Clara City Care Center
Inspection Findings
F-Tag F0656
F 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
the director of nursing (DON) was interviewed and stated Resident R1's care plan had not been updated yet to include individualized interventions for his exit seeking behavior and it was not part of the remaining follow up after the elopement event. On 10/22/25 at 12:30 p.m., trained medical assistant (TMA)-A, was interviewed and stated that the care plan should indicate if a resident is at risk for elopement. On 10/22/25 at 12:45 p.m., RN-B was interviewed and stated residents who are elopement risks have a section about safety and falls in their care plans. There are interventions staff are doing that is not documented in the care plans when residents had been exit seeking. RN-B said those interventions could be added to the care plans. On 10/22/25 at 1:30 p.m., nursing assistant (NA)-B was interviewed, and was able to list interventions for each resident with exit seeking behaviors but was unsure where those interventions were documented. The facility policy, Resident MDS and Care Planning, last modified on 1/13/21 directs that all residents will have a comprehensive assessment completed upon admission, annually and with a significant change. Risk factors and assessment to be competed by a nurse on an admission, quarterly and PRN and includes elopement.
Event ID:
Facility ID:
If continuation sheet
Printed: 04/13/2026 Form Approved OMB No. 0938-0391
Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
10/23/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Clara City Care Center
1012 North Division Street Clara City, MN 56222
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F-Tag F0689
Federal health inspectors cited CLARA CITY CARE CENTER in CLARA CITY, MN for a deficiency under regulatory tag F-F0689 during a complaint investigation conducted on 2025-10-23.
Category: Quality of Life and Care Deficiencies
The facility was found deficient in the following area: Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Scope/Severity Level J: isolated, immediate jeopardy to resident health or safety.
This represents an immediate jeopardy situation, the most serious level of deficiency.
This was one of 2 deficiencies cited during this inspection of CLARA CITY CARE CENTER.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-11-12.
CLARA CITY CARE CENTER in CLARA CITY, MN inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
Frequently Asked Questions
- What is an F-tag violation?
- F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
- Were these violations corrected?
- Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
- How often do nursing home inspections happen?
- CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
- What should families do about these violations?
- Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in CLARA CITY, MN, (5) Report new concerns to state authorities.
- Where can I see the full inspection report?
- Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from CLARA CITY CARE CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.