SNF
BETHANY ON 42ND
CCN: 355123 · FARGO, ND 58104 · Cass County
Overview
- Address
- 4255 30TH AVE S, FARGO, ND 58104
- Phone
- 7014788900
- Certified beds
- 116
- Avg daily residents
- 114 (98% of beds filled)
- Ownership
- Non-profit corporation
- Provider type
- Medicare and Medicaid
- Medicare/Medicaid since
- 2010-01-20
- Setting
- Urban
5 /5
★★★★★
CMS Overall Rating
CMS 5-Star Ratings
CMS rates every Medicare/Medicaid-certified nursing home on four domains. The Overall rating is driven primarily by Health Inspection results, then adjusted up or down by Staffing and Quality Measures.
Staffing & Workforce
Direct-care staffing is the strongest operational driver of quality in nursing homes. Values are hours per resident per day, derived from payroll-based journal (PBJ) submissions. "Case-mix" adjusts for resident acuity; "Adjusted" is the CMS rating-input value.
| Role | Reported | Case-mix expected | Adjusted | Federal floor | |
|---|---|---|---|---|---|
| Total nurse All nursing staff combined: RN + LPN + Aide | 5.27 | 3.92 | 5.20 | ≥ 3.48 | |
| Registered Nurse (RN) Licensed RN hours. Strongest driver of clinical outcomes. | 0.62 | 0.69 | 0.61 | ≥ 0.55 | |
| Licensed Practical Nurse (LPN) LPN/LVN hours. Often handles medication administration. | 0.88 | 0.87 | 0.87 | — | |
| Nurse aide CNA hours. Bulk of direct resident care — bathing, feeding, mobility. | 3.77 | 2.36 | 3.72 | — | |
| Licensed (RN + LPN) Combined licensed nurse coverage. | 1.50 | — | — | — | |
| Physical therapist Rehabilitation therapist hours — important for post-acute / rehab admissions. | 0.03 | — | — | — |
Federal minimums (phasing in under the CMS 2024 minimum staffing rule) shown for reference. RN: 0.55 hrs/resident/day. Total nurse: 3.48 hrs/resident/day.
Weekend staffing
Total nurse (weekend)
4.79
hrs / resident / day
RN (weekend)
0.48
hrs / resident / day
Total nurse (adjusted, weekend)
4.72
hrs / resident / day
Weekend under-staffing is a common quality-of-care concern — adverse events are more frequent when licensed coverage drops.
Staff turnover
Total nursing staff turnover
56.7%
annual
RN turnover
45.8%
annual
Administrators departed
0
last 12 months
Resident acuity
Nursing Case-Mix Index
1.39
higher acuity than avg
Case-Mix Index Ratio
1.01
facility / state ratio
Health Inspections
CMS weights three inspection cycles to compute the Health Inspection rating: the most recent (50%), the second most recent (33%), and the oldest (17%). Each standard-survey deficiency is assigned a score based on scope and severity; complaint-survey findings and revisit scores are added to produce the cycle total.
| Cycle | Date | Total defs. | Standard | Complaint | Deficiency score | Revisits | Total score |
|---|---|---|---|---|---|---|---|
| Cycle 1 (most recent) | 2025-05-01 | 1 | 1 | 1 | 4 | 1 | 4 |
| Cycle 2/3 (prior) | 2024-03-14 | 10 | 2 | 8 | 68 | 1 | 68 |
Total weighted health score
20.0
lower is better
Deficiencies (11)
Individual survey findings. Scope/severity uses the CMS A–L matrix: letters further down the alphabet indicate greater harm and wider scope, up through J–L (immediate jeopardy).
