Alexandria, Minnesota · CCN 245434 · Phone: 3207621567 · 83 beds · Ownership: For Profit - Corporation
Bethany On The Lake LLC is a Medicare-certified skilled nursing facility (CCN 245434) in Alexandria, Minnesota. It holds a CMS overall Five-Star rating of 5 of 5 stars on CMS Care Compare. FileFlo scores its CMS survey-readiness at 88/100 (Survey-Ready).
Free CMS Survey-Readiness Audit · 3 minutes · No signup
Run a CFR-cited survey readiness audit on Bethany On The Lake LLC
Walks every Condition of Participation at 42 CFR Part 484/483/418. Pulls the CCN's data from CMS Compare. Every gap names its CFR section + F-Tag.
24-page PDF · F-Tag-by-Tag prep · Plan of Correction template · Joint Commission tracer prep · Unsubscribe anytime
Bethany On The Lake LLC is a Medicare- and Medicaid-certified skilled nursing facility in Alexandria, Minnesota, operating under CMS Certification Number (CCN) 245434. 83-bed facility. For Profit - Corporation. Part of the Monarch Healthcare Management chain. The facility is required to comply with the Requirements for Long-Term Care Facilities at 42 CFR Part 483.
Bethany On The Lake LLC has held its Medicare/Medicaid certification for approximately 39 years (certification date on file: 1987-02-01). Long-tenured facilities (15+ years) often have established F-tag remediation playbooks and a deeper standard-survey trail; newly-certified facilities (under 3 years) are subject to a different initial survey cadence under 42 CFR 488.308.
Local market context (Douglas County): Bethany On The Lake LLC shares Douglas County with 1 other Medicare-certified SNF in our Minnesota sample. Two-facility counties typically see direct competitive comparison on Care Compare ratings during discharge-planner decisions.
CMS publishes Five-Star ratings for nursing homes monthly, drawn from the most recent three years of standard surveys, complaint surveys, and Minimum Data Set (MDS) submissions.
Long-Stay Quality Measure rating: ★★☆☆☆ (2 of 5). Long-stay measures cover residents in the facility 100+ days and include indicators like residents experiencing one or more falls with major injury, residents whose ability to move independently worsened, and residents with a urinary tract infection.
Short-Stay Quality Measure rating: ★★★★☆ (4 of 5). Short-stay measures cover post-acute residents discharged within 100 days and include rehospitalization within 30 days, successful return to community, and improvement in function.
Differentiating long-stay from short-stay QMs matters for placement decisions — a facility with strong short-stay QMs may still underperform on long-stay metrics, and vice versa.
Bethany On The Lake LLC has none of the four CMS-published red-flag indicators active at the most recent publish: not on the Special Focus Facility list, no Abuse Icon on Care Compare, no overdue inspection flag, and no recent change-of-ownership flag. Absence of these flags does not mean the facility is deficiency-free — see the survey history below.
Recent health deficiencies cited at last standard survey: 2. National average for facilities of this size is approximately 8 deficiencies per cycle. Bethany On The Lake LLC has no CMS fines in its most recent reporting cycle. Last documented standard health survey: 2025-08-13. CMS conducts standard surveys at most every 15 months for SNFs, with substandard-quality findings triggering more frequent revisits.
CMS health survey weighted score: 15. The weighted score multiplies deficiency severity (A-L) by scope (isolated, pattern, widespread); higher weighted scores translate directly into the Health Inspection star rating tier breakpoints CMS publishes monthly.
At today's staffing levels, Bethany On The Lake LLC would not meet the cadre-specific minimums scheduled to take effect on the May 2029 timeline under 89 FR 40876: nurse-aide HPRD is 1.747 vs the 2.45 floor, a 0.70-hour gap. Closing this gap typically requires either net new hires at the specific cadre, shifted scheduling that reallocates existing FTEs to direct-care hours, or a hardship exemption application under 42 CFR 483.35.
Total nurse staffing: 3.815 hours per resident day (HPRD), which is 0.33 hours above the 3.48 total HPRD floor that the CMS Minimum Staffing Standards rule (89 FR 40876, May 2024) phases in for rural-facility facilities by May 2029.
Staffing mix: RN 0.938 HPRD, LPN 1.13 HPRD, CNA 1.747 HPRD. The same CMS final rule also phases in cadre-specific minimums of 0.55 RN HPRD and 2.45 nurse aide HPRD on the 2029 timeline; RN-specific shortfalls have historically been the most common single-facility staffing deficiency at standard surveys.
