Heritage Manor
321 Northeast Sixth Street, Chisholm, MN 55719 · St. Louis County · 65 certified beds · avg 57 residents/day · certified since Sep 1, 1982
Part of chain: ST. FRANCIS HEALTH SERVICES (14 facilities, chain avg rating 2.8★)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★☆☆☆☆1/5 · CMS overall rating: 1/5
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.
Most serious findings (actual harm or immediate jeopardy)
▲ Actual harm, one-off · Jun 26, 2025 · F-0684
The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals.
Why it matters: Care that strays from doctor's orders or ignores the resident's wishes can lead to declining health and avoidable harm.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Aug 20, 2025 (Deficient, Provider has date of correction)
All citations in the current public record (25)
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Jun 26, 2025 | ▲ G · Actual harm, one-off | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. |
| Jun 26, 2025 | F · Potential for harm, facility-wide | The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. |
| Jun 26, 2025 | F · Potential for harm, facility-wide | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Jun 26, 2025 | E · Potential for harm, repeated | The facility did not have a working call system — the button or cord residents use to summon help — in each resident's bathroom and bathing area. |
| Jun 26, 2025 | D · Potential for harm, one-off | The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. |
| Jun 26, 2025 | D · Potential for harm, one-off | The facility did not allow residents to take their own medications when a clinical review showed they could do so safely. Residents have this right if their care team determines it's appropriate. |
| Jun 26, 2025 | D · Potential for harm, one-off | The facility did not honor residents' right to make their own choices about their daily lives, such as when to wake up, what to eat, or how to spend their time. |
| Jun 26, 2025 | D · Potential for harm, one-off | The facility gave residents unnecessary mind-altering (psychotropic) medications, or used drugs in a way that restrained residents by dulling their ability to think, move, or function. |
| Jun 26, 2025 | D · Potential for harm, one-off | The facility did not create and follow a basic care plan covering a new resident's most immediate needs within 48 hours of admission. The first days are when a new resident is most vulnerable. |
| Jun 26, 2025 | D · Potential for harm, one-off | The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. |
| Jun 26, 2025 | D · Potential for harm, one-off | The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. |
| Jun 26, 2025 | D · Potential for harm, one-off | The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. |
| Jun 26, 2025 | D · Potential for harm, one-off | The facility did not provide safe, appropriate care for residents who need dialysis — the treatment that filters the blood when kidneys fail. |
| Jun 26, 2025 | D · Potential for harm, one-off | The facility's medication error rate was 5 percent or higher — meaning too many doses were given incorrectly, such as the wrong drug, dose, or time. |
| Jun 26, 2025 | D · Potential for harm, one-off | The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. |
| Jun 26, 2025 | D · Potential for harm, one-off | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Jun 26, 2025 | F · Potential for harm, facility-wide | The facility did not have enough nursing staff each day to meet every resident's needs, or did not have a licensed nurse in charge on each shift. Adequate staffing is one of the strongest predictors of good care. · from a complaint |
| May 16, 2024 | F · Potential for harm, facility-wide | The facility could not meet the required nurse staffing levels but did not request the official waiver that the rules require in that situation. |
| May 16, 2024 | D · Potential for harm, one-off | The facility did not fully assess residents on time — a complete assessment of health, abilities, and needs is required when a resident is first admitted and at least once every 12 months after that. |
| May 16, 2024 | D · Potential for harm, one-off | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · from a complaint |
| May 16, 2024 | D · Potential for harm, one-off | The facility used feeding tubes without a valid medical reason or the resident's agreement, or did not provide proper care to residents who have feeding tubes. |
| May 16, 2024 | D · Potential for harm, one-off | The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. |
| Mar 9, 2023 | D · Potential for harm, one-off | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. |
| Mar 9, 2023 | D · Potential for harm, one-off | The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. |
| Mar 9, 2023 | D · Potential for harm, one-off | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. |
Inspection trend by year
Citations from standard inspections increased between the last two inspection cycles (5 → 16).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 3 | 0 | D |
| 2024 | 5 | 0 | F |
| 2025 | 17 | 1 | G ▲ |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
Fines and enforcement (last 3 years)
No fines or payment denials in the published 3-year window.
