Map showing the location of KNUTE NELSON CARE CENTER in ALEXANDRIA, Minnesota
420 12TH AVENUE EAST, ALEXANDRIA, MN, 56308

Overall Score

CMS Five-Star Quality Rating
5/5Much above averageCMS Five-Star overall rating
  1. Much below average
  2. Below average
  3. Average
  4. Above average
  5. Much above average

Where it ranks

  • MinnesotaAbove 74% of peers337 rated homes · average 3.2★
  • United StatesAbove 80% of peers14,574 rated homes · average 3.0★

How the rating is built

  • Health inspectionsStarting point4★+1.2 vs MN avg
  • StaffingCan add or remove a star5★+0.9 vs MN avg
  • Quality measuresCan add or remove a star4★+0.8 vs MN avg

CMS starts from the health inspection stars, then adds or subtracts a star for staffing and for quality measures. Stars are assigned relative to other facilities in the same state.

Ratings & measures

Tap a row to see what it means
Health inspection ratingCMS stars from the last three on-site inspection cycles4★Above 65% of peersMN avg2.8★U.S. avg2.8★
What is health inspection rating?

Stars assigned from the last three standard surveys and every complaint investigation in that window, weighted toward the most recent and the most serious findings. CMS assigns these stars relative to other facilities in the same state.

Why it matters

It carries the most weight in the overall rating and is the only domain based on what trained inspectors saw on site rather than what the facility reported.

Staffing ratingCMS stars from payroll-reported hours and turnover5★Above 56% of peersMN avg4.1★U.S. avg2.9★
What is staffing rating?

Nurse and aide hours per resident day from payroll records CMS collects every quarter, adjusted for how much care residents need, plus staff turnover and weekend coverage.

Why it matters

More hours and lower turnover are the strongest predictors of fewer falls, pressure sores, and avoidable hospital stays.

Quality measures ratingCMS stars from clinical outcomes and resident assessments4★Above 61% of peersMN avg3.2★U.S. avg3.6★
What is quality measures rating?

Clinical outcomes from resident assessments and Medicare claims: falls with injury, pressure ulcers, hospitalizations, antipsychotic use, and more, for both short-stay and long-stay residents.

Why it matters

It shows whether care is working, but part of it comes from the facility’s own assessments, so read it alongside the inspection results.

Total nurse hoursPer resident per day, all nursing staff4.13hrsAbove only 48% of peersMN avg4.23Benchmark4.10
What is total nurse hours?

All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.

Why it matters

Federal research links 4.1 hours a day to fewer avoidable harms. Below about 3 hours, residents wait longer for help with basics like toileting and repositioning.

RN hoursPer resident per day, registered nurses only1.01hrsAbove 53% of peersMN avg1.06Benchmark0.75
What is rn hours?

Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.

Why it matters

RN coverage is the staffing measure most tied to fewer hospital transfers and infections, and it is where thinly staffed facilities cut first.

Nursing staff turnoverShare of nursing staff who left within a year · lower is better38%Above 60% of peersMN avg42%RN turnover19%
What is nursing staff turnover?

The share of nursing staff who left within the past year, from the same payroll data.

Why it matters

High turnover means residents are cared for by people who do not know them, and it is one of the strongest predictors of inspection problems.

Fines in the last three yearsCivil money penalties imposed by CMS · lower is better$0Above only 41% of peersMN avg$19,953Fines · denials0 · 0
What is fines in the last three years?

Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.

Why it matters

Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.

Inspection history

Last three inspection cycles
14citations
5inspection dates
0actual harm (G–I)
0immediate jeopardy (J–L)
Mar 5, 2025most recent

Citations by monthApr 2023 – Mar 2025

  • No actual harm (D–F)
  • Actual harm (G–I)
  • Immediate jeopardy (J–L)
  • $Fine or payment denial

Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.

