Velarion Records

Skilled nursing facility · CMS certification number 355103

FOUR SEASONS HEALTH CARE INC

FORMAN, North Dakota · Medicare and Medicaid

Certified beds, as filed in Care Compare: 25

Download this facility’s record (CSV)

A CSV file of this facility’s record: its name and location, its Medicare cost-report finances year by year, its ownership, its inspections, deficiencies and penalties, and the Care Compare provider information — each figure with the worksheet, line and column or file it came from.

In Care Compare’s provider information: Penalties: 2 · Fines: 2 · Fines, total amount: $107,746.00 · Payment denials: 0. The most recent penalty on file: October 30, 2024, Fine, $78,309. Every penalty on file ↓

For this facility: the citable document with full history — $295 · an email when this record changes — $99/month

Finances, as filed

From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.

Cost report for July 1, 2024 to June 30, 2025 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on January 20, 2026.

None of these figures is carried on this report.

CMS report record 1446762, read from the public cost report file SNF10FY2024.zip.

Fiscal year 2024, ended June 30, 2024

Cost report for July 1, 2023 to June 30, 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on February 19, 2025.

None of these figures is carried on this report.

CMS report record 1403884, read from the public cost report file SNF10FY2023.zip.

Fiscal year 2023, ended June 30, 2023

Cost report for July 1, 2022 to June 30, 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on March 20, 2024.

None of these figures is carried on this report.

CMS report record 1375281, read from the public cost report file SNF10FY2022.zip.

Fiscal year 2022, ended June 30, 2022

Cost report for July 1, 2021 to June 30, 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on March 14, 2023.

None of these figures is carried on this report.

CMS report record 1344307, read from the public cost report file SNF10FY2021.zip.

Fiscal year 2021, ended June 30, 2021

Cost report for July 1, 2020 to June 30, 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on February 11, 2022.

None of these figures is carried on this report.

CMS report record 1310320, read from the public cost report file SNF10FY2020.zip.

Fiscal year 2020, ended June 30, 2020

Cost report for July 1, 2019 to June 30, 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on April 21, 2021.

None of these figures is carried on this report.

CMS report record 1282682, read from the public cost report file SNF10FY2019.zip.

Fiscal year 2019, ended June 30, 2019

Cost report for July 1, 2018 to June 30, 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on January 16, 2020.

None of these figures is carried on this report.

CMS report record 1249419, read from the public cost report file SNF10FY2018.zip.

Fiscal year 2018, ended June 30, 2018

Cost report for July 1, 2017 to June 30, 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on November 21, 2018.

None of these figures is carried on this report.

CMS report record 1214219, read from the public cost report file SNF10FY2017.zip.

Fiscal year 2017, ended June 30, 2017

Cost report for July 1, 2016 to June 30, 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on October 20, 2017.

None of these figures is carried on this report.

CMS report record 1177397, read from the public cost report file SNF10FY2016.zip.

Fiscal year 2016, ended June 30, 2016

Cost report for July 1, 2015 to June 30, 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on October 26, 2016.

None of these figures is carried on this report.

CMS report record 1145443, read from the public cost report file SNF10FY2015.zip.

Fiscal year 2015, ended June 30, 2015

Cost report for July 1, 2014 to June 30, 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on October 30, 2015.

None of these figures is carried on this report.

CMS report record 1112128, read from the public cost report file SNF10FY2014.zip.

Fiscal year 2014, ended June 30, 2014

Cost report for July 1, 2013 to June 30, 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on December 12, 2014.

None of these figures is carried on this report.

CMS report record 1082622, read from the public cost report file SNF10FY2013.zip.

Fiscal year 2013, ended June 30, 2013

Cost report for July 1, 2012 to June 30, 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on February 3, 2014.

None of these figures is carried on this report.

CMS report record 1055115, read from the public cost report file SNF10FY2012.zip.

