Federal inspection record · CMS data as of October 1, 2026
Missouri Slope
4916 N Washington St, Bismarck, ND · (701) 223-9407
- Certified beds
- 192
- Residents per day
- 187
- Ownership
- Non-Profit
- Chain
- No chain reported
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- November 22, 2021
1
How this home got 4 stars
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in North Dakota.
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Staffing
★★★★★+1 star
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
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Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
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Overall
★★★★★4 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among North Dakota homes
Missouri Slope carries 38 inspection points. That is fewer than 45% of North Dakota's 71 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in North Dakota: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–10 pts
- 4★ 10–23 pts
- 3★ 23–42.5 pts
- 2★ 42.5–76 pts
- 1★ over 76 pts
Bars show every rated home in North Dakota by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
20 health citations on record since 2024. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
Harm and immediate-jeopardy citations (2)
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G
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
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G
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Everything else, by area of care
Quality of Life and Care7D
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
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.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide safe and appropriate respiratory care for a resident when needed.
- D
Provide safe, appropriate pain management for a resident who requires such services.
- D
Provide or get specialized rehabilitative services as required for a resident.
Infection Control3E
- E
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
Pharmacy Service3D
- D
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
- D
Ensure medication error rates are not 5 percent or greater.
- D
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Resident Rights2E
- E
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- D
Allow residents to self-administer drugs if determined clinically appropriate.
Resident Assessment and Care Planning2D
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Nutrition and Dietary1E
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspection history
2026-05-14
3 health deficiencies · 1 fire-safety deficiencies
Top issue: Infection Control (1 deficiency)
2025-03-27
7 health deficiencies · 1 fire-safety deficiencies
Top issue: Resident Rights (2 deficiencies)
2024-02-15
10 health deficiencies · 1 fire-safety deficiencies
Top issue: Quality of Life and Care (7 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 5 h 30 min of nursing staff time a day, 1 h 3 min of it from a registered nurse.
This home
5 h 30 min
North Dakota average
4 h 28 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 48% of nursing staff and 24% of registered nurses left in the past year.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Fines and payment denials
$39,404 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2024-10-15 | Fine | $30,580 |
| 2024-06-12 | Fine | $8,824 |
6
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.1 pts worse | 1.6 | 1.5 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.4 pts better | 1.4 | 1.8 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine1.3 pts better | 99.8% | 98.5% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine1.7 pts better | 100.0% | 98.3% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury2.4 pts better | 2.7% | 5.1% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms2.5 pts better | 1.7% | 4.2% | 13.5% |
| Percentage of long-stay residents who lose too much weight0.2 pts better | 5.6% | 5.8% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication7 pts better | 10.6% | 17.6% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication3.7 pts better | 19.1% | 22.8% | 15.4% |
| Percentage of long-stay residents who were physically restrained0.3 pts worse | 0.5% | 0.2% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened2.2 pts worse | 18.5% | 16.3% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased2.9 pts better | 17.0% | 19.9% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.2 pts worse | 1.6% | 1.4% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection0.4 pts worse | 2.9% | 2.5% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence0.3 pts worse | 24.3% | 24.0% | 18.3% |
| Percentage of long-stay residents with pressure ulcers1.6 pts better | 3.1% | 4.7% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine6.3 pts better | 97.6% | 91.3% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit1.7 pts better | 10.8% | 12.5% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication0.4 pts worse | 2.1% | 1.7% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine10.9 pts better | 96.6% | 85.7% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission7.2 pts better | 12.6% | 19.8% | 23.4% |
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Who owns and runs it
11 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Missouri Slope Lutheran Care Center, Inc. | 5% Or Greater Direct Ownership Interest · Organization | 100% | 1 facilities |
| Andrist, Steve | Corporate Director · Individual | 0% | 1 facilities |
| Hebert, Brian | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Hebert, Brian | Adp Of The SNF · Individual | 0% | 1 facilities |
| Missouri Slope Lutheran Care Center, Inc. | Operational/Managerial Control · Organization | 0% | 1 facilities |
| Missouri Slope Lutheran Care Center, Inc. | Adp Of The SNF · Organization | 0% | 1 facilities |
| Nitschke, Darrell | Corporate Director · Individual | 0% | 1 facilities |
| Saude, Jerry | Corporate Director · Individual | 0% | 1 facilities |
| Thompson, Reier | Corporate Officer · Individual | 0% | 1 facilities |
| Thompson, Reier | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Thompson, Reier | Adp Of The SNF · Individual | 0% | 1 facilities |
·
Fire safety
3 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Services3F
- F
Have properly installed electrical wiring and gas equipment.
- F
Have properly installed electrical wiring and gas equipment.
- F
Have properly installed electrical wiring and gas equipment.
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