Good Samaritan Society - Holstein

505 West Second Street
Holstein, IA, 51025
7123684304
CCN: 165207
2
Overall
2
Health
4
Staffing
4
Quality
ChainGOOD SAMARITAN SOCIETY
Special FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
NameRole%
SANFORD5% OR GREATER DIRECT OWNERSHIP INTEREST100%
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY5% OR GREATER INDIRECT OWNERSHIP INTEREST100%
LUNDEEN, MARKCORPORATE DIRECTORNOT APPLICABLE
GASSEN, WILLIAMCORPORATE DIRECTORNOT APPLICABLE
GULSVIG, NEILCORPORATE DIRECTORNOT APPLICABLE
HERSETH SANDLIN, STEPHANIECORPORATE DIRECTORNOT APPLICABLE
MCCAUSLAND, MAUREENCORPORATE DIRECTORNOT APPLICABLE
MOLBERT, LAURISCORPORATE DIRECTORNOT APPLICABLE
NORTH, ANDREWCORPORATE DIRECTORNOT APPLICABLE
SCHIEFFER, KEVINCORPORATE DIRECTORNOT APPLICABLE
SHULKIN, DAVIDCORPORATE DIRECTORNOT APPLICABLE
TEIKEN, BRENTCORPORATE DIRECTORNOT APPLICABLE
VENTLING-HERRMANN, MARNIECORPORATE DIRECTORNOT APPLICABLE
WENZEL, THOMASCORPORATE DIRECTORNOT APPLICABLE
BROWN, GEORGECORPORATE DIRECTORNOT APPLICABLE
DYKHOUSE, DANACORPORATE DIRECTORNOT APPLICABLE
ENGBRECHT, WESLEYCORPORATE DIRECTORNOT APPLICABLE
MIDDLETON, AIMEECORPORATE OFFICERNOT APPLICABLE
OLSON, NICHOLASCORPORATE OFFICERNOT APPLICABLE
SCHEMA, NATHANCORPORATE OFFICERNOT APPLICABLE
FLUIT, JOELCORPORATE OFFICERNOT APPLICABLE
GASSEN, WILLIAMCORPORATE OFFICERNOT APPLICABLE
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETYOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
SANFORDOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
ANDERSON, TROYOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
LUFT, MICHAELOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
MORRISON, TONYOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
SANDGREN, DEEANDRAOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Penalties (1)
DateTypeAmount
2024-08-17Fine$99K
Health Deficiencies (22)
2025-06-02 · Health
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.
2025-03-20 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
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
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
F677 · Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
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
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.
2024-08-17 · Health
E
F741 · Quality of Life and Care Deficiencies
Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents.
J
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.
J
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.
2024-06-17 · Health
E
F755 · Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
2023-12-21 · Health
E
F801 · Nutrition and Dietary Deficiencies
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
D
F755 · Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
E
F726 · Nursing and Physician Services Deficiencies
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
E
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
F658 · Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
D
F641 · Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
D
F604 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
D
F580 · Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
2022-12-15 · Health
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
F641 · Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
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.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day
3.51
3.68
RN Hrs/Resident/Day
1.01
0.54
LPN Hrs/Resident/Day
0.30
0.81
CNA Hrs/Resident/Day
2.20
2.33
PT Hrs/Resident/Day
0.00
0.12
Data as of 2026-03-01