Mar 5, 20253 citationsCycle 1worst F · no actual harm
  1. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryF · widespreadCorrected Apr 9, 2025
  2. F623Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.Resident RightsD · isolatedCorrected Apr 9, 2025
  3. F686Provide appropriate pressure ulcer care and prevent new ulcers from developing.Quality of Life and CareD · isolatedCorrected Apr 9, 2025
May 22, 20246 citationsCycle 2worst E · no actual harm
  1. F804Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.Nutrition and DietaryE · patternCorrected Jul 1, 2024
  2. F883Develop and implement policies and procedures for flu and pneumonia vaccinations.Infection ControlE · patternCorrected Jul 1, 2024
  3. F686Provide appropriate pressure ulcer care and prevent new ulcers from developing.Quality of Life and CareD · isolatedCorrected Jul 1, 2024
  4. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareD · isolatedCorrected Jul 1, 2024
  5. F604Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Jul 1, 2024
  6. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareD · isolatedCorrected Jul 1, 2024
Sep 22, 20231 citationCycle 3worst D · no actual harm
  1. F583Keep residents' personal and medical records private and confidential.Resident RightsD · isolatedCorrected Oct 18, 2023
Jul 13, 20231 citationCycle 3worst D · no actual harm
  1. F880Provide and implement an infection prevention and control program.Infection ControlD · isolatedCorrected Aug 25, 2023
Apr 19, 20233 citationsCycle 3worst E · no actual harm
  1. F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Resident RightsD · isolatedCorrected Jun 1, 2023
  2. F730Observe each nurse aide's job performance and give regular training.Nursing and Physician ServicesE · patternCorrected Jun 1, 2023
  3. F947Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.Nursing and Physician ServicesE · patternCorrected Jun 1, 2023

Staffing

From quarterly payroll reports

Hours per resident per day

  • All nursing staffRNs, LPNs and aides combined4.13hrsAbove only 48% of peers−0.10 vs MN avg
  • Registered nursesRN hours only1.01hrsAbove 53% of peers−0.05 vs MN avg
  • Licensed practical nursesLPN hours0.85hrs
  • Nurse aidesCNA hours2.27hrs
  • Weekend nursingAll staff on Saturdays and Sundays3.53hrs
  • Minnesota average
  • Research benchmark (4.10 total, 0.75 RN)

Turnover & capacity

  • Nursing staff turnoverShare who left within a year · lower is better38%Above 60% of peersMN avg 42%
  • RN turnoverRegistered nurses only19%Not ranked by CMS
  • Administrators who leftIn the past year0Stable leadership
  • Occupancy83 certified beds · ~64 residents a day77%Above only 27% of peersMN avg 83%

Fines & penalties

Roughly the past three years

Enforcement summary

  • $0In fines
  • 0Fines
  • 0Payment denials
  • $19,953MN avg in fines
Above only 41% of peersFewer fines than 41% of rated homes in Minnesota

Actions on record

No fines or payment denialsNothing on record in the current reporting window. Minnesota facilities average 1.0 penalties.

Ownership

As filed with CMS

Structure

Ownership type
Non profit - Corporation
Chain
Independent
Certification
Medicare and Medicaid
Location type
Rural
Ownership change
None in the last 12 months

People and entities on file

Direct owners (5%+)
  • Vivie
Corporate directors
  • Greg Billberg
  • Pamela Carlson
  • Chad Coauette
  • Julie Critz
  • Vicki Jodsaas
  • Jeff Montgomery
  • Sara O'Kane
  • Deena Steffl
Corporate officers
  • Mark Anderson
  • Marnie Gugisberg
  • Phillip Hanson
  • Katie Perry
  • Fred Semmer
  • Angela Urman
  • David Wolf
Managing employees
  • Mark Anderson
  • Marnie Gugisberg
  • Katie Perry
  • Angela Urman

Person Organization

Sources & notes

Public data, updated quarterly

Data sources

  • CMS Care Compare · Provider InformationStar ratings, staffing hours, turnover, penalties and flags · processed February 2026.
  • CMS Health CitationsEvery deficiency from the last three inspection cycles, with scope, severity and inspection cycle.
  • CMS Penalties and Ownership filesCivil money penalties, payment denials, and the owners and managers on file.

Notes

  • CMS Certification Number 245435 · 420 12TH AVENUE EAST, ALEXANDRIA, MN, 56308.
  • Percentiles compare this facility with every rated nursing home in Minnesota and Douglas County. Turnover and fines are inverted so a high percentile is always good.
  • This is an informational summary of public data, not medical, legal, or placement advice. Facilities cannot pay to change it; a facility that believes a record is wrong can dispute it with CMS.

Own or manage a facility?

Claim your free listing to correct details, reply to reviews, and show your verified badge.

Claim your facility

Read our latest articles