THE GOOD SAMARITAN SOCIETY-KISSIMMEE VILLAGE

KISSIMMEE, FL

CMS provider ID 105559CMS source updated July 29, 2026

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CMS overview

CMS overall

Health inspection

Staffing

Quality-measure

No proprietary TrustHub score. These ratings are published separately by CMS.

How CMS describes these ratings

CMS overall rating: The CMS overall rating summarizes health inspections, staffing, and quality measures within Medicare's Five-Star system.
Health inspection rating: The CMS health inspection rating reflects findings from standard and complaint inspections used in Medicare's Five-Star system.
Staffing rating: The CMS staffing rating reflects staffing levels and related measures used in Medicare's Five-Star system.
Quality-measure rating: The CMS quality-measure rating summarizes selected resident assessment and claims-based measures used in Medicare's Five-Star system.

CMS certified beds: 161
Ownership descriptor: Non profit - Corporation
Medicare participation: Yes
Medicaid participation: Yes

Facility information

Contact

CMS remains the primary federal record. Public website and additional contact details appear only when independently verified.

Phone: 4078467201CMS Provider Information

Decision guide

What to review

Factual evidence to examine before you decide. These summaries are not a score or recommendation.

Staffing

CMS publishes a 5-star staffing rating for this facility.

RN staffing was 0.81 hours per resident day in 2026Q1, calculated from CMS PBJ records.

View staffing evidence

Inspections

The latest standard inspection on Dec 11, 2025 cited 6 deficiencies.

View inspection evidence

Ownership

CMS-published records list 23 ownership or control parties.

View ownership evidence

Chain context

CMS groups this facility with a chain covering 91 facilities across 9 states or territories.

View chain evidence

Enforcement record

CMS records show a $11,629 fine in the loaded enforcement dataset.

View enforcement evidence →

Ownership & operation

Ownership & Operation

Operator, licensee, owner, manager, and chain stay separate. A connected organization is not automatically the party that runs daily operations.

Ownership type: Non profit - CorporationCMS
Chain: GOOD SAMARITAN SOCIETYCMS identifies this facility as part of the GOOD SAMARITAN SOCIETY chain.
Related facilities: 91Current CMS organization identity

Explore ownership network →

Who is behind this facility?

SeniorTrustHub found evidence connecting this facility to:

1 CMS-reported ownership organization
CMS reports 21 individual ownership interests
a CMS chain / common-control group

Related facilities

91 currently connected nursing homes share this CMS organization identity with THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY.

Average CMS overall rating: 3 stars across 90 reporting facilities
CMS monetary penalties: 47 of 91 facilities had a recorded monetary penalty in the available CMS period.
Recent CMS penalties: 26 facilities had a CMS penalty in the last 18 months.
Recent high-value CMS enforcement: 21 facilities had a high-value CMS fine or payment denial in the last 18 months.
Recent CMS complaint inspections: 55 facilities had a CMS complaint inspection in the last 18 months.
Total recorded CMS fines: $2,237,184

These figures summarize currently connected CMS-certified nursing homes. Some facilities have incomplete measures; missing values are omitted, not treated as zero. Ownership structures can change. State operator or licensee evidence may differ from CMS ownership disclosures.

Ownership

Who CMS records show is connected to this facility

These are CMS-published ownership disclosures. Medicare enrollment ownership and managerial-control information is reported by enrolled providers through CMS forms; it is not an independent determination of beneficial ownership.

Reported party records: 23
Organizations shown: 2
Individuals shown: 21
Latest ownership source update: Jul 27, 2026