Fiscal year 2012, ended June 30, 2012

Cost report for July 1, 2011 to June 30, 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on November 12, 2012.

None of these figures is carried on this report.

CMS report record 1019475, read from the public cost report file SNF10FY2011.zip.

Fiscal year 2011, ended June 30, 2011

Cost report for July 1, 2010 to June 30, 2011 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on January 18, 2012.

None of these figures is carried on this report.

CMS report record 423095, read from the public cost report file SNFFY2010.zip.

Fiscal year 2010, ended June 30, 2010

Cost report for July 1, 2009 to June 30, 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on January 23, 2011.

None of these figures is carried on this report.

CMS report record 393008, read from the public cost report file SNFFY2009.zip.

Fiscal year 2009, ended June 30, 2009

Cost report for July 1, 2008 to June 30, 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on March 1, 2010.

None of these figures is carried on this report.

CMS report record 364648, read from the public cost report file SNFFY2008.zip.

Fiscal year 2008, ended June 30, 2008

Cost report for July 1, 2007 to June 30, 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on January 20, 2009.

None of these figures is carried on this report.

CMS report record 332033, read from the public cost report file SNFFY2007.zip.

Fiscal year 2007, ended June 30, 2007

Cost report for July 1, 2006 to June 30, 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on February 1, 2008.

None of these figures is carried on this report.

CMS report record 301588, read from the public cost report file SNFFY2006.zip.

Fiscal year 2006, ended June 30, 2006

Cost report for July 1, 2005 to June 30, 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on October 16, 2007.

None of these figures is carried on this report.

CMS report record 294780, read from the public cost report file SNFFY2005.zip.

Fiscal year 2005, ended June 30, 2005

Cost report for July 1, 2004 to June 30, 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on November 21, 2006.

None of these figures is carried on this report.

CMS report record 266814, read from the public cost report file SNFFY2004.zip.

Fiscal year 2004, ended June 30, 2004

Cost report for July 1, 2003 to June 30, 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on October 19, 2005.

None of these figures is carried on this report.

CMS report record 235072, read from the public cost report file SNFFY2003.zip.

Fiscal year 2003, ended June 30, 2003

Cost report for July 1, 2002 to June 30, 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on October 29, 2004.

None of these figures is carried on this report.

CMS report record 198456, read from the public cost report file SNFFY2002.zip.

Fiscal year 2002, ended June 30, 2002

Cost report for July 1, 2001 to June 30, 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on September 1, 2004.

None of these figures is carried on this report.

CMS report record 191369, read from the public cost report file SNFFY2001.zip.

Fiscal year 2001, ended June 30, 2001

Cost report for March 1, 2001 to June 30, 2001 — a reporting period of 121 days, not a full year, on form CMS-2540-96, settled, processed by CMS on February 13, 2003.

None of these figures is carried on this report.

CMS report record 131407, read from the public cost report file SNFFY2001.zip.

Nurse staffing

Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.

The staffing record →

Ownership, as filed with CMS

Care Compare

As filed in the CMS file dated September 1, 2026 (Care Compare ownership).

Owner or managerRoleTypeOwnership percentageAssociation
ELLEFSON, PATTYCORPORATE OFFICERIndividualNOT APPLICABLEsince 07/01/2014
JOHNSON, DEBORAHCORPORATE OFFICERIndividualNOT APPLICABLEsince 07/01/2014
MARTINSON, DAVIDCORPORATE OFFICERIndividualNOT APPLICABLEsince 07/01/2014
MCLEAN, STEVENCORPORATE OFFICERIndividualNOT APPLICABLEsince 07/01/2014
ROCKSWOLD, JASONCORPORATE OFFICERIndividualNOT APPLICABLEsince 07/01/2014
SCHLECHT, NATHANCORPORATE OFFICERIndividualNOT APPLICABLEsince 07/01/2014
WOYTASSEK, MARY KAYCORPORATE OFFICERIndividualNOT APPLICABLEsince 07/01/2014
KLEINGARTNER, ANDREAW-2 MANAGING EMPLOYEEIndividualNOT APPLICABLEsince 12/02/2014
LANG, SONYAW-2 MANAGING EMPLOYEEIndividualNOT APPLICABLEsince 12/02/2014

Medicare enrollment

As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of FOUR SEASONS HEALTHCARE CENTER INC (enrollment ID O20110316001001).

CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; where the private equity, real estate investment trust or holding company field below has not been filed under the current cycle, it reads “Paused by CMS”.

OwnerIndividual or organizationRoleOwnership percentageAssociation dateDescribed in the filing as
DAVID MARTINSONIndividualCORPORATE OFFICER14.297/1/2014
Private equity company: Paused by CMS
Real estate investment trust: Paused by CMS
Holding company: Paused by CMS
DEBORAH JOHNSONIndividualCORPORATE OFFICER14.297/1/2014
Private equity company: Paused by CMS
Real estate investment trust: Paused by CMS
Holding company: Paused by CMS
JASON ROCKSWOLDIndividualCORPORATE OFFICER14.297/1/2014
Private equity company: Paused by CMS
Real estate investment trust: Paused by CMS
Holding company: Paused by CMS
MARY KAY WOYTASSEKIndividualCORPORATE OFFICER14.297/1/2014
Private equity company: Paused by CMS
Real estate investment trust: Paused by CMS
Holding company: Paused by CMS
NATHAN SCHLECHTIndividualCORPORATE OFFICER14.297/1/2014
Private equity company: Paused by CMS
Real estate investment trust: Paused by CMS
Holding company: Paused by CMS
PATTY ELLEFSONIndividualCORPORATE OFFICER14.297/1/2014
Private equity company: Paused by CMS
Real estate investment trust: Paused by CMS
Holding company: Paused by CMS
STEVEN MCLEANIndividualCORPORATE OFFICER14.297/1/2014
Private equity company: Paused by CMS
Real estate investment trust: Paused by CMS
Holding company: Paused by CMS
ANDREA J KLEINGARTNERIndividualW-2 MANAGING EMPLOYEE012/2/2014
Private equity company: Paused by CMS
Real estate investment trust: Paused by CMS
Holding company: Paused by CMS
SONYA M LANGIndividualW-2 MANAGING EMPLOYEE012/2/2014
Private equity company: Paused by CMS
Real estate investment trust: Paused by CMS
Holding company: Paused by CMS

Changes in ownership

No change in ownership appears in the CMS files on record since September 20, 2022.

Recent changes on this record

  • January 20, 2026: A cost report was filed for fiscal year 2025, on form CMS-2540-10. SNF10FY2024.zip
  • February 19, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2023.zip
  • March 20, 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2022.zip
  • March 14, 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2021.zip
  • February 11, 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2020.zip
  • April 21, 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2019.zip
  • January 16, 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2018.zip
  • November 21, 2018: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2017.zip
  • October 20, 2017: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2016.zip
  • October 26, 2016: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2015.zip
  • October 30, 2015: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2014.zip
  • December 12, 2014: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2013.zip
  • February 3, 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2012.zip
  • November 12, 2012: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2011.zip
  • January 18, 2012: A cost report was filed for fiscal year 2011, on form CMS-2540-96. SNFFY2010.zip
  • January 23, 2011: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2009.zip
  • March 1, 2010: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2008.zip
  • January 20, 2009: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2007.zip
  • February 1, 2008: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2006.zip
  • October 16, 2007: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2005.zip
  • November 21, 2006: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2004.zip
  • October 19, 2005: A cost report was filed for fiscal year 2004, on form CMS-2540-96. SNFFY2003.zip
  • October 29, 2004: A cost report was filed for fiscal year 2003, on form CMS-2540-96. SNFFY2002.zip
  • September 1, 2004: A cost report was filed for fiscal year 2002, on form CMS-2540-96. SNFFY2001.zip
  • February 13, 2003: A cost report was filed for fiscal year 2001, on form CMS-2540-96. SNFFY2001.zip
  • February 12, 2002: A cost report was filed for fiscal year 2001, on form CMS-2540-96. SNFFY2000.zip

Inspections

Inspection cycleHealth inspectionFire safety inspectionHealth deficienciesFire safety deficiencies
1February 19, 2026February 19, 202693
2October 30, 2024October 30, 2024140
3November 8, 2023November 8, 202352

From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.

