Good Samaritan Society - Estherville
1646 Fifth Avenue North
Estherville, IA, 51334
7123623522
CCN: 165192
1
Overall2
Health3
Staffing1
QualitySpecial FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
| Name | Role | % |
|---|---|---|
| SANFORD | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% |
| TANGEN, LORRAINE | CONTRACTED MANAGING EMPLOYEE | NOT APPLICABLE |
| DYKHOUSE, DANA | CORPORATE DIRECTOR | NOT APPLICABLE |
| ENGBRECHT, WESLEY | CORPORATE DIRECTOR | NOT APPLICABLE |
| GASSEN, WILLIAM | CORPORATE DIRECTOR | NOT APPLICABLE |
| GULSVIG, NEIL | CORPORATE DIRECTOR | NOT APPLICABLE |
| HERSETH SANDLIN, STEPHANIE | CORPORATE DIRECTOR | NOT APPLICABLE |
| LUNDEEN, MARK | CORPORATE DIRECTOR | NOT APPLICABLE |
| MOLBERT, LAURIS | CORPORATE DIRECTOR | NOT APPLICABLE |
| NORTH, ANDREW | CORPORATE DIRECTOR | NOT APPLICABLE |
| SHULKIN, DAVID | CORPORATE DIRECTOR | NOT APPLICABLE |
| TEIKEN, BRENT | CORPORATE DIRECTOR | NOT APPLICABLE |
| VENTLING-HERRMANN, MARNIE | CORPORATE DIRECTOR | NOT APPLICABLE |
| ROGERS, MICHAEL | CORPORATE DIRECTOR | NOT APPLICABLE |
| CAIN, JAMES | CORPORATE DIRECTOR | NOT APPLICABLE |
| FLUIT, JOEL | CORPORATE OFFICER | NOT APPLICABLE |
| GASSEN, WILLIAM | CORPORATE OFFICER | NOT APPLICABLE |
| MIDDLETON, AIMEE | CORPORATE OFFICER | NOT APPLICABLE |
| OLSON, NICHOLAS | CORPORATE OFFICER | NOT APPLICABLE |
| SCHEMA, NATHAN | CORPORATE OFFICER | NOT APPLICABLE |
| THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| BERRY, PATRICK | W-2 MANAGING EMPLOYEE | NOT APPLICABLE |
| MORRISON, TONY | W-2 MANAGING EMPLOYEE | NOT APPLICABLE |
Health Deficiencies (38)
2025-11-10 · Health
D
F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
2024-10-31 · Health
F
F851 · Administration Deficiencies
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
E
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
F804 · Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
D
F657 · Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
D
F550 · Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
2023-11-30 · Health
E
F809 · Nutrition and Dietary Deficiencies
Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.
E
F803 · Nutrition and Dietary Deficiencies
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
D
F802 · Nutrition and Dietary Deficiencies
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
E
F725 · Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
2023-08-30 · Health
E
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
E
F868 · Administration Deficiencies
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
E
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
F805 · Nutrition and Dietary Deficiencies
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
E
F804 · Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
D
F758 · Pharmacy Service Deficiencies
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
D
F688 · Quality of Life and Care Deficiencies
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.
E
F657 · Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
D
F644 · Resident Assessment and Care Planning Deficiencies
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
D
F641 · Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
E
F585 · Resident Rights Deficiencies
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
2022-06-01 · Health
E
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
E
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
F803 · Nutrition and Dietary Deficiencies
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
E
F800 · Nutrition and Dietary Deficiencies
Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.
D
F758 · Pharmacy Service Deficiencies
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
E
F756 · Pharmacy Service Deficiencies
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
E
F732 · Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
E
F725 · Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
D
F690 · Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
K
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
F688 · Quality of Life and Care Deficiencies
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.
E
F658 · Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
D
F657 · Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
D
F656 · Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
D
F644 · Resident Assessment and Care Planning Deficiencies
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
E
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
E
F578 · Resident Rights Deficiencies
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day3.68
3.49
RN Hrs/Resident/Day0.54
0.98
LPN Hrs/Resident/Day0.81
0.31
CNA Hrs/Resident/Day2.33
2.19
PT Hrs/Resident/Day0.12
0.00
Data as of 2026-03-01