The declaration came on February 12, 2025, at 4:23 in the afternoon.
Nursing Home News — Page 467
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He was found unresponsive in his bed just after midnight on May 13.
The citation, issued under F867, targets the facility's QAPI program directly.
His legs were resting directly on a disposable pad.
Her blood pressure was 144/68 that morning.
The resident, identified in inspection records only as R901, had been admitted to the facility with a broken left femur, diabetes, and hypertension.
Inspectors from the Centers for Medicare and Medicaid Services visited the facility on May 27, 2026, and reviewed care planning for two residents.
The violation was cited during a complaint inspection on May 26, 2026, at Carrier Mills Nursing & Rehab Center.
The Director of Nursing confirmed it at 7:53 a.m.: no residents, no census.
That gap, documented during a May 2026 complaint inspection, sat at the center of what federal surveyors found at the Chisago City facility.
The inspection was triggered by a complaint, not a routine survey.
It isn't always a dramatic failure, a fall with broken bones, or a resident found on the floor for hours.