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The Estates at Twin Rivers LLC
305 Fremont Street, Anoka, MN 55303 (opens Google Maps) · Anoka County · (763) 421-5660· 50 certified beds · avg 39 residents/day · certified since Oct 1, 1985 · Medicare and Medicaid certified
Certified for both programmes. Certification means the facility can bill Medicaid — it does not mean a Medicaid-funded bed is free right now, so ask directly. Who pays for nursing home care →
Part of chain: MONARCH HEALTHCARE MANAGEMENT (45 facilities, chain avg rating 2.2★)
2/5
Health inspection rating (on-site)
inspected Jul 2, 2026
1
Serious findings on record
most recent Nov 13, 2025
$0
Fines, last 3 years
4.13
Nurse hours/resident/day (adjusted)
Every record stays on this page.
What health inspectors found (on-site government inspections — the most independent evidence available)
New to these records? How to read an inspection report →
Health inspection rating: ★★☆☆☆2/5 · CMS overall rating: 2/5 · how star ratings work →
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 quality measures from resident assessments and claims.
Most serious findings (actual harm or immediate jeopardy)
▲ Immediate jeopardy, isolated · Nov 13, 2025 · F-0760 · triggered by a complaint
The facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication.
▲ Immediate jeopardy, isolated · Nov 13, 2025 · F-0760 · triggered by a complaint
The facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication.
Why it matters: A serious medication error can cause real harm, hospitalization, or worse.
Severity (J): Immediate jeopardy to resident health or safety was cited. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.
Corrected: Nov 10, 2025 (Past Non-Compliance)
Inspection findings in the public record
Showing the latest 3 of 41 inspection findings. Open the full record below to read every finding.
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. F-0550
The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. · from a complaint F-0584
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. F-0605
View all 41 inspection findingsShow only the latest 3 findings
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed — that window is CMS's, not ours. Within it, every citation CMS publishes for this facility is listed here: none excluded.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Jul 2, 2026 | D · Potential for more than minimal harm, isolated | 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. · F-0550 |
| Jul 2, 2026 | D · Potential for more than minimal harm, isolated | The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. · from a complaint · F-0584 |
| Jul 2, 2026 | D · Potential for more than minimal harm, isolated | 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. · F-0605 |
| Jul 2, 2026 | D · Potential for more than minimal harm, isolated | 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. · from a complaint · F-0677 |
| Jul 2, 2026 | D · Potential for more than minimal harm, isolated | The facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections. · F-0690 |
| Jul 2, 2026 | D · Potential for more than minimal harm, isolated | 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. · F-0880 |
| Jul 2, 2026 | D · Potential for more than minimal harm, isolated | The facility did not develop and follow policies and procedures for offering residents flu and pneumonia vaccinations. · F-0883 |
| Mar 27, 2026 | D · Potential for more than minimal harm, isolated | 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. · from a complaint · F-0880 |
| Nov 13, 2025 | ▲ J · Immediate jeopardy, isolated | The facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication. · from a complaint · F-0760 |
| May 23, 2025 | F · Potential for more than minimal harm, widespread | 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. · F-0812 |
| May 23, 2025 | F · Potential for more than minimal harm, widespread | 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. · from a complaint · F-0880 |
| May 23, 2025 | F · Potential for more than minimal harm, widespread | The facility had resident rooms smaller than required — at least 80 square feet per person in shared rooms and 100 square feet in single rooms. · F-0912 |
| May 23, 2025 | E · Potential for more than minimal harm, pattern | 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. · from a complaint · F-0761 |
| May 23, 2025 | E · Potential for more than minimal harm, pattern | The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature. · from a complaint · F-0804 |
| May 23, 2025 | D · Potential for more than minimal harm, isolated | 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. · F-0550 |
| May 23, 2025 | D · Potential for more than minimal harm, isolated | The facility did not make sure residents were fully informed about their own health, care, and treatments in a way they could understand. · F-0552 |
