Adams County, North Dakota · Nursing home
Western Horizons Care Center
1 of 5 overall from CMS
1104 Hwy 12, Hettinger, ND 58639
At a glance
- Overall rating 1 of 5 Below the state average of 3.2
- Nurse time per resident, per day 4.75 hours Above the state average of 4.42
- Nursing staff who left in a year Not reported
- Health citations, last 3 inspection cycles 35 5 at the harm level or above
- Fines in 3 years $63,485 3 fines
- Certified beds in use 92.3% of 31 beds, on an average day
Arrows only show whether a figure is above or below the state average. They are not a judgment of the home.
Western Horizons Care Center is a 31-bed nursing home in Hettinger, North Dakota (Adams County). CMS rates it 1 of 5 stars overall as of Sep 2026. It reports 4.75 nurse staffing hours per resident per day, above the North Dakota average of 4.42. CMS lists 3 fines totaling $63,485 in the past three years.
- Certified beds
- 31
- Residents per day (average)
- 28.6
- Certified since
- 1978 (48 yrs)
Non profit - Corporation Participates in Medicare and MedicaidCMS abuse citation icon: Yes
Bed use is this site's calculation: average residents per day divided by certified beds. It is an average, so it does not show today's openings.
- Abuse citation icon. CMS assigns this icon when a home was cited for abuse where residents were found to be harmed, on its most recent standard inspection or on a complaint or infection-control inspection in the past 12 months, or was cited for abuse with potential harm in that period and again in the period before. Signs of abuse and how to report it
These labels are shown as CMS publishes them. They describe the inspection record, not what has changed since.
Terms used on this page
- CMS
- The Centers for Medicare & Medicaid Services, the federal agency that publishes the ratings, staffing figures, inspection results and penalties shown here.
- Certified beds
- The number of federally certified beds CMS lists for the home.
- Deficiency or citation
- A federal requirement that inspectors found the home did not meet. Each one gets a letter from A to L for how serious it was and how many residents were affected. What the letters mean
- Actual harm
- Letters G, H and I: actual harm to a resident that is not immediate jeopardy.
- Immediate jeopardy
- Letters J, K and L: the problem caused, or was likely to cause, serious injury, harm, impairment or death to a resident.
- Inspection cycle
- A standard inspection plus the complaint and infection-control citations CMS assigns to it. This page shows the three most recent cycles.
- Special Focus Facility (SFF)
- A home CMS has placed under closer oversight because of its inspection record. More about the program
Questions to ask Western Horizons Care Center
Chosen from this home's public data.
- CMS lists 3 fines totaling $63,485 in the past three years. What changed after the most recent one?Penalties in CMS data
- CMS counts 9 health deficiencies in the latest inspection cycle (the standard inspection on Sep 4, 2025 plus complaint and infection-control inspections); the North Dakota average is 5.6. Which have been corrected?Inspection results in CMS data
- Reported nurse staffing is 4.02 hours per resident on weekends against 4.75 overall. Who covers Saturdays and Sundays?Weekend staffing in CMS data
More in what to ask on a nursing home tour.
CMS star ratings
- Overall 1 of 5 North Dakota average 3.2
- Health inspections 1 of 5 North Dakota average 2.8
- Staffing 3 of 5 North Dakota average 4.2
- Quality measures 1 of 5 North Dakota average 2.7
The vertical line marks the North Dakota average. Ratings run from 1 to 5. How to read CMS star ratings
Nurse staffing
Hours of care per resident per day, as the home reported to CMS.
What these roles do
Nurse aides give most hands-on daily care, such as help with bathing, dressing and meals. Licensed practical nurses give medications and routine nursing care. Registered nurses assess residents and direct their care.
- All nursing staff 4.75 h North Dakota average 4.42
- Nurse aides 3.50 h North Dakota average 2.97
- Licensed practical nurses 0.56 h North Dakota average 0.52
- Registered nurses 0.69 h North Dakota average 0.93
- All staff, weekends 4.02 h North Dakota average 3.80
How much nurse staffing is enough? All bars share one scale, 0 to 7 hours. The vertical line marks the North Dakota average; the national average for all nursing staff is 3.86 hours.
- Nursing staff turnoverNot reported
- North Dakota average48.8%
- Registered nurse turnoverNot reported
- North Dakota average40.3%
Quality measures
CMS calculates these from residents' assessments and Medicare claims. They are shown as published, next to the North Dakota and national averages. marks the measures CMS uses in its quality star rating; for those, the rating gives more points for a lower rate.
