Good Samaritan Society - Windom
705 SIXTH STREET
WINDOM, MN, 56101
5078311788
CCN: 245558
1
Overall1
Health1
Staffing3
QualitySpecial FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
| Name | Role | % |
|---|---|---|
| SANFORD | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% |
| MCCAUSLAND, MAUREEN | 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 |
| SCHIEFFER, KEVIN | CORPORATE DIRECTOR | NOT APPLICABLE |
| SHULKIN, DAVID | CORPORATE DIRECTOR | NOT APPLICABLE |
| TEIKEN, BRENT | CORPORATE DIRECTOR | NOT APPLICABLE |
| VENTLING-HERRMANN, MARNIE | CORPORATE DIRECTOR | NOT APPLICABLE |
| WENZEL, THOMAS | CORPORATE DIRECTOR | NOT APPLICABLE |
| BROWN, GEORGE | CORPORATE DIRECTOR | 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 |
| OLSON, NICHOLAS | CORPORATE OFFICER | NOT APPLICABLE |
| SCHEMA, NATHAN | CORPORATE OFFICER | NOT APPLICABLE |
| FLUIT, JOEL | CORPORATE OFFICER | NOT APPLICABLE |
| GASSEN, WILLIAM | CORPORATE OFFICER | NOT APPLICABLE |
| MIDDLETON, AIMEE | CORPORATE OFFICER | NOT APPLICABLE |
| THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| MORRISON, TONY | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| WEPPLO, NANCY | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| DYNES, RODNEY | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
Health Deficiencies (35)
2026-02-12 · Health
F
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
F
F868 · Administration Deficiencies
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
D
F759 · Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
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
F755 · Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
F695 · Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
D
F685 · Quality of Life and Care Deficiencies
Assist a resident in gaining access to vision and hearing services.
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
F645 · Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
D
F638 · Resident Assessment and Care Planning Deficiencies
Assure that each resident’s assessment is updated at least once every 3 months.
D
F628 · Resident Rights Deficiencies
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
E
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
E
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.
E
F582 · Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
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.
2026-01-27 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
F791 · Quality of Life and Care Deficiencies
Provide or obtain dental services for each resident.
K
F686 · Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
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
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.
D
F550 · Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
2024-12-11 · Health
F
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
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.
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.
D
F550 · Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
2023-11-02 · Health
F
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
F847 · Administration Deficiencies
Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse.
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.
F
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
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.
D
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
F641 · Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
D
F554 · Resident Rights Deficiencies
Allow residents to self-administer drugs if determined clinically appropriate.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day
No data
3.68RN Hrs/Resident/Day
No data
0.54LPN Hrs/Resident/Day
No data
0.81CNA Hrs/Resident/Day
No data
2.33PT Hrs/Resident/Day
No data
0.12Data as of 2026-03-01