North Shore Health
NORTH SHORE HEALTH in GRAND MARAIS, MN — inspection on May 27, 2026.
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
During an observation and interview on 5/26/26 at 6:14 p.m., both of R6's lower extremities were very edematous and R6 stated that is how they have been and has had those tight socks in the past but not here.
During an interview on 5/27/26 at 1:41 p.m., RN-A stated she had just noticed R6's weight gain this past weekend and notified the provider and the nurse manager. RN-A also stated R6 was admitted with the edema and they used to have edema monitoring on the treatment administration record (TAR) but the provider discontinued it and started a nebulizer.
Today, RN-A stated R6 had diminished lung sounds and both lower legs were three-plus pitting edema, and she had been waiting to hear if they got any new orders and they did get one for Lasix (a diuretic medication), and RN-A felt his legs had been getting bigger and the risk for R6 could be skin breakdown and his legs to start weeping.
During an interview on 5/27/26 at 2:39 p.m., the director of nursing (DON) stated would expect the nurses to assess the edema and listen to the lungs.
Also, the DON stated she would expect the ongoing monitoring, documentation, and for it to be on the care plan.
The DON added that even if the provider discontinued the edema monitoring, it was still within a nurse's scope to monitor edema.A policy, Care Plans - Comprehensive dated 1/3/26, identified its purpose was for a comprehensive, person-centered care plan that included measurable objectives and timetables to meet the resident's physical, psychosocial and functional needs was developed and implemented for each resident.
Assessments of residents were ongoing and care plans were revised as information about the resident and the resident's conditions changed.
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided.
For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE
245384 05/27/2026
North Shore Health 515 - 5th Avenue West Grand Marais, MN 55604
of monitoring, for a resident with chronic lower extremity edema for 1 of 1 resident (R6) reviewed for
moderately impaired cognition and diagnosis of chronic kidney disease, stage four (severe kidney damage and a significant loss of kidney function).R6's care plan dated 4/19/26 lacked a focus statement for edema management.R6's provider orders 5/7/26, identified to take R6's weight in the morning every Thursday, but didn't include monitoring for edema.A history and physical dated 4/14/26, identified R6 had a past medical history of chronic lower extremity edema, and had one-plus bilateral edema on exam.A Clinical admission assessment dated [DATE], identified R6's left and right lower extremities were extremely puffy with mild non-pitting edema in the calves, ankles and dorsum of feet.A monthly rounding provider note dated 5/19/26, identified two-plus pitting edema to the knees as stableA progress note dated 5/25/26, identified R6's provider was contacted, and nurse manager updated, due to an 18.1-pound weight gain since admission on [DATE]. A comprehensive skin assessment dated [DATE], identified R6 had mild bilateral, non-pitting edema in calves, ankles and dorsum of feet.During an observation and interview on 5/26/26 at 6:14 p.m., both of R6's lower extremities were very edematous and R6 stated that is how they have been and has had those tight socks in the past but not here.
During an interview on 5/27/26 at 1:41 p.m., RN-A stated she had just noticed R6's weight gain this past weekend and notified the provider and the nurse manager. RN-A also stated R6 was admitted with the edema and they used to have edema monitoring on the treatment administration record (TAR) but the provider discontinued it and started a nebulizer.
Today, RN-A stated R6 had diminished lung sounds and both lower legs were three-plus pitting edema, and she had been waiting to hear if they got any new orders and they did get one for Lasix (a diuretic medication), and RN-A felt his legs had been getting bigger and the risk for R6 could be skin breakdown and his legs to start weeping.
During an interview on 5/27/26 at 2:39 p.m., the director of nursing (DON) stated would expect the nurses to assess the edema and listen to the lungs.
Also, the DON stated she would expect the ongoing monitoring, documentation, and for it to be on the care plan.
The DON added that even if the provider discontinued the edema monitoring, it was still within a nurse's scope to monitor edema.A policy, Assessment - Comprehensive Skin dated 3/7/24, identified its purpose was to develop a systematic assessment for all residents at risk for alterations in skin integrity.
The policy further identified a comprehensive skin assessment included, but was not limited to, the skin color, temperature, edema, turgor, moisture and integrity.A policy, Care Plans - Comprehensive dated 1/3/26, identified its purpose was for a comprehensive, person-centered care plan that included measurable objectives and timetables to meet the resident's physical, psychosocial and functional needs was developed and implemented for each resident.
Assessments of residents were ongoing and care plans were revised as information about the resident and the resident's conditions changed.
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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.