Cycle 1
Health 2025-09-04 · Fire 2025-09-04
8 health deficiencies
Top issue: Resident Rights (2 deficiencies)
4 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (2 deficiencies)
Hettinger, ND
Western Horizons Care Center
1-star overall rating with 2-star inspections with abuse icon flag with $71,991 in total fines with 8 recent health deficiencies with 4 fire-safety deficiencies in the latest cycle
1104 Hwy 12, Hettinger, ND
(701) 567-2401
Overall
1 / 5
CMS overall stars
Health inspections
2 / 5
Survey and complaint cycles
Staffing
4 / 5
RN + nurse staffing
Quality measures
1 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
40
Certified beds
Average residents
32
Average occupied residents
Ownership
Non-Profit
Publicly displayed owner type
Chain
No chain reported
Operator or chain grouping
Approved since
1978-05-01
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
1.01
Registered nurse staffing · state 0.93 · national 0.68
LPN hours / resident day
0.27
Licensed practical nurse staffing · state 0.50 · national 0.87
Aide hours / resident day
3.45
Nurse aide staffing · state 2.99 · national 2.35
Total nurse hours
4.72
All reported nurse hours · state 4.41 · national 3.89
Licensed hours
1.28
RN + LPN hours · state 1.42 · national 1.54
Weekend hours
3.91
Weekend nurse staffing · state 3.75 · national 3.43
Weekend RN hours
0.63
Weekend registered nurse coverage · state 0.59 · national 0.47
Physical therapist
0.03
Reported PT staffing · state 0.04 · national 0.07
Adjusted RN hours
1.00
CMS adjusted RN staffing hours
Adjusted total hours
4.72
CMS adjusted total nurse staffing hours
Case-mix index
1.37
Higher values indicate more complex resident acuity
RN turnover
55%
Annual RN turnover · state 38% · national 45%
Total nurse turnover
67%
Annual nurse turnover · state 49% · national 46%
SNF VBP
Value-based purchasing
Program rank
7,426
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
29.78
Composite VBP score used to determine payment impact.
Payment multiplier
0.9856
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
3.57
Performance 6.77% · Measure score 3.57 · Achievement 3.57 · This facility did not have sufficient data to calculate a baseline period measure result.
Total nurse turnover
0.85
Baseline 72.34% · Performance 65.91% · Measure score 0.85 · Achievement 0 · Improvement 0.85
Adjusted total nurse staffing
4.51
Baseline 4.18 hours · Performance 4.36 hours · Measure score 4.51 · Achievement 4.51 · Improvement 0.65
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 10.47% |
10.72%
0.2 pts better
|
No Different than the National Rate · Eligible stays 51 · Observed rate 7.84% · Lower 95% interval 6.85% |
| Discharge to community | 33.46% |
50.57%
17.1 pts worse
|
Worse than the National Rate · Eligible stays 39 · Observed rate 23.08% · Lower 95% interval 23.93% |
| Medicare spending per beneficiary | 0.62 |
1.02
0.4 pts better
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 32 · Denominator 32 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 32 |
| Discharge self-care score | Not Available |
53.69%
|
Numerator Not Available · Denominator 19 · Too few residents or stays to report publicly. |
| Discharge mobility score | Not Available |
50.94%
|
Numerator Not Available · Denominator 19 · Too few residents or stays to report publicly. |
| Pressure ulcers or injuries, new or worsened | 0% |
2.29%
2.3 pts better
|
Numerator 0 · Denominator 32 · Adjusted rate 0% |
| Healthcare-associated infections requiring hospitalization | 6.77% |
7.12%
0.4 pts better
|
No Different than the National Rate · Eligible stays 30 · Observed rate 3.33% · Lower 95% interval 3.87% |
| Staff COVID-19 vaccination coverage | 15.52% |
8.2%
7.3 pts better
|
Numerator 9 · Denominator 58 |
| Staff flu vaccination coverage | 59.26% |
42%
17.3 pts better
|
Numerator 32 · Denominator 54 |
| Discharge function score | Not Available |
56.45%
|
Numerator Not Available · Denominator 19 · Too few residents or stays to report publicly. |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 2 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 8 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | Not Available |
25.2%
|
Numerator Not Available · Denominator 10 · 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 | 1.2 |
1.4
0.2 pts better
|
1.9
0.7 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.2 · Observed 1.0 · Expected 1.5 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 2.1 |
1.9
0.2 pts worse
|
1.8
0.3 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.1 · Observed 1.9 · Expected 1.5 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 96.2% |
98.3%
2.1 pts worse
|
93.4%
2.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 91.2% · Q2 100.0% · Q3 100.0% · Q4 93.8% · 4Q avg 96.2% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 91.7% |
98.8%
7.1 pts worse
|
95.5%
3.8 pts worse
