Sholom Home West
3620 PHILLIPS PARKWAY SOUTH
SAINT LOUIS PARK, MN, 55426
9529356311
CCN: 245574
4
Overall3
Health5
Staffing3
QualitySpecial FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
OIG Federal Exclusion Matches (1)
This facility's name matches one or more entities on the OIG List of Excluded Individuals/Entities (LEIE). Excluded parties are prohibited from participation in Medicare and Medicaid programs.
FOREST LAKE HOME CARE INC.
1128a1
Excluded 2017-08-20
Ownership
| Name | Role | % |
|---|---|---|
| PEDERSON, JANE | CONTRACTED MANAGING EMPLOYEE | NOT APPLICABLE |
| FURMAN, LISA | CORPORATE DIRECTOR | NOT APPLICABLE |
| LAMPERT, RENEE | CORPORATE DIRECTOR | NOT APPLICABLE |
| MEICHES, ROBERT | CORPORATE DIRECTOR | NOT APPLICABLE |
| NIRENSTEIN, DAVID | CORPORATE DIRECTOR | NOT APPLICABLE |
| PIEROTTI, JEREMY | CORPORATE DIRECTOR | NOT APPLICABLE |
| RESIG, MICHAEL | CORPORATE DIRECTOR | NOT APPLICABLE |
| ROSEN, LAYNE | CORPORATE DIRECTOR | NOT APPLICABLE |
| RUTZICK, SHERYL | CORPORATE DIRECTOR | NOT APPLICABLE |
| SALITA, MARC | CORPORATE DIRECTOR | NOT APPLICABLE |
| SCHANFIELD, PAUL | CORPORATE DIRECTOR | NOT APPLICABLE |
| SEILER, SCOTT | CORPORATE DIRECTOR | NOT APPLICABLE |
| STEIN, LINDA | CORPORATE DIRECTOR | NOT APPLICABLE |
| STONE, JON | CORPORATE DIRECTOR | NOT APPLICABLE |
| UNGERMAN, SONIA | CORPORATE DIRECTOR | NOT APPLICABLE |
| WEISSMAN, DOUGLAS | CORPORATE DIRECTOR | NOT APPLICABLE |
| WOLSON, KIMBERLY | CORPORATE DIRECTOR | NOT APPLICABLE |
| EDSTROM, LISA | CORPORATE DIRECTOR | NOT APPLICABLE |
| RUDICK, JERRY | CORPORATE OFFICER | NOT APPLICABLE |
| BERRYMAN, DAVID | CORPORATE OFFICER | NOT APPLICABLE |
| BERRYMAN, DAVID | W-2 MANAGING EMPLOYEE | NOT APPLICABLE |
| HORVATH, ANDREA | W-2 MANAGING EMPLOYEE | NOT APPLICABLE |
| SCHMELING, CORY | W-2 MANAGING EMPLOYEE | NOT APPLICABLE |
| WYCKOFF, DOUG | W-2 MANAGING EMPLOYEE | NOT APPLICABLE |
Health Deficiencies (17)
2025-03-12 · Health
D
F919 · Environmental Deficiencies
Make sure that a working call system is available in each resident's bathroom and bathing area.
2025-01-08 · 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.
E
F803 · Nutrition and Dietary Deficiencies
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
D
F686 · Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
D
F679 · Quality of Life and Care Deficiencies
Provide activities to meet all resident's needs.
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
F644 · Resident Assessment and Care Planning Deficiencies
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
E
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.
2024-12-05 · Health
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.
2024-03-04 · Health
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
2023-09-21 · Health
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.
2021-07-15 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
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
F677 · Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
F583 · Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day3.68
5.43
RN Hrs/Resident/Day0.54
1.31
LPN Hrs/Resident/Day0.81
1.12
CNA Hrs/Resident/Day2.33
3.01
PT Hrs/Resident/Day0.12
0.12
Data as of 2026-03-01