CMS-published ownership and control parties

SANFORD
Organization · 5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date reported to CMS: Jan 1, 2019
Other facilities connected through this exact CMS organization identity: 0 across FL.
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
CHAPPEL, CHRISTOPHER
Individual · CONTRACTED MANAGING EMPLOYEE
Association date reported to CMS: Sep 17, 2018
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
CAIN, JAMES
Individual · CORPORATE DIRECTOR
Association date reported to CMS: May 30, 2024
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
DYKHOUSE, DANA
Individual · CORPORATE DIRECTOR
Association date reported to CMS: May 30, 2024
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
ENGBRECHT, WESLEY
Individual · CORPORATE DIRECTOR
Association date reported to CMS: May 30, 2024
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
GASSEN, WILLIAM
Individual · CORPORATE DIRECTOR
Association date reported to CMS: May 30, 2024
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
GULSVIG, NEIL
Individual · CORPORATE DIRECTOR
Association date reported to CMS: May 30, 2024
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
HERSETH SANDLIN, STEPHANIE
Individual · CORPORATE DIRECTOR
Association date reported to CMS: May 30, 2024
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
LUNDEEN, MARK
Individual · CORPORATE DIRECTOR
Association date reported to CMS: May 30, 2024
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
MOLBERT, LAURIS
Individual · CORPORATE DIRECTOR
Association date reported to CMS: May 30, 2024
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
NORTH, ANDREW
Individual · CORPORATE DIRECTOR
Association date reported to CMS: May 30, 2024
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
SHULKIN, DAVID
Individual · CORPORATE DIRECTOR
Association date reported to CMS: May 30, 2024
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
TEIKEN, BRENT
Individual · CORPORATE DIRECTOR
Association date reported to CMS: May 30, 2024
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
VENTLING-HERRMANN, MARNIE
Individual · CORPORATE DIRECTOR
Association date reported to CMS: May 30, 2024
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
GASSEN, WILLIAM
Individual · CORPORATE OFFICER
Association date reported to CMS: May 30, 2024
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
MIDDLETON, AIMEE
Individual · CORPORATE OFFICER
Association date reported to CMS: Jan 27, 2022
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
OLSON, NICHOLAS
Individual · CORPORATE OFFICER
Association date reported to CMS: Apr 8, 2024
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
ROGERS, MICHAEL
Individual · CORPORATE OFFICER
Association date reported to CMS: Jun 13, 2022
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
SCHEMA, NATHAN
Individual · CORPORATE OFFICER
Association date reported to CMS: Jan 1, 2022
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
FLUIT, JOEL
Individual · W-2 MANAGING EMPLOYEE
Association date reported to CMS: Oct 1, 2022
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
MORRISON, TONY
Individual · W-2 MANAGING EMPLOYEE
Association date reported to CMS: Jan 1, 2019
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
SPIES, DORENE
Individual · W-2 MANAGING EMPLOYEE
Association date reported to CMS: Sep 26, 2022
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Ownership
CMS dataset identifier
y2hd-n93e
Source updated
Jul 1, 2026
Retrieved
Aug 15, 2026
View official CMS source
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Organization · Medicare-enrolled legal organization
Other facilities connected through this exact CMS organization identity: 90 across CO, FL, HI, IA, KS, MN, ND, NE, SD.
View ownership source details
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset
Skilled Nursing Facility Enrollments
CMS dataset identifier
5f2c306f-3b1c-42cd-b037-187b2ce22126
Source updated
Jul 27, 2026
Retrieved
Aug 15, 2026
View official CMS source

What this means

Roles are shown as CMS publishes them. Different CMS sources can describe different enrollment, ownership, and control concepts, so TrustHub keeps each source-specific disclosure distinct.

Questions to ask

CMS records list several organizations with ownership or control roles. Which entity is responsible for day-to-day operations at this facility?
CMS records connect THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY to 91 facilities. Which policies and staffing decisions are managed centrally versus locally?

Chain context

CMS groups this facility with GOOD SAMARITAN SOCIETY

Chain-level values describe this CMS-defined group, not any one facility. CMS Chain ID 726 is a grouping identifier, not a legal organization.

Facilities: 91
States and territories: 9
Average overall rating: 3
Average staffing rating: 4
Average total nurse HPRD: 3.7
Total fines: 81

Review CMS chain evidence

CMS-published history

Monthly chain measures
Month	Facilities	Overall rating	Staffing rating
Wed Jul	91	3	4
Mon Jun	92	2.9	3.9
Fri May	92	3	3.8
Wed Apr	88	3	3.9
Sun Mar	89	3	3.8
Sun Feb	92	2.9	3.8

Questions to ask

CMS groups facilities in 9 states or territories under this chain. Which operational policies are set at the chain level?
CMS reports 81 fines across the chain in this dataset. What compliance functions are managed centrally?

CMS chain source and methodology

Nursing Home Chain Performance Measures, fixed version da2db00a-0f3d-40a9-a535-588ff1220c55. Membership comes separately from CMS Skilled Nursing Facility Enrollments.

View official CMS source

Inspections & deficiencies

What CMS inspection records show

Scope and severity terms below are CMS classifications. They are not a TrustHub score.