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 91.7% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 5.3% |
5.1%
0.2 pts worse
|
3.3%
2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 5.9% · Q3 6.2% · Q4 9.4% · 4Q avg 5.3% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 15.9% |
4.4%
11.5 pts worse
|
11.4%
4.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 12.1% · Q2 21.9% · Q3 16.1% · Q4 13.3% · 4Q avg 15.9% |
| Percentage of long-stay residents who lose too much weight | 5.6% |
5.5%
0.1 pts worse
|
5.4%
0.2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 8.8% · Q2 9.1% · Q3 0.0% · Q4 3.8% · 4Q avg 5.6% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 29.2% |
17.4%
11.8 pts worse
|
19.6%
9.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 29.4% · Q2 29.4% · Q3 28.1% · Q4 30.0% · 4Q avg 29.2% |
| Percentage of long-stay residents who received an antipsychotic medication | 30.3% |
23.4%
6.9 pts worse
|
16.7%
13.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 23.3% · Q2 29.6% · Q3 36.0% · Q4 33.3% · 4Q avg 30.3% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.2%
0.2 pts better
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 29.9% |
19.0%
10.9 pts worse
|
16.3%
13.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · 4Q avg 29.9% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 29.1% |
20.1%
9 pts worse
|
14.9%
14.2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 24.1% · Q2 43.3% · Q3 26.7% · Q4 21.4% · 4Q avg 29.1% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 2.2% |
1.8%
0.4 pts worse
|
1.0%
1.2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 4.4% · Q2 2.1% · Q3 2.0% · Q4 0.0% · 4Q avg 2.2% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 8.8% |
3.1%
5.7 pts worse
|
1.7%
7.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 11.8% · Q2 6.1% · Q3 12.9% · Q4 3.7% · 4Q avg 8.8% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 27.2% |
25.2%
2 pts worse
|
19.8%
7.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 31.5% · Q2 21.1% · Q3 22.5% · Q4 34.3% · 4Q avg 27.2% |
| Percentage of long-stay residents with pressure ulcers | 5.5% |
5.3%
0.2 pts worse
|
5.1%
0.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 8.9% · Q2 3.2% · Q3 5.8% · Q4 3.5% · 4Q avg 5.5% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 75.8% |
93.6%
17.8 pts worse
|
81.7%
5.9 pts worse
|
Short Stay · 2024Q4-2025Q3 · 4Q avg 75.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication | 4.8% |
1.9%
2.9 pts worse
|
1.6%
3.2 pts worse
|
Short Stay · 2024Q4-2025Q3 · 4Q avg 4.8% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-07-24 · Fire 2024-07-24
16 health deficiencies
Top issue: Quality of Life and Care (5 deficiencies)
3 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (1 deficiency)
Cycle 3
Health 2023-08-29 · Fire 2023-08-29
10 health deficiencies
Top issue: Resident Assessment and Care Planning (3 deficiencies)
2 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (1 deficiency)
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2025-09-04
K291 · Egress Deficiencies
Fire Safety
Install emergency lighting that can last at least 1 1/2 hours.
Corrected 2025-09-23
F · Potential for more than minimal harm
2025-09-04
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 2025-09-26
F · Potential for more than minimal harm
2025-09-04
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2025-09-23
D · Potential for more than minimal harm
2025-09-04
K355 · Smoke Deficiencies
Fire Safety
Properly select, install, inspect, or maintain portable fire extinguishes.
Corrected 2025-09-23
F · Potential for more than minimal harm
2024-07-24
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2024-08-15
D · Potential for more than minimal harm
2024-07-24
K511 · Services Deficiencies
Fire Safety
Have properly installed electrical wiring and gas equipment.
Corrected 2024-08-13
D · Potential for more than minimal harm
2024-07-24
K923 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have proper medical gas storage and administration areas.
Corrected 2024-08-13
F · Potential for more than minimal harm
2023-08-29
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2023-09-27
D · Potential for more than minimal harm
2023-08-29
K712 · Miscellaneous Deficiencies
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2023-09-27
Inspection history
Recent health citations
G · Actual harm
2025-09-04
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Not marked corrected
G · Actual harm
2025-09-04
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 2025-09-05
E · Potential for more than minimal harm
2025-09-04
F761 · Pharmacy Service Deficiencies
Health
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.
Corrected 2025-09-26
D · Potential for more than minimal harm
2025-09-04
F583 · Resident Rights Deficiencies
Health
Keep residents' personal and medical records private and confidential.