Weekend RN staffing: 0.564 HPRD. Weekend RN coverage is a separately reported CMS measure; facilities with low weekend RN HPRD frequently see resident-acuity-driven adverse events spike on the weekend shift.
Total nurse staff turnover: 38.8% annualized — moderate.
RN-specific turnover: 18.2% annualized. RN turnover above 50% is the single strongest correlate with QM rating decline in CMS's own internal analyses.
Bethany On The Lake LLC is operated as part of Monarch Healthcare Management, a chain operating 45 Medicare-certified facilities (CMS chain identifier 361). Chain-operated facilities tend to share corporate compliance staff, standard operating procedures, and survey-prep resources — but also share enforcement exposure when CMS designates a chain-wide issue under the system-wide quality assurance framework.
Provider type designation: Medicare And Medicaid.
The facility is classified by CMS as rural (outside metropolitan statistical areas). Rural SNFs face different challenges — referral pipeline depth, RN availability, ambulance distance for transfers — and CMS applies certain modifiers to the staffing minimums under hardship exemption pathways for rural facilities.
Peer comparisons use a same-state cohort of 200 Medicare-certified SNFs, pulled live from CMS Provider Data. The cohort excludes terminated and surrendered certifications.
FileFlo's compliance indicator for Bethany On The Lake LLC is 88/100 (Survey-Ready). The score is derived from publicly published health-deficiency counts, weighted survey scores, infection-control citations, fines, and staffing hours per resident day. It is not a CMS rating. The full survey-readiness audit (covering F-tags from the most recently cited deficiencies, infection control, staffing minimums, MDS accuracy) is at /tools/cms-survey-readiness-score.
FileFlo publishes a profile for every Medicare-certified nursing home so administrators, DONs, and family members can find the same publicly-published quality data without bouncing between Care Compare, the SFF list, and the CMS Provider Data Catalog. Field-level CFR citations are linked throughout. Dispute this record if any field is incorrect — we resync with CMS monthly and process correction requests within five business days.
Reviews from residents, family members, and facility staff help others making care decisions. All reviews are verified and PII-scrubbed before publishing.
Share your experience →This page serves four common audiences. Pick the path that matches your reason for visiting.
Run a free CMS Survey-Readiness Audit for Bethany On The Lake LLC. The audit walks F-tag preparedness across 42 CFR Part 483 in about three minutes. No signup, no payment. Start the audit for Bethany On The Lake LLC →
White-label F-Tag preparation tools + 25% recurring commission per client referral. Skilled nursing consultants typically serve 8-30 facilities; FileFlo replaces the spreadsheet handoffs you used to do post-engagement. See SNF Consultant Partner Program →
Filtering high-quality SNF post-acute providers? FileFlo's free Provider Network gives verified facility quality data, F-Tag history, 5-star ratings, and Special Focus status to vet placements. Get free Provider Network access →
Pre-acquisition compliance diligence across multiple facilities? Get a free batch compliance report (up to 5 CCNs at once) with F-Tag history, deficiency trends, Special Focus status, and CMP exposure. Request batch report →
Bethany On The Lake LLC (CCN 245434) holds a CMS overall Five-Star rating of 5 of 5 stars on CMS Care Compare. CMS updates these ratings quarterly from the facility's submitted assessment and claims data.
Bethany On The Lake LLC is a Medicare-certified skilled nursing facility (CMS Certification Number 245434) in Alexandria, Minnesota.
FileFlo scores Bethany On The Lake LLC's CMS survey-readiness at 88/100 (Survey-Ready). This is a FileFlo indicator built from CMS-published data, not an official CMS rating.
As a Medicare-certified skilled nursing facility, Bethany On The Lake LLC is surveyed against the Conditions of Participation in 42 CFR Part 483 — covering patient/resident rights, assessment and care planning, quality (QAPI), infection control, and aide services. Each CoP section is linked on this page.
Run FileFlo's free CMS survey-readiness audit for Bethany On The Lake LLC — it grades the skilled nursing facility against every Condition of Participation in 42 CFR Part 483 in about three minutes, names each gap's F-Tag, and requires no signup.
The 42 CFR Part 483 CoP sections a CMS survey actually checks, in plain English:
Compliance terms: F-Tag · Joint Commission. See the Skilled Nursing Facility directory and the Healthcare compliance guide →
← Browse All Nursing Homes · Minnesota Nursing Homes · Healthcare Compliance Guide · F-Tag Response Playbook · CMS CoPs Guide
Compare the best SNF compliance software →
Data sourced from CMS Care Compare (publish 2026-04-01). Information may not reflect the facility's current status. Resync occurs monthly. Dispute this record · Claim this profile