11 D/E/F Actual harm — potential for minor
| Tag | Description | Scope/Severity | Survey date | Corrected |
|---|---|---|---|---|
| 0880 | Provide and implement an infection prevention and control program. | D | 2025-05-01 | 2025-05-23 |
| 0640 | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. | D | 2024-03-14 | 2024-04-01 |
| 0641 | Ensure each resident receives an accurate assessment. | E | 2024-03-14 | 2024-04-01 |
| 0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | 2023-03-30 | 2023-05-03 |
| 0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2023-03-30 | 2023-05-03 |
| 0641 | Ensure each resident receives an accurate assessment. | E | 2023-03-30 | 2023-05-03 |
| 0688 | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | D | 2023-03-30 | 2023-05-03 |
| 0760 | Ensure that residents are free from significant medication errors. | E | 2023-03-30 | 2023-05-03 |
| 0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | 2023-03-30 | 2023-05-03 |
| 0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | 2023-03-30 | 2023-05-03 |
| 0880 | Provide and implement an infection prevention and control program. | E | 2023-03-30 | 2023-05-03 |
Financial Health (FY 2023)
Payer mix (share of resident days)
Medicare 5.6% Medicaid 52.7% Other 41.7%
Operating performance
Operating Margin
0.3%
Total Margin
2.0%
Occupancy Rate
99.4%
Cost per Resident Day
$27
Revenue & costs
Net Patient Revenue
$20.5M
Total Costs
$1.1M
Net Income
$423K
Balance sheet
Total Assets
$44.4M
Total Liabilities
$30.8M
Fund Balance
$13.5M
Current Ratio
2.23
Source: CMS SNF Cost Report (FY 2023). Cost report data lags by ~2 years.
Ownership & Corporate Structure
Owner / manager organizations (6)
| Organization | Role | Association |
|---|---|---|
| BELL BANK ARROWHEAD OFFICE | OPERATIONAL/MANAGERIAL CONTROL | since 03/01/1996 |
| BETHANY HOMES, INC | OPERATIONAL/MANAGERIAL CONTROL | since 01/01/2009 |
| BETHANY ON 42ND | OPERATIONAL/MANAGERIAL CONTROL | since 01/14/2010 |
| BLUE STONE THERAPY INC | OPERATIONAL/MANAGERIAL CONTROL | since 05/01/2019 |
| EIDE BAILLY LLP | OPERATIONAL/MANAGERIAL CONTROL | since 01/01/1998 |
| BELL BANK ARROWHEAD OFFICE | 5% OR GREATER MORTGAGE INTEREST | since 04/01/2010 |
Owner / manager individuals (16)
| Name | Role | Association |
|---|---|---|
| ANGUS, KAYE | OPERATIONAL/MANAGERIAL CONTROL | since 10/01/2022 |
| GUPTA, PARUL | OPERATIONAL/MANAGERIAL CONTROL | since 10/01/2020 |
| STUHAUG, SHAWN | OPERATIONAL/MANAGERIAL CONTROL | since 06/23/2009 |
| ANDERSON, CHERYL | CORPORATE DIRECTOR | since 04/18/2023 |
| BRANTNER-ADAMS, JERILYNN | CORPORATE DIRECTOR | since 04/18/2023 |
| DAVIDSON, BRUCE | CORPORATE DIRECTOR | since 05/13/2025 |
| HERTSGAARD, JOHN | CORPORATE DIRECTOR | since 04/09/2024 |
| NESS OWENS, LAURA | CORPORATE DIRECTOR | since 04/09/2024 |
| OLSON, ROGER | CORPORATE DIRECTOR | since 04/19/2022 |
| RENNER, BETH | CORPORATE DIRECTOR | since 04/18/2023 |
| ROCKSTAD, LIANNE | CORPORATE DIRECTOR | since 04/09/2024 |
| RYDELL, JACK | CORPORATE DIRECTOR | since 05/13/2025 |
| STEEN, RICK | CORPORATE DIRECTOR | since 04/09/2024 |
| WENDT, JOSEPH | CORPORATE DIRECTOR | since 05/13/2025 |
| ANGUS, KAYE | CORPORATE OFFICER | since 10/01/2022 |
| STUHAUG, SHAWN | CORPORATE OFFICER | since 06/23/2009 |
Source: CMS Nursing Home Ownership. Percent ownership is rarely disclosed — CMS only requires it for specific roles.