Long-stay residents
| Measure | This home | North Dakota | U.S. |
|---|---|---|---|
| ★ Percentage of long-stay residents whose need for help with daily activities has increased | 16.2% | 19.8% | 13.9% |
| Percentage of long-stay residents who lose too much weight | 4.5% | 5.8% | 5.2% |
| ★ Percentage of long-stay residents with a catheter inserted and left in their bladder | 1.0% | 1.6% | 0.8% |
| ★ Percentage of long-stay residents with a urinary tract infection | 8.0% | 2.6% | 1.6% |
| Percentage of long-stay residents who have depressive symptoms | 13.0% | 4.4% | 12.8% |
| Percentage of long-stay residents who were physically restrained | 0.0% | 0.2% | 0.1% |
| ★ Percentage of long-stay residents experiencing one or more falls with major injury | 7.3% | 5.1% | 3.2% |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 96.8% | 98.6% | 93.6% |
| ★ Percentage of long-stay residents whose ability to walk independently worsened | 19.0% | 17.6% | 14.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 26.9% | 17.4% | 19.5% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 91.7% | 98.8% | 95.5% |
| ★ Percentage of long-stay residents with pressure ulcers | 7.0% | 4.9% | 4.6% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 32.7% | 24.9% | 19.0% |
| ★ Percentage of long-stay residents who received an antipsychotic medication | 35.9% | 22.7% | 15.4% |
| ★ Number of hospitalizations per 1000 long-stay resident days | 2.36 | 1.49 | 1.90 |
| ★ Number of outpatient emergency department visits per 1000 long-stay resident days | 3.99 | 1.86 | 1.78 |
Short-stay residents
| Measure | This home | North Dakota | U.S. |
|---|---|---|---|
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 81.4% | 92.3% | 82.0% |
| ★ Percentage of short-stay residents who newly received an antipsychotic medication | Too few residents or stays to report | 1.5% | 1.6% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | Too few residents or stays to report | 88.3% | 79.8% |
| ★ Percentage of short-stay residents who were rehospitalized after a nursing home admission | Too few residents or stays to report | 19.9% | 23.8% |
| ★ Percentage of short-stay residents who had an outpatient emergency department visit | Too few residents or stays to report | 11.4% | 12.0% |
Measure periods: April 2025 to March 2026 for most measures; July 2024 to June 2025 for the flu vaccine measures; January to December 2025 for the hospital and emergency department measures, which CMS risk-adjusts. See the measures on Medicare.gov
Inspection history
Inspectors cited 35 health deficiencies in the three most recent inspection cycles. Of these, 1 was at the immediate jeopardy level and 4 involved actual harm; the rest were graded as no actual harm. 9 were cited in connection with a complaint investigation. The most recent citation at the harm level or above was on Apr 28, 2026: Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
| Standard inspection | Health | Fire safety |
|---|---|---|
| Sep 4, 2025 | 9 | 4 |
| Jul 24, 2024 | 15 | 3 |
| Aug 29, 2023 | 11 | 2 |
North Dakota homes averaged 5.6 health deficiencies in the latest cycle; the national average is 9.2. Each cycle's health count covers the standard inspection on that date plus the complaint and infection-control citations CMS assigns to that cycle.
Health citations, three most recent inspection cycles (35)
-
GActual harm, isolated
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Complaint investigation · Quality of Life and Care · Past Non-Compliance (Mar 24, 2026)
-
GActual harm, isolated
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Past Non-Compliance
-
GActual harm, isolated
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Sep 5, 2025)
-
EPotential for more than minimal harm, pattern
Ensure 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.
Complaint investigation · Pharmacy Service · Deficient, Provider has date of correction (Sep 26, 2025)
-
DPotential for more than minimal harm, isolated
Keep residents' personal and medical records private and confidential.
Resident Rights · Deficient, Provider has date of correction (Sep 26, 2025)
Show 25 more
-
DPotential for more than minimal harm, isolated
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Complaint investigation · Resident Rights · Deficient, Provider has date of correction (Nov 26, 2025)
-
DPotential for more than minimal harm, isolated
Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning · Deficient, Provider has date of correction (Sep 26, 2025)
-
DPotential for more than minimal harm, isolated
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Nutrition and Dietary · Deficient, Provider has date of correction (Sep 26, 2025)
-
DPotential for more than minimal harm, isolated
Provide and implement an infection prevention and control program.
Infection Control · Deficient, Provider has date of correction (Sep 26, 2025)
-
GActual harm, isolated
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Feb 7, 2025)
-
DPotential for more than minimal harm, isolated
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Deficient, Provider has date of correction (Nov 21, 2024)
-
DPotential for more than minimal harm, isolated
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Deficient, Provider has date of correction (Nov 21, 2024)
-
EPotential for more than minimal harm, pattern
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary · Deficient, Provider has date of correction (Aug 21, 2024)
-
EPotential for more than minimal harm, pattern
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Environmental · Deficient, Provider has date of correction (Aug 28, 2024)
-
EPotential for more than minimal harm, pattern
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Environmental · Deficient, Provider has date of correction (Aug 28, 2024)
-
DPotential for more than minimal harm, isolated
Allow residents to self-administer drugs if determined clinically appropriate.