Deficiencies cited

29 deficiencies on file, newest inspection first
Inspection dateInspection typeTagCategoryWhat was citedScope and severityComplaintCorrectedCorrection date
May 19, 2026HealthF 0580Resident Rights DeficienciesImmediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.DYesDeficient, Provider has date of correctionJune 22, 2026
May 19, 2026HealthF 0689Quality of Life and Care DeficienciesEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.DYesDeficient, Provider has date of correctionJune 22, 2026
February 19, 2026HealthF 0640Resident Assessment and Care Planning DeficienciesEncode each resident’s assessment data and transmit these data to the State within 7 days of assessment.FNoDeficient, Provider has date of correctionApril 6, 2026
February 19, 2026HealthF 0641Resident Assessment and Care Planning DeficienciesEnsure each resident receives an accurate assessment.DNoDeficient, Provider has date of correctionApril 6, 2026
February 19, 2026HealthF 0657Resident Assessment and Care Planning DeficienciesDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.DNoDeficient, Provider has date of correctionApril 6, 2026
February 19, 2026HealthF 0684Quality of Life and Care DeficienciesProvide appropriate treatment and care according to orders, resident’s preferences and goals.DNoDeficient, Provider has date of correctionApril 6, 2026
February 19, 2026HealthF 0883Infection Control DeficienciesDevelop and implement policies and procedures for flu and pneumonia vaccinations.DNoDeficient, Provider has date of correctionApril 13, 2026
December 29, 2025HealthF 0689Quality of Life and Care DeficienciesEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.DYesDeficient, Provider has date of correctionJanuary 28, 2026
September 24, 2025HealthF 0600Freedom from Abuse, Neglect, and Exploitation DeficienciesProtect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.DYesDeficient, Provider has date of correctionSeptember 25, 2025
October 30, 2024HealthF 0584Resident Rights DeficienciesHonor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.EYesDeficient, Provider has date of correctionDecember 12, 2024
October 30, 2024HealthF 0625Resident Rights DeficienciesNotify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.DYesDeficient, Provider has date of correctionDecember 12, 2024
October 30, 2024HealthF 0641Resident Assessment and Care Planning DeficienciesEnsure each resident receives an accurate assessment.EYesDeficient, Provider has date of correctionJanuary 14, 2025
October 30, 2024HealthF 0644Resident Assessment and Care Planning DeficienciesCoordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.DYesDeficient, Provider has date of correctionDecember 12, 2024
October 30, 2024HealthF 0657Resident Assessment and Care Planning DeficienciesDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.DYesDeficient, Provider has date of correctionDecember 12, 2024
October 30, 2024HealthF 0658Resident Assessment and Care Planning DeficienciesEnsure services provided by the nursing facility meet professional standards of quality.DYesDeficient, Provider has date of correctionDecember 12, 2024
October 30, 2024HealthF 0684Quality of Life and Care DeficienciesProvide appropriate treatment and care according to orders, resident’s preferences and goals.GYesDeficient, Provider has date of correctionDecember 12, 2024
October 30, 2024HealthF 0689Quality of Life and Care DeficienciesEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.DYesDeficient, Provider has date of correctionDecember 12, 2024
October 30, 2024HealthF 0725Nursing and Physician Services DeficienciesProvide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.EYesDeficient, Provider has date of correctionDecember 12, 2024
October 30, 2024HealthF 0732Nursing and Physician Services DeficienciesPost nurse staffing information every day.CYesDeficient, Provider has date of correctionDecember 12, 2024
October 30, 2024HealthF 0761Pharmacy Service DeficienciesEnsure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.DYesDeficient, Provider has date of correctionDecember 12, 2024
October 30, 2024HealthF 0812Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.EYesDeficient, Provider has date of correctionDecember 12, 2024
October 30, 2024HealthF 0865Administration DeficienciesHave a plan that describes the process for conducting QAPI and QAA activities.FYesDeficient, Provider has date of correctionDecember 12, 2024
October 30, 2024HealthF 0880Infection Control DeficienciesProvide and implement an infection prevention and control program.DYesDeficient, Provider has date of correctionJanuary 14, 2025
November 8, 2023HealthF 0655Resident Assessment and Care Planning DeficienciesCreate and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedDNoDeficient, Provider has date of correctionDecember 19, 2023
November 8, 2023HealthF 0657Resident Assessment and Care Planning DeficienciesDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.DNoDeficient, Provider has date of correctionDecember 13, 2023
November 8, 2023HealthF 0658Resident Assessment and Care Planning DeficienciesEnsure services provided by the nursing facility meet professional standards of quality.DNoDeficient, Provider has date of correctionDecember 13, 2023
November 8, 2023HealthF 0679Quality of Life and Care DeficienciesProvide activities to meet all resident's needs.DNoDeficient, Provider has date of correctionDecember 13, 2023
November 8, 2023HealthF 0684Quality of Life and Care DeficienciesProvide appropriate treatment and care according to orders, resident’s preferences and goals.DNoDeficient, Provider has date of correctionDecember 13, 2023
August 30, 2023HealthF 0689Quality of Life and Care DeficienciesEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.GYesPast Non-ComplianceAugust 15, 2023