Facility Features
- CCRC
- No
- Hospital-based
- No
- Resident / family council
- Resident
- Sprinkler systems
- Yes
- Abuse citation flag
- No
Methodology & sources
- Nursing Home Provider Info (
nh-provider-info), vintage 2026, downloaded 2026-04-14 , 14,703 rows. - Nursing Home Health Deficiencies (
nh-deficiencies), vintage 2026, downloaded 2026-04-14 , 418,972 rows. - Nursing Home Ownership (
nh-ownership), vintage 2026, downloaded 2026-04-14 , 160,393 rows. - Skilled Nursing Facility Cost Report (
snf-cost-report), vintage 2023, downloaded 2026-04-14 , 14,120 rows.
All Data
Every labeled field shipped for this facility by CMS. No national median or percentile context is available for SNFs in the current release.
Show 113 rows
| Source | Metric | Value | Raw key |
|---|---|---|---|
| Cost Report | Cost per Resident Day ($) | $27 | metrics.cost_per_resident_day |
| Cost Report | Current Ratio | 2.23 | metrics.current_ratio |
| Cost Report | fiscal_year | 2,023 | fiscal_year |
| Cost Report | Medicaid Day Share (%) | 52.7% | metrics.medicaid_day_share |
| Cost Report | Medicare Day Share (%) | 5.6% | metrics.medicare_day_share |
| Cost Report | Net Income ($) | $422,669 | metrics.net_income |
| Cost Report | Net Patient Revenue ($) | $20,507,351 | metrics.net_patient_revenue |
| Cost Report | Occupancy Rate (%) | 99.4% | metrics.occupancy_rate |
| Cost Report | Operating Margin (%) | 0.3% | metrics.operating_margin |
| Cost Report | Total Assets ($) | $44,353,121 | metrics.total_assets |
| Cost Report | Total Costs ($) | $1,144,202 | metrics.total_costs |
| Cost Report | Total Fund Balances ($) | $13,535,938 | metrics.fund_balance |
| Cost Report | Total Liabilities ($) | $30,817,183 | metrics.total_liabilities |
| Cost Report | Total Margin (%) | 2.0% | metrics.total_margin |
| Provider Information | Abuse Icon | N | Abuse Icon |
| Provider Information | Adjusted LPN Staffing Hours per Resident per Day | 0.87148 | Adjusted LPN Staffing Hours per Resident per Day |
| Provider Information | Adjusted Nurse Aide Staffing Hours per Resident per Day | 3.71588 | Adjusted Nurse Aide Staffing Hours per Resident per Day |
| Provider Information | Adjusted RN Staffing Hours per Resident per Day | 0.60871 | Adjusted RN Staffing Hours per Resident per Day |
| Provider Information | Adjusted Total Nurse Staffing Hours per Resident per Day | 5.19607 | Adjusted Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Adjusted Weekend Total Nurse Staffing Hours per Resident per Day | 4.71751 | Adjusted Weekend Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Administrator turnover footnote | — | Administrator turnover footnote |
| Provider Information | Automatic Sprinkler Systems in All Required Areas | Yes | Automatic Sprinkler Systems in All Required Areas |
| Provider Information | Average Number of Residents per Day | 114.2 | Average Number of Residents per Day |
| Provider Information | Average Number of Residents per Day Footnote | — | Average Number of Residents per Day Footnote |
| Provider Information | Case-Mix LPN Staffing Hours per Resident per Day | 0.86969 | Case-Mix LPN Staffing Hours per Resident per Day |
| Provider Information | Case-Mix Nurse Aide Staffing Hours per Resident per Day | 2.36363 | Case-Mix Nurse Aide Staffing Hours per Resident per Day |
| Provider Information | Case-Mix RN Staffing Hours per Resident per Day | 0.68551 | Case-Mix RN Staffing Hours per Resident per Day |
| Provider Information | Case-Mix Total Nurse Staffing Hours per Resident per Day | 3.91883 | Case-Mix Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day | 3.45404 | Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Chain Average Health Inspection Rating | — | Chain Average Health Inspection Rating |
| Provider Information | Chain Average Overall 5-star Rating | — | Chain Average Overall 5-star Rating |
| Provider Information | Chain Average QM Rating | — | Chain Average QM Rating |
| Provider Information | Chain Average Staffing Rating | — | Chain Average Staffing Rating |