Resident Rights · Deficient, Provider has date of correction (Aug 21, 2024)
-
DPotential for more than minimal harm, isolated
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Resident Rights · Deficient, Provider has date of correction (Aug 16, 2024)
-
DPotential for more than minimal harm, isolated
Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning · Deficient, Provider has date of correction (Aug 27, 2024)
-
DPotential for more than minimal harm, isolated
PASARR screening for Mental disorders or Intellectual Disabilities
Resident Assessment and Care Planning · Deficient, Provider has date of correction (Aug 16, 2024)
-
DPotential for more than minimal harm, isolated
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Resident Assessment and Care Planning · Deficient, Provider has date of correction (Aug 21, 2024)
-
DPotential for more than minimal harm, isolated
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care · Deficient, Provider has date of correction (Aug 5, 2024)
-
DPotential for more than minimal harm, isolated
Provide care or services that was trauma informed and/or culturally competent.
Quality of Life and Care · Deficient, Provider has date of correction (Aug 21, 2024)
-
DPotential for more than minimal harm, isolated
Provide routine and 24-hour emergency dental care for each resident.
Quality of Life and Care · Deficient, Provider has date of correction (Aug 31, 2024)
-
DPotential for more than minimal harm, isolated
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Nutrition and Dietary · Deficient, Provider has date of correction (Aug 27, 2024)
-
DPotential for more than minimal harm, isolated
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Complaint investigation · Quality of Life and Care · Past Non-Compliance (Jun 11, 2024)
-
KImmediate jeopardy, pattern
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care · Deficient, Provider has date of correction (Oct 6, 2023)
-
FPotential for more than minimal harm, widespread
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Infection Control · Deficient, Provider has date of correction (Oct 6, 2023)
-
EPotential for more than minimal harm, pattern
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Resident Assessment and Care Planning · Deficient, Provider has date of correction (Oct 6, 2023)
-
EPotential for more than minimal harm, pattern
Provide and implement an infection prevention and control program.
Infection Control · Deficient, Provider has date of correction (Oct 6, 2023)
-
DPotential for more than minimal harm, isolated
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Resident Rights · Deficient, Provider has date of correction (Oct 6, 2023)
Showing the 30 most recent of 35.
What severity letters A to L mean
Each sentence above is the requirement that was not met, in CMS's wording. For the inspection results as Medicare publishes them, open this home's page on Medicare.gov and look under "Health inspections".
Penalties, past three years
| Date | Type | Amount |
|---|---|---|
| Apr 28, 2026 | Fine | $19,635 |
| Sep 4, 2025 | Fine | $17,252 |
| Jan 16, 2025 | Fine | $26,598 |
North Dakota homes averaged 1.1 fines and $27,629 in fine amounts; the national averages are 0.9 and $30,972.
Cost
Not in the public data. CMS does not publish what a nursing home charges.
Ask the home for its daily private-pay rate and whether a bed is open for your coverage. See what Medicare covers and how Medicaid pays for a nursing home.
Compared within North Dakota
- Size61 of 72 by certified beds
- North Dakota average residents per day63.3
- ChainNone listed
- Resident or family councilResident
- Homes in Adams County1
Common questions
What is the CMS star rating for Western Horizons Care Center?
Western Horizons Care Center has an overall rating of 1 of 5 stars from CMS as of Sep 2026. Its health inspection rating is 1, staffing is 3 and quality measures is 1.
How many beds does Western Horizons Care Center have?
Western Horizons Care Center has 31 certified beds. It averages 28.6 residents per day, about 92.3% of its certified beds.
How much nursing care do residents get at Western Horizons Care Center?
The home reports 4.75 hours of nurse staffing per resident per day, including 0.69 hours from registered nurses. The North Dakota average is 4.42 hours and 0.93 hours from registered nurses.
Has Western Horizons Care Center been fined?
Yes. CMS lists 3 fines totaling $63,485 in the past three years.
Does Western Horizons Care Center accept Medicare or Medicaid?
CMS lists its participation as "Medicare and Medicaid". Ask the home whether a bed is open for your coverage.
Guides for families looking at this home
- Understanding the recordWhat to ask on a nursing home tourQuestions that turn a home's public record into a useful conversation when you tour, plus what to look for yourself.
- Understanding the recordInspection severity letters A to LHow inspectors grade each deficiency by harm and by how many residents were affected.
- Understanding the recordHow to read CMS star ratingsWhat the overall, health inspection, staffing and quality measure ratings cover, and what they leave out.
Nearest nursing homes
- 1 of 5 Five Counties Nursing Home 38beds 90.8%in use 2.90nurse hours a day
- 5 of 5 St Benedicts Health Center 124beds 91.9%in use 3.75nurse hours a day
- 5 of 5 St Lukes Home 88beds 98.0%in use 6.30nurse hours a day
Sorted by straight-line distance. This is not a ranking or a recommendation. Compare all homes in Adams County
Source: CMS Provider Data Catalog, nursing home datasets processed Sep 1, 2026. CMS Certification Number 355042. See this home's official record on Medicare.gov
See something shown incorrectly? Tell us. This site shows each record as CMS publishes it and cannot change the underlying record.