From the Care Compare health citations file NH_HealthCitations_Sep2026_2.csv, processed on September 1, 2026.

Penalties

Penalty dateTypeFine amountPayment denial beganPayment denial, daysFine ID
October 30, 2024Fine$78,30999657
November 8, 2023Fine$29,43799606
August 30, 2023Fine$7,73899608

From the Care Compare penalties file NH_Penalties_Sep2026_2.csv, processed on September 1, 2026.

Care Compare provider information

FieldAs filed
Provider TypeMedicare and Medicaid
Ownership TypeNon profit - Corporation
Legal Business NameFOUR SEASONS HEALTHCARE CENTER INC
Date First Approved to Provide Medicare and Medicaid Services1991-05-01
Provider Resides in HospitalN
Continuing Care Retirement CommunityN
UrbanN
County/ParishSargent
Telephone Number7017246211
Provider Changed Ownership in Last 12 MonthsN
With a Resident and Family CouncilResident
Automatic Sprinkler Systems in All Required AreasYes
Number of Certified Beds25
Average Number of Residents per Day23.3
Overall Rating1
Health Inspection Rating2
QM Rating4
Long-Stay QM Rating4
Processing Date2026-09-01

From the Care Compare Provider Information file NH_ProviderInfo_Sep2026_3.csv, processed on September 1, 2026.

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One email a day naming what moved on FOUR SEASONS HEALTH CARE INC: the field, the value before, the value after, and the date of the file that first showed it.

The facility alert follows this one record: a cost report filed or a figure on one changed, an inspection, a deficiency or a penalty recorded, an owner added or removed. The certification number arrives filled in.

On January 20, 2026: A cost report was filed for fiscal year 2025, on form CMS-2540-10. That is one line of the alert.

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The citable document for FOUR SEASONS HEALTH CARE INC

This page shows the record as it stands today. The report is the citable document: the same figures with the cell each came from, and beyond this page — five facilities of a similar size in North Dakota at the same fiscal year, listed by name; every change on the record rather than the recent ones below; the inspection and staffing history in blocks of their own; and a citation block naming every CMS file it was read from.

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