| Provider Information | Chain ID | — | Chain ID |
| Provider Information | Chain Name | — | Chain Name |
| Provider Information | City/Town | FARGO | City/Town |
| Provider Information | CMS Certification Number (CCN) | 355123 | CMS Certification Number (CCN) |
| Provider Information | Continuing Care Retirement Community | N | Continuing Care Retirement Community |
| Provider Information | County/Parish | Cass | County/Parish |
| Provider Information | Date First Approved to Provide Medicare and Medicaid Services | 2010-01-20 | Date First Approved to Provide Medicare and Medicaid Services |
| Provider Information | Geocoding Footnote | — | Geocoding Footnote |
| Provider Information | Health Inspection Rating | 4 | Health Inspection Rating |
| Provider Information | Health Inspection Rating Footnote | — | Health Inspection Rating Footnote |
| Provider Information | Latitude | 46.9156 | Latitude |
| Provider Information | Legal Business Name | BETHANY ON 42ND | Legal Business Name |
| Provider Information | Location | 4255 30TH AVE S,FARGO,ND,58104 | Location |
| Provider Information | Long-Stay QM Rating | 5 | Long-Stay QM Rating |
| Provider Information | Long-Stay QM Rating Footnote | — | Long-Stay QM Rating Footnote |
| Provider Information | Longitude | -96.798 | Longitude |
| Provider Information | Most Recent Health Inspection More Than 2 Years Ago | N | Most Recent Health Inspection More Than 2 Years Ago |
| Provider Information | Number of administrators who have left the nursing home | 0 | Number of administrators who have left the nursing home |
| Provider Information | Number of Certified Beds | 116 | Number of Certified Beds |
| Provider Information | Number of Citations from Infection Control Inspections | — | Number of Citations from Infection Control Inspections |
| Provider Information | Number of Facilities in Chain | — | Number of Facilities in Chain |
| Provider Information | Number of Fines | 0 | Number of Fines |
| Provider Information | Number of Payment Denials | 0 | Number of Payment Denials |
| Provider Information | Nursing Case-Mix Index | 1.38827 | Nursing Case-Mix Index |
| Provider Information | Nursing Case-Mix Index Ratio | 1.00771 | Nursing Case-Mix Index Ratio |
| Provider Information | Overall Rating | 5 | Overall Rating |
| Provider Information | Overall Rating Footnote | — | Overall Rating Footnote |
| Provider Information | Ownership Type | Non profit - Corporation | Ownership Type |
| Provider Information | Physical Therapist Staffing Footnote | — | Physical Therapist Staffing Footnote |
| Provider Information | Processing Date | 2026-03-01 | Processing Date |
| Provider Information | Provider Address | 4255 30TH AVE S | Provider Address |
| Provider Information | Provider Changed Ownership in Last 12 Months | N | Provider Changed Ownership in Last 12 Months |
| Provider Information | Provider Name | BETHANY ON 42ND | Provider Name |
| Provider Information | Provider Resides in Hospital | N | Provider Resides in Hospital |
| Provider Information | Provider SSA County Code | 080 | Provider SSA County Code |
| Provider Information | Provider Type | Medicare and Medicaid | Provider Type |
| Provider Information | QM Rating | 5 | QM Rating |
| Provider Information | QM Rating Footnote | — | QM Rating Footnote |
| Provider Information | Rating Cycle 1 Health Deficiency Score | 4 | Rating Cycle 1 Health Deficiency Score |
| Provider Information | Rating Cycle 1 Health Revisit Score | 0 | Rating Cycle 1 Health Revisit Score |
| Provider Information | Rating Cycle 1 Number of Complaint Health Deficiencies | 1 | Rating Cycle 1 Number of Complaint Health Deficiencies |
| Provider Information | Rating Cycle 1 Number of Health Revisits | 1 | Rating Cycle 1 Number of Health Revisits |
| Provider Information | Rating Cycle 1 Number of Standard Health Deficiencies | 1 | Rating Cycle 1 Number of Standard Health Deficiencies |
