Cycle 1
Health 2025-12-31 · Fire 2025-12-31
3 health deficiencies
Top issue: Infection Control (1 deficiency)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Mayville, ND
Luther Memorial Home
4-star overall rating with 3-star inspections with $5,814 in total fines with 3 recent health deficiencies
750 Main St E, Mayville, ND
(701) 786-3401
Overall
4 / 5
CMS overall stars
Health inspections
3 / 5
Survey and complaint cycles
Staffing
5 / 5
RN + nurse staffing
Quality measures
3 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
62
Certified beds
Average residents
59
Average occupied residents
Ownership
Non-Profit
Publicly displayed owner type
Chain
No chain reported
Operator or chain grouping
Approved since
1978-06-01
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
1.04
Registered nurse staffing · state 0.93 · national 0.68
LPN hours / resident day
0.47
Licensed practical nurse staffing · state 0.50 · national 0.87
Aide hours / resident day
3.84
Nurse aide staffing · state 2.99 · national 2.35
Total nurse hours
5.36
All reported nurse hours · state 4.41 · national 3.89
Licensed hours
1.52
RN + LPN hours · state 1.42 · national 1.54
Weekend hours
4.54
Weekend nurse staffing · state 3.75 · national 3.43
Weekend RN hours
0.61
Weekend registered nurse coverage · state 0.59 · national 0.47
Physical therapist
0.02
Reported PT staffing · state 0.04 · national 0.07
Adjusted RN hours
1.24
CMS adjusted RN staffing hours
Adjusted total hours
6.38
CMS adjusted total nurse staffing hours
Case-mix index
1.15
Higher values indicate more complex resident acuity
RN turnover
29%
Annual RN turnover · state 38% · national 45%
Total nurse turnover
51%
Annual nurse turnover · state 49% · national 46%
SNF VBP
Value-based purchasing
Program rank
984
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
61.37
Composite VBP score used to determine payment impact.
Payment multiplier
1.0164
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
Not reported
This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.
Healthcare-associated infections
Not reported
This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.
Total nurse turnover
2.27
Baseline 38.89% · Performance 54.39% · Measure score 2.27 · Achievement 2.27 · Improvement 0
Adjusted total nurse staffing
10
Baseline 5.74 hours · Performance 6.23 hours · Measure score 10 · Achievement 10 · Improvement 9
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | Not Available |
10.72%
|
Not Available · Eligible stays 18 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly. |
| Discharge to community | Not Available |
50.57%
|
Not Available · Eligible stays 10 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly. |
| Medicare spending per beneficiary | Not Available |
1.02
|
Too few residents or stays to report publicly. |
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 21 · Denominator 21 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 21 |
| Discharge self-care score | Not Available |
53.69%
|
Numerator Not Available · Denominator 17 · Too few residents or stays to report publicly. |
| Discharge mobility score | Not Available |
50.94%
|
Numerator Not Available · Denominator 17 · Too few residents or stays to report publicly. |
| Pressure ulcers or injuries, new or worsened | 4.76% |
2.29%
2.5 pts worse
|
Numerator 1 · Denominator 21 · Adjusted rate 4.31% |
| Healthcare-associated infections requiring hospitalization | Not Available |
7.12%
|
Not Available · Eligible stays 15 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly. |
| Staff COVID-19 vaccination coverage | 6.72% |
8.2%
1.5 pts worse
|
Numerator 9 · Denominator 134 |
| Staff flu vaccination coverage | 40% |
42%
2 pts worse
|
Numerator 70 · Denominator 175 |
| Discharge function score | Not Available |
56.45%
|
Numerator Not Available · Denominator 17 · Too few residents or stays to report publicly. |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 4 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 2 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | Not Available |
25.2%
|
Numerator Not Available · Denominator 13 · Too few residents or stays to report publicly. |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 0.6 |
1.4
0.8 pts better
|
1.9
1.3 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.6 · Observed 0.5 · Expected 1.6 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 2.4 |
1.9
0.5 pts worse
|
1.8
0.6 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.4 · Observed 2.2 · Expected 1.5 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 99.5% |
98.3%
1.2 pts better
|
93.4%
6.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 98.0% · Q3 100.0% · Q4 100.0% · 4Q avg 99.5% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% |
98.8%
1.2 pts better
|
95.5%
4.5 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 4.1% |
5.1%
1 pts better
|
3.3%
0.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 3.6% · Q2 2.0% · Q3 3.6% · Q4 6.9% · 4Q avg 4.1% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 3.9% |
4.4%
0.5 pts better
|
11.4%
