GOOD SAMARITAN SOCIETY - WACONIA AND WESTVIEW ACRE

333 FIFTH STREET WEST
WACONIA, MN, 55387
9524425111
CCN: 245234
1
Overall
1
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%
WENZEL, THOMASCORPORATE DIRECTORNOT APPLICABLE
TEIKEN, BRENTCORPORATE DIRECTORNOT APPLICABLE
VENTLING-HERRMANN, MARNIECORPORATE DIRECTORNOT APPLICABLE
GASSEN, WILLIAMCORPORATE DIRECTORNOT APPLICABLE
GULSVIG, NEILCORPORATE DIRECTORNOT APPLICABLE
HERSETH SANDLIN, STEPHANIECORPORATE DIRECTORNOT APPLICABLE
LUNDEEN, MARKCORPORATE DIRECTORNOT APPLICABLE
MCCAUSLAND, MAUREENCORPORATE DIRECTORNOT APPLICABLE
MOLBERT, LAURISCORPORATE DIRECTORNOT APPLICABLE
NORTH, ANDREWCORPORATE DIRECTORNOT APPLICABLE
SCHIEFFER, KEVINCORPORATE DIRECTORNOT APPLICABLE
SHULKIN, DAVIDCORPORATE 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
GASSEN, WILLIAMCORPORATE OFFICERNOT APPLICABLE
FLUIT, JOELCORPORATE OFFICERNOT APPLICABLE
GIWOJNA, ALYSSAOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
MCMICHAEL, TARAOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
MORRISON, TONYOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
SANDGREN, DEEANDRAOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Penalties (1)
DateTypeAmount
2023-06-29Fine$13K
Health Deficiencies (37)
2025-07-24 · Health
J
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.
2025-05-27 · Health
D
F883 · Infection Control Deficiencies
Develop and implement policies and procedures for flu and pneumonia vaccinations.
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
F757 · Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
D
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.
C
F732 · Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
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.
G
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.
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
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
F655 · Resident Assessment and Care Planning Deficiencies
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
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.
G
F628 · Resident Rights Deficiencies
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
D
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
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.
D
F605 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
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.
2025-02-27 · Health
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
F687 · Quality of Life and Care Deficiencies
Provide appropriate foot care.
D
F686 · Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
2024-10-01 · Health
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
2024-08-15 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
F
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.
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
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.
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.
2023-09-14 · Health
D
F849 · Administration Deficiencies
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
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.
D
F759 · Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
D
F698 · Quality of Life and Care Deficiencies
Provide safe, appropriate dialysis care/services for a resident who requires such services.
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
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.
2023-06-29 · Health
J
F700 · Quality of Life and Care Deficiencies
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day
4.11
3.68
RN Hrs/Resident/Day
1.21
0.54
LPN Hrs/Resident/Day
0.49
0.81
CNA Hrs/Resident/Day
2.40
2.33
PT Hrs/Resident/Day
0.05
0.12
Data as of 2026-03-01