| Provider Information | Rating Cycle 1 Standard Survey Health Date | 2025-05-01 | Rating Cycle 1 Standard Survey Health Date |
| Provider Information | Rating Cycle 1 Total Health Score | 4 | Rating Cycle 1 Total Health Score |
| Provider Information | Rating Cycle 1 Total Number of Health Deficiencies | 1 | Rating Cycle 1 Total Number of Health Deficiencies |
| Provider Information | Rating Cycle 2 Number of Standard Health Deficiencies | 2 | Rating Cycle 2 Number of Standard Health Deficiencies |
| Provider Information | Rating Cycle 2 Standard Health Survey Date | 2024-03-14 | Rating Cycle 2 Standard Health Survey Date |
| Provider Information | Rating Cycle 2/3 Health Deficiency Score | 68 | Rating Cycle 2/3 Health Deficiency Score |
| Provider Information | Rating Cycle 2/3 Health Revisit Score | 0 | Rating Cycle 2/3 Health Revisit Score |
| Provider Information | Rating Cycle 2/3 Number of Complaint Health Deficiencies | 8 | Rating Cycle 2/3 Number of Complaint Health Deficiencies |
| Provider Information | Rating Cycle 2/3 Number of Health Revisits | 1 | Rating Cycle 2/3 Number of Health Revisits |
| Provider Information | Rating Cycle 2/3 Total Health Score | 68 | Rating Cycle 2/3 Total Health Score |
| Provider Information | Rating Cycle 2/3 Total Number of Health Deficiencies | 10 | Rating Cycle 2/3 Total Number of Health Deficiencies |
| Provider Information | Registered Nurse hours per resident per day on the weekend | 0.48430 | Registered Nurse hours per resident per day on the weekend |
| Provider Information | Registered Nurse turnover | 45.8 | Registered Nurse turnover |
| Provider Information | Registered Nurse turnover footnote | — | Registered Nurse turnover footnote |
| Provider Information | Reported Licensed Staffing Hours per Resident per Day | 1.50238 | Reported Licensed Staffing Hours per Resident per Day |
| Provider Information | Reported LPN Staffing Hours per Resident per Day | 0.88455 | Reported LPN Staffing Hours per Resident per Day |
| Provider Information | Reported Nurse Aide Staffing Hours per Resident per Day | 3.77161 | Reported Nurse Aide Staffing Hours per Resident per Day |
| Provider Information | Reported Physical Therapist Staffing Hours per Resident Per Day | 0.03312 | Reported Physical Therapist Staffing Hours per Resident Per Day |
| Provider Information | Reported RN Staffing Hours per Resident per Day | 0.61784 | Reported RN Staffing Hours per Resident per Day |
| Provider Information | Reported Staffing Footnote | — | Reported Staffing Footnote |
| Provider Information | Reported Total Nurse Staffing Hours per Resident per Day | 5.27399 | Reported Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Short-Stay QM Rating | 4 | Short-Stay QM Rating |
| Provider Information | Short-Stay QM Rating Footnote | — | Short-Stay QM Rating Footnote |
| Provider Information | Special Focus Status | — | Special Focus Status |
| Provider Information | Staffing Rating | 4 | Staffing Rating |
| Provider Information | Staffing Rating Footnote | — | Staffing Rating Footnote |
| Provider Information | State | ND | State |
| Provider Information | Telephone Number | 7014788900 | Telephone Number |
| Provider Information | Total Amount of Fines in Dollars | 0.00 | Total Amount of Fines in Dollars |
| Provider Information | Total number of nurse staff hours per resident per day on the weekend | 4.78826 | Total number of nurse staff hours per resident per day on the weekend |
| Provider Information | Total Number of Penalties | 0 | Total Number of Penalties |
| Provider Information | Total nursing staff turnover | 56.7 | Total nursing staff turnover |
| Provider Information | Total nursing staff turnover footnote | — | Total nursing staff turnover footnote |
| Provider Information | Total Weighted Health Survey Score | 20.000 | Total Weighted Health Survey Score |
| Provider Information | Urban | Y | Urban |
| Provider Information | With a Resident and Family Council | Resident | With a Resident and Family Council |
| Provider Information | ZIP Code | 58104 | ZIP Code |