Above average — CMS composite of the measures below.
The next survey window likely opens around December 2026
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 Towner County Living Ctr during CMS and state inspections, most recent first.
Delayed Meal Service Due to Insufficient Dietary Staffing: The facility failed to provide enough dietary staff to serve meals on time. Resident council minutes repeatedly noted short staffing and long waits for food, and the dietary schedule showed multiple days with fewer than three dietary assistants at lunch. During meal observation, the dietary manager and cook served the noon meal, and residents did not receive it until 1:00 p.m., one hour past the posted time.
Failure to use QAPI for ongoing meal service delays. Residents repeatedly reported long waits for meals, and meal service was observed to be late, with the noon meal served an hour past the posted time and one resident’s lunch tray delivered nearly two hours late. Resident council minutes over several months documented the same dietary concern, but staff stated no PIP had been conducted to address the repeated complaints.
A resident who required hands-on assistance with ambulation was injured when staff failed to provide adequate supervision and support while the resident walked to the bathroom. According to the facility’s fall prevention policy, residents are to receive care based on their individualized fall risk, and the resident reported that CNAs usually held onto them when walking. On the day of the incident, a CNA applied a gait belt and opened the bathroom door but, per the resident’s repeated statements to multiple staff, did not accompany the resident into the bathroom and remained in the bedroom. The resident walked alone, lost balance, and struck their head on the countertop, sustaining a quarter-sized open flap wound to the posterior head with active bleeding. An RN documented the injury and the resident’s condition, and an administrative staff member confirmed the expectation that staff follow the care plan and provide adequate assistance.
Food Storage and Kitchen Sanitation Deficiencies: Surveyors found multiple food storage and sanitation issues in the kitchen, including unlabeled and undated foods in the cooler, freezer, dry storage, and small fridge; food stored on the floor; debris in storage areas; dirty equipment; and expired quaternary ammonia sanitizer test strips. The dietary manager stated prepared foods and opened containers should be labeled and dated, confirmed the sanitizer strips were outdated, and acknowledged there was no daily cleaning checklist being initialed.
A CNA provided transfer and toileting care to a resident on EBP using gloves but did not wear a gown, despite signage and PPE supplies being posted outside the room. The resident had EBP orders related to an indwelling catheter and G-tube, and an admin nurse confirmed staff were expected to wear a gown for transferring and toileting care.
The facility failed to serve beverages at palatable temperatures during a meal observation, with milk being served at temperatures above the facility's policy requirements. A resident complained about the warm drinks, and a dietary staff member confirmed the expectation for acceptable serving temperatures.
A facility failed to ensure accurate labeling of medications for a resident with a G-tube, as observed during a medication pass. The facility's policy requires medications to be labeled according to federal and state requirements and to include the route of administration. Despite a physician's order to administer medications via G-tube, a nurse administered five medications this way, although the medication cartridge instructions stated to give them by mouth, crushed, in pudding. An administrative nurse confirmed the need for proper labeling according to physician's orders.
Delayed Meal Service Due to Insufficient Dietary Staffing
Penalty
Summary
The facility failed to provide sufficient support personnel to safely and effectively carry out food and nutrition services, resulting in delayed meal service in 1 of 1 dining room. Facility policy stated meals were to be served at 7:30 a.m., 11:45 a.m., and 5:30 p.m., and that staffing would be adequate to meet residents’ nutritional needs and provide safe, timely meal preparation and meal service. Review of resident council minutes from August 2025 through January 2026 repeatedly documented concerns that dietary was short staffed and that residents were waiting too long for food. Review of the facility assessment identified one full-time dietary manager on day shift, three dietary assistants for 8 hours on day shift, and one dietary assistant for 2.5 hours on day shift. The dietary schedule from December 8, 2025, through January 18, 2026, showed 18 days with fewer than three dietary assistants during the noon meal. During observation of the noon meal, the dietary manager and cook prepared and served the meal, and residents in the dining room did not receive their meals until 1:00 p.m., one hour after the posted serving time. The dietary manager stated she would expect three to four kitchen staff during both day and evening shifts and that meals should be served at the scheduled times.
Failure to Use QAPI for Ongoing Meal Service Delays
Penalty
Summary
The facility failed to take actions aimed at performance improvement and, after implementing those actions, measure their success and track performance to ensure improvements were identified and sustained. Review of the facility’s QAPI policy showed the program was intended to encompass all segments of the facility and include performance improvement projects designed to revise and improve care or services in areas needing attention, but the facility did not conduct a PIP related to the ongoing concern with long wait times for meal service. Observation of the noon meal showed residents in the dining room received their meal one hour past the posted serving time. During interviews, a confidential resident stated residents had complained about long wait times for meals at resident meetings and nothing ever happened, and Resident #1 stated lunch trays were often late and that they had requested food earlier while waiting in their room hungry. Review of resident council meeting minutes from August through December 2025 showed repeated dietary concerns that residents continued to wait too long for food, with concerns shared verbally and by email with the dietary manager. Administrative staff stated food service complaints were sent directly to the dietary manager, the facility had not been notified of dietary concerns, and no PIP had been conducted related to the long wait times for meal service.