| May 23, 2025 | D · Potential for more than minimal harm, isolated | 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. · from a complaint · F-0561 |
| May 23, 2025 | D · Potential for more than minimal harm, isolated | The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. · F-0584 |
| May 23, 2025 | D · Potential for more than minimal harm, isolated | 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. · F-0655 |
| May 23, 2025 | D · Potential for more than minimal harm, isolated | 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. · from a complaint · F-0657 |
| May 23, 2025 | D · Potential for more than minimal harm, isolated | 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. · from a complaint · F-0677 |
| May 23, 2025 | D · Potential for more than minimal harm, isolated | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · F-0684 |
| May 23, 2025 | D · Potential for more than minimal harm, isolated | The facility did not provide the care needed to maintain or improve residents' movement and flexibility — such as range-of-motion exercises — leading to avoidable decline. · F-0688 |
| May 23, 2025 | D · Potential for more than minimal harm, isolated | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · F-0689 |
| May 23, 2025 | D · Potential for more than minimal harm, isolated | The facility did not keep residents' medications free from unnecessary drugs. Residents should only take medicines they truly need, at the right dose, for a clear reason. · F-0757 |
| May 23, 2025 | C · Potential for minimal harm, widespread | The facility did not make its inspection results easy for residents to see, or made it hard for residents to contact advocacy agencies like the ombudsman. · F-0577 |
| May 1, 2025 | D · Potential for more than minimal harm, isolated | 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. · from a complaint · F-0656 |
| May 1, 2025 | D · Potential for more than minimal harm, isolated | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint · F-0689 |
| Jan 21, 2025 | D · Potential for more than minimal harm, isolated | The facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away. · from a complaint · F-0580 |
| Jan 21, 2025 | D · Potential for more than minimal harm, isolated | The facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication. · from a complaint · F-0760 |
| Jan 9, 2025 | D · Potential for more than minimal harm, isolated | The facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away. · from a complaint · F-0580 |
| Jan 9, 2025 | D · Potential for more than minimal harm, isolated | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint · F-0689 |
| Oct 17, 2024 | D · Potential for more than minimal harm, isolated | 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. · from a complaint · F-0550 |
| Oct 17, 2024 | D · Potential for more than minimal harm, isolated | 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. · from a complaint · F-0656 |
| Oct 17, 2024 | D · Potential for more than minimal harm, isolated | The facility did not safely and appropriately administer IV fluids (fluids given through a vein) for residents who needed them. · from a complaint · F-0694 |
| Apr 24, 2024 | F · Potential for more than minimal harm, widespread | The facility did not have a registered nurse on duty at least 8 hours a day, or did not have a registered nurse serving full-time as director of nursing. · F-0727 |
| Apr 24, 2024 | E · Potential for more than minimal harm, pattern | The facility had resident rooms smaller than required — at least 80 square feet per person in shared rooms and 100 square feet in single rooms. · F-0912 |
| Apr 24, 2024 | D · Potential for more than minimal harm, isolated | 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. · F-0554 |
| Apr 24, 2024 | D · Potential for more than minimal harm, isolated | The facility did not make reasonable adjustments to fit each resident's individual needs and preferences — things like call buttons within reach, preferred wake-up times, or accessible room setups. · F-0558 |
| Mar 15, 2024 | F · Potential for more than minimal harm, widespread | 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. · from a complaint · F-0812 |
| Mar 15, 2024 | F · Potential for more than minimal harm, widespread | The facility did not keep its building and grounds safe, functional, clean, and comfortable for residents, staff, and visitors. · from a complaint · F-0921 |
Inspection trend by year
Citations from standard inspections decreased between the last two inspection cycles (16 → 7).
All citationsSerious citations (G–L)
2024
All citations: 9
Serious citations (G–L): 0
2025
All citations: 24
Serious citations (G–L): 1
2026
All citations: 8
Serious citations (G–L): 0
All bars start at zero. Exact values and supporting details remain below.
