Sargent County, North Dakota · Nursing home
Four Seasons Health Care Inc
1 of 5 overall from CMS
483 4th St SW, Forman, ND 58032
At a glance
- Overall rating 1 of 5 Below the state average of 3.2
- Nurse time per resident, per day Not reported
- Nursing staff who left in a year Not reported
- Health citations, last 3 inspection cycles 28 1 at the harm level or above
- Fines in 3 years $107,746 2 fines
- Certified beds in use 93.2% of 25 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.
Four Seasons Health Care Inc is a 25-bed nursing home in Forman, North Dakota (Sargent County). CMS rates it 1 of 5 stars overall as of Sep 2026. CMS lists 2 fines totaling $107,746 in the past three years.
- Certified beds
- 25
- Residents per day (average)
- 23.3
- Certified since
- 1991 (35 yrs)
Non profit - Corporation Participates in Medicare and Medicaid
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.
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 Four Seasons Health Care Inc
Chosen from this home's public data.
- CMS lists 2 fines totaling $107,746 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 Feb 19, 2026 plus complaint and infection-control inspections); the North Dakota average is 5.6. Which have been corrected?Inspection results in CMS data
- What is the daily private-pay rate, and are Medicaid beds available now?CMS does not publish prices
More in what to ask on a nursing home tour.
CMS star ratings
- Overall 1 of 5 North Dakota average 3.2
- Health inspections 2 of 5 North Dakota average 2.8
- Staffing 1 of 5 North Dakota average 4.2
- Quality measures 4 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 Not reported North Dakota average 4.42
- Nurse aides Not reported North Dakota average 2.97
- Licensed practical nurses Not reported North Dakota average 0.52
- Registered nurses Not reported North Dakota average 0.93
- All staff, weekends Not reported 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 | 19.5% | 19.8% | 13.9% |
| Percentage of long-stay residents who lose too much weight | 0.0% | 5.8% | 5.2% |
| ★ Percentage of long-stay residents with a catheter inserted and left in their bladder | 1.2% | 1.6% | 0.8% |
| ★ Percentage of long-stay residents with a urinary tract infection | 2.4% | 2.6% | 1.6% |
| Percentage of long-stay residents who have depressive symptoms | 1.1% | 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 | 3.3% | 5.1% | 3.2% |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 97.8% | 98.6% | 93.6% |
| ★ Percentage of long-stay residents whose ability to walk independently worsened | 20.3% | 17.6% | 14.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 14.3% | 17.4% | 19.5% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 96.4% | 98.8% | 95.5% |
| ★ Percentage of long-stay residents with pressure ulcers | 0.0% | 4.9% | 4.6% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 26.4% | 24.9% | 19.0% |
| ★ Percentage of long-stay residents who received an antipsychotic medication | 53.5% | 22.7% | 15.4% |
| ★ Number of hospitalizations per 1000 long-stay resident days | Too few residents or stays to report | 1.49 | 1.90 |
| ★ Number of outpatient emergency department visits per 1000 long-stay resident days | Too few residents or stays to report | 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 | 83.3% | 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 28 health deficiencies in the three most recent inspection cycles. Of these, 1 involved actual harm; the rest were graded as no actual harm. 18 were cited in connection with a complaint investigation. The most recent citation at the harm level or above was on Oct 30, 2024: Provide appropriate treatment and care according to orders, resident’s preferences and goals.
| Standard inspection | Health | Fire safety |
|---|---|---|
| Feb 19, 2026 | 9 | 3 |
| Oct 30, 2024 | 14 | 0 |
| Nov 8, 2023 | 5 | 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 (28)
-
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.
Complaint investigation · Resident Rights · Deficient, Provider has date of correction (Jun 22, 2026)
-
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 · Deficient, Provider has date of correction (Jun 22, 2026)
-
FPotential for more than minimal harm, widespread
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Resident Assessment and Care Planning · Deficient, Provider has date of correction (Apr 6, 2026)
-
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 (Apr 6, 2026)
-
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 (Apr 6, 2026)
Show 23 more
-
DPotential for more than minimal harm, isolated
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care · Deficient, Provider has date of correction (Apr 6, 2026)
-
DPotential for more than minimal harm, isolated
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Infection Control · Deficient, Provider has date of correction (Apr 13, 2026)
-
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 · Deficient, Provider has date of correction (Jan 28, 2026)
-
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 (Sep 25, 2025)
-
GActual harm, isolated
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Dec 12, 2024)
-
FPotential for more than minimal harm, widespread
Have a plan that describes the process for conducting QAPI and QAA activities.
