Havenwood Care Center
Bemidji · 1.4 mi · 65 beds
Citations0Substantiated0
Neilson Place
1000 ANNE STREET NORTHWEST, Bemidji, MN, 56601
Nursing home78 licensed beds0 citations on record
1 more within 6 milesOpen in Maps
Has this facility been cited?
Yes. Federal inspectors cited 11 deficiencies against Neilson Place in Bemidji, Minnesota at its most recent standard inspection on 2026-03-05, 4 of them arising from complaints. 1 finding has been recorded at the immediate-jeopardy level, the most serious CMS uses, meaning a resident was placed in immediate danger. Medicare has fined it 3 times, totalling $45,915. CMS currently flags this home for abuse. Medicare rates it 1 out of 5 overall.
1 / 5Medicare overall rating
78certified beds
11deficiencies at the last inspection
1immediate-jeopardy findings on record
5actual-harm findings on record
3federal fines, $45,915
What the inspectors found
Every deficiency on record, by how serious CMS judged it
CMS grades each finding from A to L on two axes: how badly residents were affected, and how many. These are its bands, not ours. The figures cover every standard and complaint survey on record, which is a longer window than the rating cycle above.
Immediate jeopardyA resident was placed in immediate danger. The most serious band CMS uses.1
Actual harmA resident was harmed, but not placed in immediate danger.5
Potential for more than minimal harmNo resident was harmed, but the failing could have caused it.40
Potential for minimal harmThe least serious band.1
Most recentEEDDDDDDGGDDDDGFFDDD
The last 20 findings, newest first
Each is the federal requirement the home was found not to meet, in CMS’s own wording, with the tag number so it can be looked up against the inspection report.
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · F0812 · 2026-03-05 · standard survey · No actual harm, potential for more than minimal harm
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · F0880 · 2026-03-05 · standard survey · No actual harm, potential for more than minimal harm
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · F0605 · 2026-03-05 · standard survey · No actual harm, potential for more than minimal harm
Assess the resident when there is a significant change in condition
Resident Assessment and Care Planning Deficiencies · F0637 · 2026-03-05 · from a complaint · No actual harm, potential for more than minimal harm
Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning Deficiencies · F0658 · 2026-03-05 · standard survey · No actual harm, potential for more than minimal harm
Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies · F0677 · 2026-03-05 · standard survey · No actual harm, potential for more than minimal harm
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Quality of Life and Care Deficiencies · F0688 · 2026-03-05 · standard survey · No actual harm, potential for more than minimal harm
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.
Quality of Life and Care Deficiencies · F0700 · 2026-03-05 · standard survey · No actual harm, potential for more than minimal harm
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · F0689 · 2025-12-09 · from a complaint · Actual harm to a resident
Protect each resident from separation (from other residents, his/her room, or confinement to his/her room).
Freedom from Abuse, Neglect, and Exploitation Deficiencies · F0603 · 2025-07-02 · from a complaint · Actual harm to a resident
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
Resident Rights Deficiencies · F0557 · 2025-07-02 · from a complaint · No actual harm, potential for more than minimal harm
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · F0880 · 2025-04-04 · from a complaint · No actual harm, potential for more than minimal harm
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · F0656 · 2025-02-25 · from a complaint · No actual harm, potential for more than minimal harm
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · F0684 · 2025-02-25 · from a complaint · No actual harm, potential for more than minimal harm
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · F0689 · 2024-12-20 · from a complaint · Actual harm to a resident
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · F0812 · 2024-12-05 · standard survey · No actual harm, potential for more than minimal harm
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · F0880 · 2024-12-05 · standard survey · No actual harm, potential for more than minimal harm
Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies · F0677 · 2024-12-05 · standard survey · No actual harm, potential for more than minimal harm
Provide enough food/fluids to maintain a resident's health.
Quality of Life and Care Deficiencies · F0692 · 2024-12-05 · standard survey · No actual harm, potential for more than minimal harm
Post nurse staffing information every day.
Nursing and Physician Services Deficiencies · F0732 · 2024-12-05 · standard survey · No actual harm, potential for more than minimal harm
Medicare’s own rating
How CMS scores this home
These stars are Medicare’s, not ours — we publish no rating of our own. They are reproduced here because they are part of the public record.
OverallCombines the three below1 of 5
Health inspectionBased on the last three inspection cycles1 of 5
StaffingNurse hours per resident, adjusted for how sick residents are4 of 5
Quality measuresResident outcomes reported by the home2 of 5
Nurse hours per resident per dayReported by the home to CMS3.80477
Nursing staff turnoverShare of nursing staff who left in a year55.4%
Penalties
What Medicare has fined this home
FinesCivil money penalties imposed by CMS3
Total fined$45,915
Payment denials and other penaltiesMedicare refusing to pay for new admissions is the usual one3
Ownership
Who owns Neilson Place
Nursing homes are frequently owned through layers of companies, and the name over the door is rarely the one that holds the licence. This is the ownership CMS has on file.
| Owner | Role | Share | Since |
|---|---|---|---|
| SANFORD NORTH | Organization | 100% | since 05/01/2014 |
| SANFORD | Organization | 100% | since 05/01/2014 |
| DULSKI, KARIN | Individual | NOT APPLICABLE | since 11/19/2012 |
| GASSEN, WILLIAM | Individual | NOT APPLICABLE | since 11/24/2020 |
| MARLETTE, WILLIAM | Individual | NOT APPLICABLE | since 06/16/2023 |
| MORRISON, TONY | Individual | NOT APPLICABLE | since 02/01/1991 |
| MUNSON, JOLYN | Individual | NOT APPLICABLE | since 02/25/2013 |
| SWENSON, STEPHANIE | Individual | NOT APPLICABLE | since 11/01/2019 |
| CAIN, JAMES | Individual | NOT APPLICABLE | since 11/19/2015 |
| ENGBRECHT, WESLEY | Individual | NOT APPLICABLE | since 01/01/2021 |
| GASSEN, WILLIAM | Individual | NOT APPLICABLE | since 11/24/2020 |
| GULSVIG, NEIL | Individual | NOT APPLICABLE | since 03/28/2019 |
Part of the SANFORD HEALTH group.
Nearby
Other licensed providers within six miles
Listed by distance. Nobody paid to appear here and the order is not for sale.
Contact
Ask Neilson Place a question
This page has not been claimed, so messages sent here would reach nobody. Call them instead — we take no commission either way, so we have no reason to steer you anywhere.
Source: Centers for Medicare & Medicaid Services, Nursing Home Care Compare. Retrieved 2026-07-29. Facility number 245039.
Figures reproduce the state’s own totals and are not re-aggregated. Methodology · Report a correction