not obtain specific CPAP settings and orders from medical providers when residents were admitted and agreed that specific settings and orders were needed.
Food Served at Improper Temperatures
Penalty
Summary
The facility failed to ensure food was served at palatable temperatures for 1 resident with intact cognition. The resident stated that 90% of the time the food arrived lukewarm. During breakfast meal service, a dietary aide and an LPN checked the resident’s tray before it was brought into the room and found the milk was 51 degrees Fahrenheit and the oatmeal was 136 degrees Fahrenheit. The dietary aide stated milk should be 40 degrees Fahrenheit or below and oatmeal should be over 140 degrees Fahrenheit, and explained that proper temperature is important to make sure residents do not get sick. The dietary supervisor also stated milk should be in the 40s and oatmeal at least 140 degrees Fahrenheit, and that the milk should have been colder and was not safe or appetizing at that temperature.
Failure to Follow Enhanced Barrier Precautions During Resident Care
Penalty
Summary
The facility failed to ensure enhanced barrier precautions (EBP) were followed for one resident who had moderate cognitive impairment, substantial assistance needs for dressing and bed mobility, and dependence for toileting hygiene and bathing. The resident’s diagnoses included urinary tract infection, type 2 diabetes, urinary retention, chronic kidney disease stage 2, lumbar vertebra compression fracture, and hypertension. The resident had an indwelling catheter ordered and was care planned for EBP because of the Foley catheter and a chronic wound. The care plan stated EBP was intended to protect the resident from drug-resistant infection and directed staff to use a gown and gloves during identified high-risk care activities. During observation, an EBP sign posted outside the resident’s room instructed staff to clean hands before entry and to wear a gown and gloves for high-contact care such as hygiene, changing briefs, and catheter care. Despite this, two nursing assistants provided bowel incontinent care while wearing gloves but not gowns. One nursing assistant stated she forgot to wear a gown and should have worn one for potential infections. The other stated she knew she needed to use a gown but did not because she was rushing, and she believed gowns were needed for catheter care but not when the resident had a bowel movement. The infection preventionist stated staff would be expected to use required PPE such as gowns and gloves to follow EBP, and would expect gown and glove use during perineal care after a bowel movement if staff were in prolonged close contact. The facility policy stated EBP is designed to reduce transmission of MDROs and that residents with chronic wounds or indwelling medical devices are at especially high risk of acquisition and colonization with MDROs.
Failure to Monitor and Track Fluid Intake for Dialysis Resident
Penalty
Summary
The facility failed to ensure that care-planned interventions for maintaining appropriate fluid balance were consistently implemented and accurately tracked for a resident receiving hemodialysis and on a fluid restriction. The resident, who had moderate cognitive impairment and multiple medical conditions including end-stage renal disease, was observed with multiple cups of fluid in her room, despite being on a 1500 ml fluid restriction. The resident and her family member were unsure of how much fluid was being given or tracked, indicating a lack of communication and monitoring by the facility staff. Nursing staff, including a nursing assistant and a licensed practical nurse, were interviewed and revealed inconsistencies in the tracking and recording of the resident's fluid intake. The nursing assistant mentioned that fluid intake should be charted every shift, but was unsure who monitored the totals to ensure the resident did not exceed her fluid restriction. The licensed practical nurse confirmed that both the point of care (POC) system and the Treatment Administration Record (TAR) should be used to track fluid intake every shift, but acknowledged that there was a lack of communication between the nurse and nursing assistants. A review of the resident's POC Response History and TAR revealed multiple instances of missing or inaccurately recorded fluid intake data. Several days lacked evidence of fluid intake being recorded for every shift, and the totals recorded in the TAR did not match the data in the POC. The registered nurse unit manager confirmed these discrepancies and acknowledged the importance of accurate and consistent tracking of the resident's fluid intake to prevent exceeding the fluid restriction. The resident was found to be dehydrated during a hospitalization for another reason, highlighting the impact of the facility's failure to properly monitor and manage the resident's fluid intake.
Failure to Follow Physician Orders and Bowel Management Protocol
Penalty
Summary
The facility failed to adhere to physician orders and notify the provider regarding a resident's refusal to wear a cervical collar. Resident R88, who had a posterior displaced type II dens fracture, Alzheimer's disease, and dementia, was observed multiple times without the cervical collar, which was supposed to be worn at all times according to the care plan and provider orders. Despite the resident's frequent removal of the collar, staff did not consistently replace it or notify the hospice team or provider of the refusal. Interviews with various staff members, including registered nurses and the director of nursing, confirmed that the resident's refusal was known but not documented or communicated to the appropriate parties. Additionally, the facility did not implement and reassess an individualized bowel management protocol for Resident R60, who was reviewed for constipation. R60, who was cognitively intact and had a history of slow transit constipation, experienced significant delays in receiving appropriate interventions for constipation. The resident's bowel records indicated multiple instances where the bowel management protocol was not activated after the resident did not have a bowel movement for the specified number of shifts. Interviews with nursing staff revealed inconsistencies in following the bowel management protocol, and the director of nursing acknowledged that the protocol was not followed as required. The facility's failure to follow physician orders and notify the provider of refusals, as well as the lack of adherence to the bowel management protocol, resulted in deficiencies in the care provided to the residents. The lack of documentation and communication regarding the residents' conditions and refusals contributed to the deficiencies observed during the survey.
Failure to Consistently Assess and Document Pressure Ulcers
Penalty
Summary
The facility failed to comprehensively assess and document the wounds of a resident, identified as R52, who was at high risk for pressure ulcers. R52 had a complex medical history, including type 2 diabetes mellitus with neuropathy, osteomyelitis, and peripheral vascular disease, which contributed to the development of a pressure ulcer on the left heel. Despite being cognitively intact and dependent on staff for various activities, the facility did not consistently perform weekly wound assessments and measurements as required. Several dates were missing from the records, indicating a lapse in the monitoring and documentation process. Interviews with the nursing staff revealed that the wound care nurse was primarily responsible for conducting these assessments, but in her absence, the responsibility was supposed to be delegated to other nursing staff. However, due to an error in entering orders, these assessments were not completed on several occasions. The wound care manager admitted to occasionally forgetting to document the assessments, and the director of nursing confirmed that these assessments should have been completed weekly. The facility's policy required comprehensive weekly assessments and collaboration among the interdisciplinary team, which was not consistently followed in this case.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Bloomington
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Presbyterian Homes Of Bloomington | 2.7 mi | ★★★★★ | 1 | 0 |
| The Estates At Bloomington Llc | 4.4 mi | ★★★★★ | 12 | 0 |
| Friendship Village Of Bloomington | 4.5 mi | ★★★★★ | 13 | 0 |
| Ebenezer Ridges Geriatric Care Center | 4.8 mi | ★★★★★ | 4 | 0 |
| Martin Luther Care Center | 4.9 mi | ★★★★★ | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.