Good Shepherd Lutheran Home

1115 4TH AVENUE NORTH
SAUK RAPIDS, MN, 56379
3202526525
CCN: 245269
5
Overall
3
Health
5
Staffing
5
Quality
Special FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
NameRole%
CLOETER, PAULCORPORATE DIRECTORNOT APPLICABLE
HAWKINSON, JOYCECORPORATE DIRECTORNOT APPLICABLE
KERSTEN, DOROTHYCORPORATE DIRECTORNOT APPLICABLE
KIRCHOFF, BARRYCORPORATE DIRECTORNOT APPLICABLE
LUEDTKE, CHARLESCORPORATE DIRECTORNOT APPLICABLE
MACHULA, JENNIFERCORPORATE DIRECTORNOT APPLICABLE
MAHNKE, BARBARACORPORATE DIRECTORNOT APPLICABLE
STROHSCHEIN, DAVIDCORPORATE DIRECTORNOT APPLICABLE
STUDENSKI, DENNISCORPORATE DIRECTORNOT APPLICABLE
TOMHAVE, GREGCORPORATE DIRECTORNOT APPLICABLE
ZOELLER, DAVIDCORPORATE DIRECTORNOT APPLICABLE
DOUVIER, MARKCORPORATE OFFICERNOT APPLICABLE
FITCH, MIKECORPORATE OFFICERNOT APPLICABLE
STORDAHL, MICHAELCORPORATE OFFICERNOT APPLICABLE
DOUVIER, MARKW-2 MANAGING EMPLOYEENOT APPLICABLE
MARTINI, KRISTAW-2 MANAGING EMPLOYEENOT APPLICABLE
STORDAHL, MICHAELW-2 MANAGING EMPLOYEENOT APPLICABLE
Penalties (1)
DateTypeAmount
2023-03-23Fine$10K
Health Deficiencies (20)
2025-04-17 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
F
F867 · Administration Deficiencies
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
E
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
F804 · Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
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.
F
F732 · Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
D
F686 · Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
D
F658 · Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
D
F554 · Resident Rights Deficiencies
Allow residents to self-administer drugs if determined clinically appropriate.
2024-05-02 · 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.
E
F698 · Quality of Life and Care Deficiencies
Provide safe, appropriate dialysis care/services for a resident who requires such services.
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
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.
E
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
2023-03-23 · Health
E
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
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
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
4.80
3.68
RN Hrs/Resident/Day
0.84
0.54
LPN Hrs/Resident/Day
0.79
0.81
CNA Hrs/Resident/Day
3.17
2.33
PT Hrs/Resident/Day
0.04
0.12
Data as of 2026-03-01