Federal inspection record · CMS data as of October 1, 2026
The Estates At Twin Rivers LLC
305 Fremont Street, Anoka, MN · (763) 421-5660
- Certified beds
- 50
- Residents per day
- 33
- Ownership
- For-Profit
- Chain
- Monarch Healthcare Management
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- October 1, 1985
1
How this home got 2 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.
-
Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Minnesota.
-
Staffing
★★★★★no change
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
-
Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
-
Overall
★★★★★2 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Minnesota homes
The Estates At Twin Rivers LLC carries 83 inspection points. That is fewer than 24% of Minnesota's 335 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Minnesota: 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★ 0–9 pts
- 4★ 9–30 pts
- 3★ 30–54 pts
- 2★ 54–92 pts
- 1★ over 92 pts
Bars show every rated home in Minnesota 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
41 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 (1)
-
J
Ensure that residents are free from significant medication errors.
Everything else, by area of care
Resident Rights12D
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- D
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- D
Ensure that residents are fully informed and understand their health status, care and treatments.
- D
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
- D
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
- C
Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- D
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.
- D
Reasonably accommodate the needs and preferences of each resident.
Quality of Life and Care9D
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- 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
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide for the safe, appropriate administration of IV fluids for a resident when needed.
Infection Control4F
- D
Provide and implement an infection prevention and control program.
- D
Develop and implement policies and procedures for flu and pneumonia vaccinations.
- D
Provide and implement an infection prevention and control program.
- F
Provide and implement an infection prevention and control program.
Resident Assessment and Care Planning4D
- D
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Nutrition and Dietary3F
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Environmental3F
- F
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
- E
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
- F
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Pharmacy Service3E
- E
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 each resident’s drug regimen must be free from unnecessary drugs.
- D
Ensure that residents are free from significant medication errors.
Freedom from Abuse, Neglect, and Exploitation1D
- D
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Nursing and Physician Services1F
- F
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Inspection history
2026-07-02
9 health deficiencies · 1 fire-safety deficiencies
Top issue: Infection Control (3 deficiencies)
2025-05-23
26 health deficiencies · 1 fire-safety deficiencies
Top issue: Resident Rights (8 deficiencies)
2024-04-24
6 health deficiencies · 3 fire-safety deficiencies
Top issue: Environmental (2 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 39 min of nursing staff time a day, 59 min of it from a registered nurse.
This home
3 h 39 min
Minnesota average
4 h 16 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 44% of nursing staff and 80% 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
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine6.8 pts worse | 90.5% | 97.3% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine3.6 pts better | 100.0% | 96.4% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury3.2 pts better | 0.9% | 4.1% | 3.2% |
| Percentage of long-stay residents who have depressive symptomsAbout the same | 4.1% | 4.1% | 13.5% |
| Percentage of long-stay residents who lose too much weight1.4 pts worse | 5.3% | 3.9% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication8.1 pts worse | 20.8% | 12.7% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication2 pts worse | 19.2% | 17.2% | 15.4% |
| Percentage of long-stay residents who were physically restrained0.1 pts better | 0.0% | 0.1% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened0.2 pts better | 18.6% | 18.8% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased6.2 pts better | 12.0% | 18.2% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder1.7 pts worse | 3.4% | 1.7% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection0.9 pts better | 1.7% | 2.6% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence8.1 pts better | 15.6% | 23.7% | 18.3% |
| Percentage of long-stay residents with pressure ulcers6.2 pts worse | 11.3% | 5.1% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine44.5 pts worse | 43.6% | 88.1% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit10.7 pts better | 3.9% | 14.6% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication2.5 pts worse | 4.4% | 1.9% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine32.4 pts worse | 50.9% | 83.3% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission7.7 pts worse | 30.7% | 23.0% | 23.4% |
·
Who owns and runs it
12 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 |
|---|---|---|---|
| Legum, Joshua | 5% Or Greater Indirect Ownership Interest · Individual | 30% | 45 facilities |
| Spartan Healthcare LLC | 5% Or Greater Direct Ownership Interest · Organization | 30% | 45 facilities |
| Yazoma Holdings, LLC | 5% Or Greater Direct Ownership Interest · Organization | 30% | 44 facilities |
| Stern, William | 5% Or Greater Direct Ownership Interest · Individual | 20% | 45 facilities |
| Arem, Jeffrey | 5% Or Greater Direct Ownership Interest · Individual | 7% | 29 facilities |
| Jaffa, Noam | 5% Or Greater Indirect Ownership Interest · Individual | 7% | 45 facilities |
| Nij LLC | 5% Or Greater Direct Ownership Interest · Organization | 7% | 44 facilities |
| Halpert, Marc | 5% Or Greater Indirect Ownership Interest · Individual | 0% | 45 facilities |
| Halpert, Marc | Corporate Director · Individual | 0% | 45 facilities |
| Legum, Joshua | W-2 Managing Employee · Individual | 0% | 45 facilities |
| Monarch Healthcare Operating Iv LLC | Operational/Managerial Control · Organization | 0% | 15 facilities |
| Stern, William | Corporate Officer · Individual | 0% | 45 facilities |
·
Fire safety
5 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Gas, Vacuum, and Electrical Systems2F
- C
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- F
Have generator or other power source capable of supplying service within 10 seconds.
Emergency Preparedness2C
- C
Address subsistence needs for staff and patients.
- C
Implement emergency and standby power systems.
Smoke1D
- D
Install an approved automatic sprinkler system.
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Other homes nearby
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Anoka Rehabilitation And Living Center
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★★★★★- Worst citation, 3 yrs
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- Nursing / resident / day
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Park River Healthcare And Rehabilitation Center Ll
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The Villas At Osseo LLC
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