7.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.1% · Q2 2.1% · Q3 3.8% · Q4 7.1% · 4Q avg 3.9% |
| Percentage of long-stay residents who lose too much weight | 1.1% |
5.5%
4.4 pts better
|
5.4%
4.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 4.5% · 4Q avg 1.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 15.1% |
17.4%
2.3 pts better
|
19.6%
4.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 17.6% · Q2 14.0% · Q3 15.2% · Q4 13.0% · 4Q avg 15.1% |
| Percentage of long-stay residents who received an antipsychotic medication | 26.7% |
23.4%
3.3 pts worse
|
16.7%
10 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 32.4% · Q2 30.0% · Q3 25.0% · Q4 20.0% · 4Q avg 26.7% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 3.6% |
0.2%
3.4 pts worse
|
0.1%
3.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 3.6% · Q2 3.9% · Q3 3.6% · Q4 3.4% · 4Q avg 3.6% |
| Percentage of long-stay residents whose ability to walk independently worsened | 16.8% |
19.0%
2.2 pts better
|
16.3%
0.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 11.9% · Q2 23.5% · Q3 13.4% · Q4 19.1% · 4Q avg 16.8% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 19.9% |
20.1%
0.2 pts better
|
14.9%
5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 14.9% · Q2 28.2% · Q3 16.3% · Q4 21.4% · 4Q avg 19.9% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.9% |
1.8%
0.9 pts better
|
1.0%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 2.0% · Q3 0.0% · Q4 1.5% · 4Q avg 0.9% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 1.4% |
3.1%
1.7 pts better
|
1.7%
0.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.0% · Q2 2.0% · Q3 0.0% · Q4 1.8% · 4Q avg 1.4% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 19.9% |
25.2%
5.3 pts better
|
19.8%
0.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 19.8% · Q2 16.5% · Q3 23.4% · Q4 19.4% · 4Q avg 19.9% |
| Percentage of long-stay residents with pressure ulcers | 4.9% |
5.3%
0.4 pts better
|
5.1%
0.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 4.2% · Q2 10.5% · Q3 4.1% · Q4 1.4% · 4Q avg 4.9% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 98.6% |
93.6%
5 pts better
|
81.7%
16.9 pts better
|
Short Stay · 2024Q4-2025Q3 · Q2 100.0% · 4Q avg 98.6% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 100.0% |
88.3%
11.7 pts better
|
79.7%
20.3 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 100.0% |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-10-10 · Fire 2024-10-10
2 health deficiencies
Top issue: Infection Control (1 deficiency)
1 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (1 deficiency)
Cycle 3
Health 2023-09-27 · Fire 2023-09-27
2 health deficiencies
Top issue: Quality of Life and Care (2 deficiencies)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2024-10-10
K914 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Corrected 2024-11-26
Inspection history
Recent health citations
E · Potential for more than minimal harm
2025-12-31
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2026-01-30
D · Potential for more than minimal harm
2025-12-31
F641 · Resident Assessment and Care Planning Deficiencies
Health
Ensure each resident receives an accurate assessment.
Corrected 2026-01-30
D · Potential for more than minimal harm
2025-12-31
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2026-01-30
D · Potential for more than minimal harm
2024-10-10
F641 · Resident Assessment and Care Planning Deficiencies
Health
Ensure each resident receives an accurate assessment.
Corrected 2024-11-07
D · Potential for more than minimal harm
2024-10-10
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2024-11-07
J · Immediate jeopardy
2024-02-05
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2024-02-06
D · Potential for more than minimal harm
2023-09-27
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2023-10-31
Penalties and ownership
What sits behind the stars
$5,814
2024-02-05
Fine
Fine · fine $5,814
Fine
Ownership
Eide, Brenda
Corporate Director · Individual
Erickson, Dean
Corporate Director · Individual
Erickson, Roger
Corporate Director · Individual
Kaldor, Gary
Corporate Director · Individual
Mewes, Richelle
Corporate Director · Individual
Petersen, Doug
Corporate Officer · Individual
Stromstad, Linda
Corporate Director · Individual
Thoreson, Terry
Corporate Director · Individual
Ulrich, Brett
Operational/Managerial Control · Individual
Ulrich, Brett
W-2 Managing Employee · Individual
Winger, Julie
Operational/Managerial Control · Individual
Winger, Julie
Corporate Officer · Individual
Nearby options
Other facilities in reach
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Hatton Prairie Village
Hatton, ND
5-star overall rating with 4-star inspections with 4 recent health deficiencies
#2
Sanford Hillsboro Care Center
Hillsboro, ND
2-star overall rating with 2-star inspections with $42,488 in total fines with 3 recent health deficiencies
#3
Halstad Living Center
Halstad, MN
4-star overall rating with 4-star inspections with 2 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
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