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Complaint Investigation

The Estates At Fridley Llc

October 27, 2025 · Fridley, MN · 5700 East River Road
Citations 2
CMS Rating 2/5
Beds 50
Provider ID 245201
Healthcare Facility
The Estates At Fridley Llc
Fridley, MN  ·  View full profile →
Source Document
Official CMS Inspection Report (Medicare.gov)
Downloaded from CMS/Medicare.gov. Reflects what state inspectors documented and does not include the facility's plan of correction, which is submitted separately. Facilities may have taken corrective actions since this report was released.
Inspection Summary

THE ESTATES AT FRIDLEY LLC in FRIDLEY, MN — inspection on October 27, 2025.

Found 2 citations. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

Inspection Findings

FF0600
Freedom from Abuse, Neglect, and Exploitation Deficiencies

The police and paramedics had been called.

The DON had the paramedics wait as she was obtaining a

and was sent right back. R1 required acute psychiatric care due to the vandalism, assaulting of staff

p.m. LPN-A stated he had a week off prior to his shift on 10/21/25. He was unaware there were any concerns with R1. R1 was going in and out of the building from his room to the smoking area on 10/21/25, which was common for him. He was laughing and smiling, which was not out of the ordinary either, however he was speaking to himself in Spanish. LPN-A did not think anything of him speaking to himself.

The facility was not completing 15-minute checks on him. A little after 8:00 p.m. on 10/21/he heard R2's roommates wife yelling for help. He ran to the room, R2 was on the floor, R1 was screaming at him ready to throw his wheelchair on him. LPN-A stood between them, and R1 was pushing him. LPN-A yelled for help and LPN-B responded and called the police. LPN-A got R1 out of R2's room and LPN-B tended to R2 along with a nursing assistant. R1 got angry and went outside.

LPN-A called the DON, and she wanted to send both R1 and R2 to the emergency department and get a 72-hour psychiatric hold on R1.

They were both taken to the emergency department. R2 was released later that evening with no concerns and R1 was hospitalized until 10/24/24. LPN-A had not worked with R1 since 10/21/25 and was told R1 had an aide monitoring one-to-one 24 hours a day.

LPN-A stated the night of the 10/21/25 the officers did not want to take R1, but LPN-A told them he did not feel safe. LPN-A stated he wondered if R1 would be under the influence again at the facility.

LPN-A stated R1 still goes out and God knows what he does which was why he got violent when he returned.

Upon interview on 10/27/25 at 3:38 p.m. the Administrator stated on 10/13/25 R1 was found scratching cars and deflating tires. R1 was not redirectable when staff attempted. He was unaware the nurse practitioner had not been notified and stated she should have been. He was not certain whether the staff had started monitoring R1 for signs and symptoms of substance abuse or not. He believed the staff implemented 15-minute safety checks on R1 after he assaulted RN-A and was found to have methamphetamines in his system.

The administrator stated there was an all staff training a few weeks prior on de-escalation.

The training was their annual training and not regarding any specific resident for any specific reason.

The Administrator stated he spoke with R2 daily following the assault and each day R2 was emotionally improving with his fears. R2 had been moved to a new room and was happy with his roommate and R1 apologized to him. A facility policy titled Abuse Prohibition/Vulnerable Adult Policy with a revision date of 4/2025 indicated the purse was to protect residents against abuse by anyone, including, but not limited to facility staff, other residents, consultants or volunteers, staff of other agencies serving the individual, family members or legal guardians, friends or other individuals, or self-abuse.Prevention:1.

Each referral received is assessed through the pre-admission medical screening process for susceptibility to abuse by individuals and their risk of abusing others.

This assessment includes risk of self-abuse.

Plans are developed and measures taken to minimize risks.

Ongoing assessments are completed with each quarterly care conference.2.

The Interdisciplinary Care Plan Team reviews residents requiring behavioral interventions at least quarterly and/or during Target Behavior meetings to develop individual behavior plans.3.

Residents and families are informed of the Residents' Rights and Grievance procedure upon admission to the facility and annually through Resident Council.4.

Department Directors are updated regarding falls and resident incidents and are responsible for ongoing supervision of subordinates regarding abuse prevention.5.

Identification and analysis of physical environmental factors that may make abuse and neglect more likely to occur is completed and reviewed by the QAPI committee.

245201 10/27/2025

The Estates at Fridley LLC 5700 East River Road Fridley, MN 55432

was not aware if the facility staff had knowledge of how to support R1 when he was distressed.

Upon

had reached out to the in-house provider to complete a diagnostic assessment on R1 following the

system.

The DON denied knowledge of R1 being offered chemical dependent or other treatment outside the facility during his stay. A policy for treatment and/or services for mental and psychosocial concerns was requested however none was provided.

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 FRIDLEY, 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 THE ESTATES AT FRIDLEY LLC or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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About This Inspection Report

Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.

Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.

Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.