GOOD SAMARITAN SOCIETY - WESTBROOK

149 FIRST STREET, BOX 218
WESTBROOK, MN, 56183
5072746155
CCN: 245595
3
Overall
3
Health
4
Staffing
2
Quality
ChainGOOD SAMARITAN SOCIETY
Special FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
NameRole%
SANFORD5% OR GREATER DIRECT OWNERSHIP INTEREST100%
MCCAUSLAND, MAUREENCORPORATE DIRECTORNOT APPLICABLE
HERSETH SANDLIN, STEPHANIECORPORATE DIRECTORNOT APPLICABLE
LUNDEEN, MARKCORPORATE 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
GASSEN, WILLIAMCORPORATE DIRECTORNOT APPLICABLE
GULSVIG, NEILCORPORATE DIRECTORNOT APPLICABLE
OLSON, NICHOLASCORPORATE OFFICERNOT APPLICABLE
SCHEMA, NATHANCORPORATE OFFICERNOT APPLICABLE
FLUIT, JOELCORPORATE OFFICERNOT APPLICABLE
GASSEN, WILLIAMCORPORATE OFFICERNOT APPLICABLE
MIDDLETON, AIMEECORPORATE OFFICERNOT APPLICABLE
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETYOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
MORRISON, TONYOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
SWANSON, MARYOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
KOPPERUD, ANDREWOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Health Deficiencies (17)
2025-01-09 · Health
E
F882 · Infection Control Deficiencies
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
E
F881 · Infection Control Deficiencies
Implement a program that monitors antibiotic use.
F
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
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.
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
F686 · Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
2023-12-06 · Health
E
F883 · Infection Control Deficiencies
Develop and implement policies and procedures for flu and pneumonia vaccinations.
F
F851 · Administration Deficiencies
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
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
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.
2023-02-16 · Health
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
F661 · Resident Assessment and Care Planning Deficiencies
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
D
F602 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from the wrongful use of the resident's belongings or money.
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.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day
3.76
3.68
RN Hrs/Resident/Day
0.56
0.54
LPN Hrs/Resident/Day
0.90
0.81
CNA Hrs/Resident/Day
2.30
2.33
PT Hrs/Resident/Day
0.00
0.12
Data as of 2026-03-01