Corrected 2025-09-26
D · Potential for more than minimal harm
2025-09-04
F628 · Resident Rights Deficiencies
Health
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Corrected 2025-11-26
D · Potential for more than minimal harm
2025-09-04
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2025-09-26
D · Potential for more than minimal harm
2025-09-04
F805 · Nutrition and Dietary Deficiencies
Health
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Corrected 2025-09-26
D · Potential for more than minimal harm
2025-09-04
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2025-09-26
G · Actual harm
2025-01-16
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 2025-02-07
D · Potential for more than minimal harm
2024-11-14
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2024-11-21
D · Potential for more than minimal harm
2024-11-14
F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected 2024-11-21
E · Potential for more than minimal harm
2024-07-24
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 2024-08-21
E · Potential for more than minimal harm
2024-07-24
F921 · Environmental Deficiencies
Health
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Corrected 2024-08-28
E · Potential for more than minimal harm
2024-07-24
F925 · Environmental Deficiencies
Health
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Corrected 2024-08-28
D · Potential for more than minimal harm
2024-07-24
F554 · Resident Rights Deficiencies
Health
Allow residents to self-administer drugs if determined clinically appropriate.
Corrected 2024-08-21
D · Potential for more than minimal harm
2024-07-24
F582 · Resident Rights Deficiencies
Health
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Corrected 2024-08-16
D · Potential for more than minimal harm
2024-07-24
F641 · Resident Assessment and Care Planning Deficiencies
Health
Ensure each resident receives an accurate assessment.
Corrected 2024-08-27
D · Potential for more than minimal harm
2024-07-24
F645 · Resident Assessment and Care Planning Deficiencies
Health
PASARR screening for Mental disorders or Intellectual Disabilities
Corrected 2024-08-16
D · Potential for more than minimal harm
2024-07-24
F657 · Resident Assessment and Care Planning Deficiencies
Health
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2024-08-21
D · Potential for more than minimal harm
2024-07-24
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 2024-08-05
D · Potential for more than minimal harm
2024-07-24
F699 · Quality of Life and Care Deficiencies
Health
Provide care or services that was trauma informed and/or culturally competent.
Corrected 2024-08-21
D · Potential for more than minimal harm
2024-07-24
F790 · Quality of Life and Care Deficiencies
Health
Provide routine and 24-hour emergency dental care for each resident.
Corrected 2024-08-31
D · Potential for more than minimal harm
2024-07-24
F806 · Nutrition and Dietary Deficiencies
Health
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Corrected 2024-08-27
D · Potential for more than minimal harm
2024-06-19
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 2024-06-11
K · Immediate jeopardy
2023-08-29
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 2023-10-06
F · Potential for more than minimal harm
2023-08-29
F882 · Infection Control Deficiencies
Health
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Corrected 2023-10-06
E · Potential for more than minimal harm
2023-08-29
F657 · Resident Assessment and Care Planning Deficiencies
Health
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2023-10-06
E · Potential for more than minimal harm
2023-08-29
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2023-10-06
D · Potential for more than minimal harm
2023-08-29
F580 · Resident Rights Deficiencies
Health
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Corrected 2023-10-06
D · Potential for more than minimal harm
2023-08-29
F623 · Resident Rights Deficiencies
Health
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Corrected 2023-10-06
D · Potential for more than minimal harm
2023-08-29
F637 · Resident Assessment and Care Planning Deficiencies
Health
Assess the resident when there is a significant change in condition
Corrected 2023-10-06
D · Potential for more than minimal harm
2023-08-29
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2023-10-06
D · Potential for more than minimal harm
2023-08-29
F948 · Nursing and Physician Services Deficiencies
Health
Ensure that paid feeding assistants have the training they need.
Corrected 2023-10-06
C · Minimal harm
2023-08-29
F625 · Resident Rights Deficiencies
Health
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Corrected 2023-10-06
Penalties and ownership
What sits behind the stars
$26,540
2025-09-04
Fine
Fine · fine $26,540
Fine
$26,598
2025-01-16
Fine
Fine · fine $26,598
Fine
$18,853
2023-08-29
Fine
Fine · fine $18,853
Fine
Ownership
Erickson, Daniel
Corporate Director · Individual
Fink, Todd
Corporate Director · Individual
Freeland, Alyson
Corporate Officer · Individual
Mellmer, Heidi
Corporate Director · Individual
Ranum, Joshua
Operational/Managerial Control · Individual
Ranum, Joshua
Contracted Managing Employee · Individual
Skogen, Seth
Corporate Director · Individual
Stadheim, Nathan
Operational/Managerial Control · Individual
Stadheim, Nathan
Corporate Officer · Individual
Stadheim, Nathan
W-2 Managing Employee · Individual
Uecker, Mallory
Operational/Managerial Control · Individual
Uecker, Mallory
W-2 Managing Employee · Individual
Vliem, Kathy
Corporate Director · Individual
Wickstrom, Laurie
Corporate Director · Individual
Nearby options
Other facilities in reach
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Five Counties Nursing Home
Lemmon, SD
1-star overall rating with 1-star inspections with Special Focus status with $31,850 in total fines with 27 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
#2
St Benedicts Health Center
Dickinson, ND
5-star overall rating with 5-star inspections with 2 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle
#3
St Lukes Home
Dickinson, ND
5-star overall rating with 5-star inspections with 1 recent health deficiencies
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