Complaint investigation · Administration · Deficient, Provider has date of correction (Dec 12, 2024)
-
EPotential for more than minimal harm, pattern
Honor 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.
Complaint investigation · Resident Rights · Deficient, Provider has date of correction (Dec 12, 2024)
-
EPotential for more than minimal harm, pattern
Ensure each resident receives an accurate assessment.
Complaint investigation · Resident Assessment and Care Planning · Deficient, Provider has date of correction (Jan 14, 2025)
-
EPotential for more than minimal harm, pattern
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Complaint investigation · Nursing and Physician Services · Deficient, Provider has date of correction (Dec 12, 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.
Complaint investigation · Nutrition and Dietary · Deficient, Provider has date of correction (Dec 12, 2024)
-
DPotential for more than minimal harm, isolated
Notify 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.
Complaint investigation · Resident Rights · Deficient, Provider has date of correction (Dec 12, 2024)
-
DPotential for more than minimal harm, isolated
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Complaint investigation · Resident Assessment and Care Planning · Deficient, Provider has date of correction (Dec 12, 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.
Complaint investigation · Resident Assessment and Care Planning · Deficient, Provider has date of correction (Dec 12, 2024)
-
DPotential for more than minimal harm, isolated
Ensure services provided by the nursing facility meet professional standards of quality.
Complaint investigation · Resident Assessment and Care Planning · Deficient, Provider has date of correction (Dec 12, 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 · Deficient, Provider has date of correction (Dec 12, 2024)
-
DPotential for more than minimal harm, isolated
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 (Dec 12, 2024)
-
DPotential for more than minimal harm, isolated
Provide and implement an infection prevention and control program.
Complaint investigation · Infection Control · Deficient, Provider has date of correction (Jan 14, 2025)
-
CPotential for minimal harm, widespread
Post nurse staffing information every day.
Complaint investigation · Nursing and Physician Services · Deficient, Provider has date of correction (Dec 12, 2024)
-
DPotential for more than minimal harm, isolated
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Resident Assessment and Care Planning · Deficient, Provider has date of correction (Dec 19, 2023)
-
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 (Dec 13, 2023)
-
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 (Dec 13, 2023)
-
DPotential for more than minimal harm, isolated
Provide activities to meet all resident's needs.
Quality of Life and Care · Deficient, Provider has date of correction (Dec 13, 2023)
-
DPotential for more than minimal harm, isolated
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care · Deficient, Provider has date of correction (Dec 13, 2023)
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 |
|---|---|---|
| Oct 30, 2024 | Fine | $78,309 |
| Nov 8, 2023 | Fine | $29,437 |
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
- Size71 of 72 by certified beds
- North Dakota average residents per day63.3
- ChainNone listed
- Resident or family councilResident
- Homes in Sargent County1
Common questions
What is the CMS star rating for Four Seasons Health Care Inc?
Four Seasons Health Care Inc has an overall rating of 1 of 5 stars from CMS as of Sep 2026. Its health inspection rating is 2, staffing is 1 and quality measures is 4.
How many beds does Four Seasons Health Care Inc have?
Four Seasons Health Care Inc has 25 certified beds. It averages 23.3 residents per day, about 93.2% of its certified beds.
Has Four Seasons Health Care Inc been fined?
Yes. CMS lists 2 fines totaling $107,746 in the past three years.
Does Four Seasons Health Care Inc 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
- 5 of 5 North Dakota Veterans Home 52beds 95.4%in use 5.07nurse hours a day
- 2 of 5 Good Samaritan Society - Oakes 46beds 95.0%in use 3.23nurse hours a day
- 3 of 5 Wheatcrest Hills Healthcare Center 60beds 72.8%in use 2.69nurse hours a day
Sorted by straight-line distance. This is not a ranking or a recommendation. Compare all homes in Sargent County
Source: CMS Provider Data Catalog, nursing home datasets processed Sep 1, 2026. CMS Certification Number 355103. 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.