Failure to Provide Hands-On Assistance With Ambulation Resulting in Resident Fall and Head Injury
Penalty
Summary
The deficiency involves the facility’s failure to provide adequate supervision and hands-on assistance with ambulation to prevent accidents for a resident identified as being at risk for falls. The facility’s Fall Prevention Policy stated that each resident would be assessed for fall risk and receive care and services according to their individualized level of risk to minimize the likelihood of falls. For this resident, the facility-reported incident (FRI) documented that a CNA called an RN to the bathroom, where the RN found the resident on the floor with a quarter-sized open flap wound to the right posterior head and active bleeding. The RN’s note indicated the CNA stated she was walking the resident to the toilet when the resident’s right ankle twisted, causing her to fall and hit her head on the countertop. In contrast, the resident consistently reported to multiple staff, including a social worker, that the CNA had applied a gait belt and opened the bathroom door but did not walk into the bathroom with her, remaining instead in the bedroom by the recliner. The resident stated she walked to the bathroom alone, attempted to catch her balance, but was unable to do so and struck her head on the countertop, describing that she “really cracked it.” She also reported that other CNAs typically “hold onto” her when she walks to the bathroom. Nursing progress notes documented the head injury, the resident’s alert status, orientation to what happened, and pain at the wound site without headache. An administrative staff member stated an expectation that staff ensure residents receive adequate assistance and that staff follow the resident’s care plan, underscoring that the resident did not receive the hands-on assistance with ambulation that was required at the time of the fall.
Food Storage and Kitchen Sanitation Deficiencies
Penalty
Summary
Food was not stored in accordance with professional standards for food service sanitation in the kitchen. Review of facility policies showed requirements for labeling, dating, covering, and properly storing food, as well as daily cleaning procedures for the dietary department. During the initial kitchen observation, surveyors found multiple items in the walk-in cooler that were not labeled or dated, including meatballs and gravy, an unknown food item, opened dressings, and an unknown meat product dated 12/21. The walk-in freezer contained French fries and other food debris on the floor, a box of English muffins stored on the floor, and an undated, unlabeled, unsealed bag of pastries in stand up freezer #3. Dry storage also contained unlabeled and undated dry cereal in containers not in original packaging, with jelly packets and debris on the floor under shelving. A later observation showed additional sanitation and storage concerns, including flour and sugar containers that were not labeled or dated, a microwave with food particles, a deep fryer lined with old food debris, and quaternary ammonia sanitizer test strips with an expiration date of December 2025. The walk-in cooler still contained the same open and undated dressings, along with unlabeled and undated mixed lettuce and deli meat dated 12/21, while debris remained on the floor. The walk-in freezer had a large tote with unlabeled or undated foods in Ziplock baggies and ice buildup on the light above the fan. Dry storage still had debris on the floor, a large bag of croissants dated 12/08/25, and two clear plastic containers of chocolate glaze dated 11/11 and not in original packaging. A small fridge contained an open and undated container of thickened cranberry juice. The dietary manager stated she expected prepared foods to be covered and labeled, opened food containers to be labeled and dated, sanitizer strips were outdated, and no daily cleaning checklist was being initialed.
Failure to Use Required Gown During Enhanced Barrier Precautions Care
Penalty
Summary
The facility failed to follow infection control and prevention standards for one sampled resident who was on Enhanced Barrier Precautions due to an indwelling catheter and G-tube. The facility policy stated that Enhanced Barrier Precautions require gowns and gloves and are used for resident care activities including transferring and changing briefs or assisting with toileting. During observation, a CNA entered the resident’s room, applied gloves, transferred the resident from a wheelchair to the toilet, provided toileting hygiene, and transferred the resident back to the wheelchair, but did not apply a gown before providing care. An administrative nurse later confirmed that staff were expected to wear a gown when transferring and toileting residents on Enhanced Barrier Precautions.
Failure to Serve Beverages at Palatable Temperatures
Penalty
Summary
The facility failed to serve beverages at palatable temperatures during one of the two meals observed, which may lead to decreased intake, weight loss, and inadequate nutrition for residents. During an observation of the breakfast meal, it was noted that staff served residents milk from three half-gallon cartons sitting in a pan of water. The temperatures of the milk were recorded as follows: whole milk at 50 degrees Fahrenheit, 2% milk at 49 degrees Fahrenheit, and chocolate milk at 60 degrees Fahrenheit. This was contrary to the facility's policy, which requires dairy products to be stored at temperatures between 33-40 degrees Fahrenheit. A resident expressed dissatisfaction, stating that the cold drinks were warm. A dietary staff member confirmed the expectation for food to be served at an acceptable temperature.
Failure to Accurately Label Medications for G-tube Administration
Penalty
Summary
The facility failed to ensure accurate labeling of medications for a resident with a gastrostomy tube (G-tube), which was observed during a medication pass. The facility's policy on labeling medications, dated July 2024, requires that all medications be labeled in accordance with federal and state requirements and current pharmaceutical principles. The policy also mandates that labels for individual drug containers must include the route of administration, and any changes in medication orders or directions must be communicated to the pharmacy. During the survey, a review of the resident's medical record showed a physician's order to administer medications via G-tube. However, an observation during a medication pass revealed that a staff nurse administered five medications to the resident via G-tube, despite the medication cartridge instructions stating to give the medications by mouth, crushed, in pudding. An administrative nurse confirmed that medications need to be labeled according to physician's orders, indicating a failure to adhere to the facility's labeling policy.
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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 Cando
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Eventide Heartland | 31.1 mi | ★★★★★ | 10 | 0 |
| Rolette Community Care Center | 31.3 mi | ★★★★★ | 11 | 1 |
| Heart Of America Care Center | 37.1 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.