Good Samaritan Society - Indianola

708 South Jefferson
Indianola, IA, 50125
5159612596
CCN: 165186
1
Overall
1
Health
2
Staffing
1
Quality
ChainGOOD SAMARITAN SOCIETY
Special FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
NameRole%
SANFORD5% OR GREATER DIRECT OWNERSHIP INTEREST100%
MOLBERT, LAURISCORPORATE DIRECTORNOT APPLICABLE
LUNDEEN, MARKCORPORATE DIRECTORNOT APPLICABLE
MCCAUSLAND, MAUREENCORPORATE 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
GASSEN, WILLIAMCORPORATE DIRECTORNOT APPLICABLE
GULSVIG, NEILCORPORATE DIRECTORNOT APPLICABLE
HERSETH SANDLIN, STEPHANIECORPORATE DIRECTORNOT APPLICABLE
SCHEMA, NATHANCORPORATE OFFICERNOT APPLICABLE
FLUIT, JOELCORPORATE OFFICERNOT APPLICABLE
GASSEN, WILLIAMCORPORATE OFFICERNOT APPLICABLE
OLSON, NICHOLASCORPORATE OFFICERNOT APPLICABLE
MIDDLETON, AIMEECORPORATE OFFICERNOT APPLICABLE
BLACKBURN, NATASHAOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
MORRISON, TONYOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
GIJIMA, DESIREOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Penalties (2)
DateTypeAmount
2025-04-24Fine$12K
2024-01-10Fine$8K
Health Deficiencies (35)
2026-01-14 · Health
E
F865 · Administration Deficiencies
Have a plan that describes the process for conducting QAPI and QAA activities.
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.
2025-07-29 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
F761 · Pharmacy Service Deficiencies
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.
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
F550 · Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
2025-04-24 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
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
F677 · Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
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.
G
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.
D
F584 · Resident Rights Deficiencies
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.
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.
2025-01-30 · Health
E
F804 · Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
F
F727 · Nursing and Physician Services Deficiencies
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
F
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
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.
2024-06-18 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
E
F842 · Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
G
F760 · Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
D
F757 · Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
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
F686 · Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
G
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
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
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
F623 · Resident Rights Deficiencies
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
D
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.
2024-01-10 · Health
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.
J
F686 · Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
2023-07-27 · Health
E
F584 · Resident Rights Deficiencies
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.
2023-05-04 · Health
G
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.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day
3.27
3.68
RN Hrs/Resident/Day
0.50
0.54
LPN Hrs/Resident/Day
0.46
0.81
CNA Hrs/Resident/Day
2.31
2.33
PT Hrs/Resident/Day
0.01
0.12
Data as of 2026-03-01