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2024 | 9 | 0 | F |
| 2025 | 24 | 1 | J ▲ |
| 2026 | 8 | 0 | D |
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)
Nurse staffing (from payroll records, adjusted for how much care residents need)
What these staffing numbers mean →
This facilityMinnesota averageU.S. average
Total nurse staffing (hours per resident per day)
This facility: 4.13
Minnesota average: 4.83
U.S. average: 3.95
Registered Nurse hours
This facility: 0.99
Minnesota average: 1.22
U.S. average: 0.69
Weekend total nurse staffing
This facility: 3.67
Minnesota average: 4.27
U.S. average: 3.50
All bars start at zero. Exact values and supporting details remain below.
| 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 21% in Minnesota; top 35% in the U.S. |
| Registered Nurse hours | 0.99 | 1.22 | 0.69 | bottom 34% in Minnesota; top 16% in the U.S. |
| Weekend total nurse staffing | 3.67 | 4.27 | 3.50 | bottom 22% in Minnesota; top 34% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.58 | 0.69 | 0.48 | bottom 48% in Minnesota; top 25% in the U.S. |
| Total nursing staff turnover (%) | 45.5 | 42.2 | 45.8 | bottom 37% in Minnesota; bottom 49% in the U.S. |
| RN turnover (%) | 85.7 | 38.6 | 42.9 | bottom 3% in Minnesota; bottom 3% in the U.S. |
Hours are per resident per day for the most recent quarter of payroll data in this CMS release (2026-08-01) — the same quarter for every facility — 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 3.48, RN 0.83, weekend 3.10.Comparing with Medicare Care Compare? Care Compare shows the raw figure (3.48 here, displayed there as hours and minutes), not the adjusted one above. Both are correct; they answer different questions. Staffing rating: 4/5.
Quality measures: assessments & claims
Note: CMS combines facility-reported resident assessments (MDS) with claims-based measures. These are different sources from on-site inspection findings. Read the measures alongside inspection and staffing records; a high QM rating does not establish that a home is safe.
Quality measures rating: 2/5 · long-stay residents: 2/5 · short-stay residents: 3/5
Costs & payment
Price evidence · separate from quality
No verified facility-specific private-pay price is available in our data for The Estates at Twin Rivers LLC. CMS inspection and staffing records do not tell us what this home will charge you.
Calculate a stay from a quote you receive
Use a written private-pay quote. This worksheet adds only the amounts you enter; it does not calculate Medicare, Medicaid or insurance benefits.
Formula: (room rate + daily extras) × days + one-time charges. A 30-day scenario is not a calendar-month quote. Refundable deposits, rate changes and charges you omit are not automatically included. Entries are not saved or sent to our server.
Before you compare prices
- Request the room type, effective date and itemized daily rate in writing.
- Ask about therapy, medicines, supplies, care-level charges, deposits, refunds and annual increases.
- Confirm insurance or Medicaid eligibility and bed availability directly; certification alone does not guarantee either.
Understand who pays for care · How we handle price evidence · Report an incorrect price
Who owns this facility
How to read ownership records →
Ownership records as published by CMS on 2026-08-01. CMS records when an owner joined but not when they left. Listed here and no longer involved? Tell us →
For profit - Corporation
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Arem, Jeffrey | Individual | 5% or Greater Direct Ownership Interest | 7% | 03/01/2017 |
| Halpert, Marc | Individual | 5% or Greater Indirect Ownership Interest | — | 03/01/2017 |
| Jaffa, Noam | Individual | 5% or Greater Indirect Ownership Interest | 7% | 03/01/2017 |
| Legum, Joshua | Individual | 5% or Greater Indirect Ownership Interest | 30% | 03/01/2017 |
| Nij LLC | Organization | 5% or Greater Direct Ownership Interest | 7% | 03/01/2017 |
| Spartan Healthcare LLC | Organization | 5% or Greater Direct Ownership Interest | 30% | 03/01/2017 |
| Stern, William | Individual | 5% or Greater Direct Ownership Interest | 20% | 03/01/2017 |
| Yazoma Holdings, LLC | Organization | 5% or Greater Direct Ownership Interest | 30% | 03/01/2017 |
| Halpert, Marc | Individual | Corporate Director | NOT APPLICABLE | 03/01/2017 |
| Legum, Joshua | Individual | W-2 Managing Employee | NOT APPLICABLE | 03/01/2017 |
| Monarch Healthcare Operating IV LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 03/01/2017 |
| Stern, William | Individual | Corporate Officer | NOT APPLICABLE | 03/01/2017 |
All 12 owning or managing parties CMS has on file are shown — none excluded.