Nurse staffing (from payroll records, adjusted for how much care residents need)
| Measure | This facility | Minnesota avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 4.13 | 4.83 | 3.95 | bottom 22% in Minnesota; top 34% in the U.S. |
| Registered Nurse hours | 1.17 | 1.22 | 0.69 | top 46% in Minnesota; top 10% in the U.S. |
| Weekend total nurse staffing | 3.54 | 4.27 | 3.50 | bottom 15% in Minnesota; top 40% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.51 | 0.69 | 0.48 | bottom 38% in Minnesota; top 31% in the U.S. |
| Total nursing staff turnover (%) | 31.0 | 42.2 | 45.8 | top 25% in Minnesota; top 16% in the U.S. |
| RN turnover (%) | 25.0 | 38.6 | 42.9 | top 27% in Minnesota; top 20% in the U.S. |
Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 3.41, RN 0.96, weekend 2.92. Staffing rating: 4/5.
Self-reported quality measures
Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.
Quality measures rating: 2/5 · long-stay residents: 1/5 · short-stay residents: 4/5
Who owns this facility
Non profit - Church related
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Anderson, Emily | Individual | Operational/Managerial Control | NOT APPLICABLE | 06/02/2017 |
| Anderson, Emily | Individual | ADP of the SNF | NOT APPLICABLE | 06/02/2017 |
| Bach, Curtis | Individual | Corporate Director | NOT APPLICABLE | 08/28/2024 |
| Bach, Curtis | Individual | Corporate Officer | NOT APPLICABLE | 08/28/2024 |
| Bach, Curtis | Individual | Operational/Managerial Control | NOT APPLICABLE | 08/28/2024 |
| Bach, Curtis | Individual | ADP of the SNF | NOT APPLICABLE | 08/28/2024 |
| Barnard, Shelley | Individual | ADP of the SNF | NOT APPLICABLE | 03/31/2025 |
| Bay, Esa | Individual | Operational/Managerial Control | NOT APPLICABLE | 08/07/2025 |
| Bay, Esa | Individual | ADP of the SNF | NOT APPLICABLE | 08/07/2025 |
| Big Stone Therapies, INC | Organization | Operational/Managerial Control | NOT APPLICABLE | 02/03/2015 |
| Big Stone Therapies, INC | Organization | ADP of the SNF | NOT APPLICABLE | 10/22/2025 |
| Blevins, Rosanne | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/18/2018 |
| Blevins, Rosanne | Individual | ADP of the SNF | NOT APPLICABLE | 05/18/2018 |
| Burrows, Amanda | Individual | Operational/Managerial Control | NOT APPLICABLE | 01/02/2024 |
| Burrows, Amanda | Individual | ADP of the SNF | NOT APPLICABLE | 01/02/2024 |
| Caspers, Megan | Individual | Operational/Managerial Control | NOT APPLICABLE | 12/29/2014 |
| Caspers, Megan | Individual | ADP of the SNF | NOT APPLICABLE | 12/29/2014 |
| Copeman, Jeffrey | Individual | Operational/Managerial Control | NOT APPLICABLE | 01/01/2025 |
| Copeman, Jeffrey | Individual | ADP of the SNF | NOT APPLICABLE | 01/01/2025 |
| Dripps, Daniel | Individual | Corporate Director | NOT APPLICABLE | 01/01/2016 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
- "How does your pharmacist review residents' medications, and how quickly can you fill new or urgent prescriptions?"
- "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
- "Can you show me the call buttons in the bathrooms and bathing areas, and tell me your average response time when one is pressed?"
- "Can you give me examples of how your staff protect residents' dignity in everyday care, like bathing and dressing?"
- "If my family member is able to manage their own medications, would you allow it, and how is that decided?"
- "What choices do residents have over their daily schedule, like meal times, bathing, and activities?"
- "What percentage of your residents are on antipsychotic or sedating medications, and how do you work to reduce that?"
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the results and plan of correction from your most recent state inspection?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Cornerstone Villa | 4.3 mi | Buhl, MN | ★★★☆☆ | 3/5 | |
| Guardian Angels Health & Rehab Center | 5.3 mi | Hibbing, MN | ★★☆☆☆ | 1/5 | |
| The Waterview Pines LLC | 15.0 mi | Virginia, MN | ★☆☆☆☆ | 1/5 | |
| Essentia Health Virginia Care Cent | 15.2 mi | Virginia, MN | ★★★★★ | 4/5 | |
| The Waterview Woods LLC | 15.6 mi | Eveleth, MN | ★☆☆☆☆ | 2/5 |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 245245.