Other facilities in the same chain
CMS lists this facility under the chain Monarch Healthcare Management — 45 facilities in the current records. Chain membership says who operates these homes. It says nothing about how any individual one of them was inspected; each has its own record.
- The Gardens at Foley LLC — Foley, MN · overall 2/5
- The Gardens at Winsted LLC — Winsted, MN · overall 2/5
- The Green Prairie Rehabilitation Center — Plainview, MN · overall 5/5
- The North Shore Estates LLC — Duluth, MN · overall 2/5
- The Villas at Brookview — Golden Valley, MN · overall 1/5
- The Villas at New Brighton — New Brighton, MN · overall 1/5
- The Villas at Osseo LLC — Osseo, MN · overall 1/5abuse
- The Villas at Richfield — Richfield, MN · overall 3/5
Listed by state, then facility name — not a ranking. Showing 8 of the 44 others, continuing from this facility's own place in that list.
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "What systems do you use to prevent medication errors, and what happens when one occurs?"
- "Can you give me examples of how your staff protect residents' dignity in everyday care, like bathing and dressing?"
- "Can we tour the resident rooms, bathrooms, and common areas today, including areas not on the usual tour route?"
- "What percentage of your residents are on antipsychotic or sedating medications, and how do you work to reduce that?"
- "How many aides are on each shift, and how do you make sure every resident gets timely help with bathing, dressing, and meals?"
- "How do you care for residents with incontinence or catheters, and what do you do to prevent urinary tract infections?"
- "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
- "What percentage of your residents and staff are vaccinated against flu and pneumonia, and how do you offer the vaccines?"
Also worth asking anywhere
- "Your weekend nurse staffing is reported below the Minnesota midpoint — how does the weekend schedule differ from a weekday?"
- "Can I see the plan of correction for the findings in your most recent state inspection?"
- "CMS reports 46% total nursing staff turnover here — who on the care team has been with you longest?"
- "Can I visit again unannounced, at a mealtime or on a weekend?"
Nearby facilities (12 closest of 59 within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Anoka Rehabilitation and Living Center | 1.0 mi | Anoka, MN | ★★★★☆ | 3/5 | |
| Park River Healthcare and Rehabilitation Center LL | 5.7 mi | Coon Rapids, MN | ★★☆☆☆ | 1/5 | |
| The Villas at Osseo LLC | 5.8 mi | Osseo, MN | ★☆☆☆☆ | 1/5 | abuse |
| Saint Therese at Oxbow Lake | 6.5 mi | Brooklyn Park, MN | ★★★☆☆ | 2/5 | |
| Maranatha Care Center | 8.4 mi | Brooklyn Center, MN | ★★★★☆ | 4/5 | |
| Woodlake Healthcare and Rehabilitation Center | 9.8 mi | Crystal, MN | ★★★☆☆ | 3/5 | |
| North Ridge Health and Rehab | 10.1 mi | New Hope, MN | ★☆☆☆☆ | 1/5 | SFF |
| The Birches at Trillium Woods | 10.1 mi | Plymouth, MN | ★★★★★ | 4/5 | |
| The Estates at Fridley LLC | 10.5 mi | Fridley, MN | ★★☆☆☆ | 2/5 | abuse |
| Guardian Angels Care Center | 10.9 mi | Elk River, MN | ★★☆☆☆ | 2/5 | |
| Victory Health and Rehabilitation Center | 11.9 mi | Minneapolis, MN | ★★☆☆☆ | 2/5 | |
| Benedictine Health Center Innsbruck | 12.3 mi | New Brighton, MN | ★★★☆☆ | 2/5 |
Compare this facility with the 3 closest →
Other facilities in the same county
CMS records place this facility in Anoka, MN — 6 certified facilities there. These are outside the 20-mile list above, or far enough down it not to appear.
- Crest View Lutheran Home — Columbia Heights, MN · overall 1/5abuse
- St Anthony Health & Rehabilitation — St Anthony, MN · overall 4/5
Listed by facility name — not a ranking. Homes already in the table above are not repeated here.
Facility data as of CMS processing date 2026-08-01. CCN 245298.