Latest recorded inspection

Date: Dec 11, 2025
Survey type: Fire Safety Standard
Linked findings: 0
Highest linked CMS classification: No linked health-deficiency finding in the loaded record

View source details

Dataset: Inspection Dates
CMS dataset ID: svdt-c123
CMS source updated: Jul 1, 2026
CMS provider ID: 105559
Source record locator: csv-row:22506:ccn:105559

View official CMS source

Dec 11, 2025 — Fire Safety Standard — 0 linked findings

No health-deficiency rows were deterministically linked to this inspection.

Dec 11, 2025 — Health Complaint — 1 linked finding

F0585 — 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.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jan 23, 2026)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65525:ccn:105559
View official CMS source

Dec 11, 2025 — Health Standard — 6 linked findings

F0641 — Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jan 23, 2026)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65526:ccn:105559
View official CMS source
F0644 — Resident Assessment and Care Planning Deficiencies
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jan 23, 2026)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65527:ccn:105559
View official CMS source
F0679 — Quality of Life and Care Deficiencies
Provide activities to meet all resident's needs.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jan 23, 2026)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65528:ccn:105559
View official CMS source
F0759 — Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jan 23, 2026)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65529:ccn:105559
View official CMS source
F0803 — 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.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jan 23, 2026)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65524:ccn:105559
View official CMS source
F0812 — Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
CMS scope/severity F: Widespread; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jan 23, 2026)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65523:ccn:105559
View official CMS source

Feb 1, 2024 — Fire Safety Standard — 0 linked findings

No health-deficiency rows were deterministically linked to this inspection.

Feb 1, 2024 — Health Standard — 4 linked findings

F0610 — Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Feb 23, 2024)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65530:ccn:105559
View official CMS source
F0645 — Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Feb 23, 2024)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65531:ccn:105559
View official CMS source
F0755 — Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Feb 23, 2024)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65532:ccn:105559
View official CMS source
F0758 — 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.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Feb 23, 2024)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65533:ccn:105559
View official CMS source

Nov 10, 2023 — Health Complaint — 1 linked finding

F0698 — Quality of Life and Care Deficiencies
Provide safe, appropriate dialysis care/services for a resident who requires such services.
CMS scope/severity G: Isolated; Actual harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Dec 4, 2023)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65534:ccn:105559
View official CMS source

Aug 10, 2023 — Health Complaint — 6 linked findings

F0600 — Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
CMS scope/severity J: Isolated; Immediate jeopardy to resident health or safety.
Correction status: Deficient, Provider has date of correction (Sep 8, 2023)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65535:ccn:105559
View official CMS source
F0609 — Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
CMS scope/severity J: Isolated; Immediate jeopardy to resident health or safety.
Correction status: Deficient, Provider has date of correction (Sep 8, 2023)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65536:ccn:105559
View official CMS source
F0657 — 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.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Oct 30, 2023)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65539:ccn:105559
View official CMS source
F0689 — Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
CMS scope/severity J: Isolated; Immediate jeopardy to resident health or safety.
Correction status: Deficient, Provider has date of correction (Oct 30, 2023)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65537:ccn:105559
View official CMS source
F0693 — Quality of Life and Care Deficiencies
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Oct 30, 2023)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65540:ccn:105559
View official CMS source
F0835 — Administration Deficiencies
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
CMS scope/severity J: Isolated; Immediate jeopardy to resident health or safety.
Correction status: Deficient, Provider has date of correction (Oct 30, 2023)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65538:ccn:105559
View official CMS source

Mar 24, 2022 — Fire Safety Standard — 0 linked findings

No health-deficiency rows were deterministically linked to this inspection.

Mar 24, 2022 — Health Standard — 4 linked findings

F0607 — Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Apr 25, 2022)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65543:ccn:105559
View official CMS source
F0609 — Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Apr 25, 2022)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65541:ccn:105559
View official CMS source
F0623 — 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.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Apr 25, 2022)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65542:ccn:105559
View official CMS source
F0732 — Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
CMS scope/severity C: Widespread; No actual harm with potential for minimal harm.
Correction status: Deficient, Provider has date of correction (Apr 25, 2022)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:65544:ccn:105559
View official CMS source

Tags appearing across inspections

F0609 appears in 2 linked inspections.

Penalties & enforcement

CMS penalty records in the loaded three-year dataset

Fine — Nov 10, 2023
Published fine amount: $11,629.00
View source details
Dataset
Penalties
CMS dataset ID
g6vv-u9sr
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:2017:ccn:105559
View official CMS source
Fine — Aug 10, 2023
Published fine amount: $234,504.00
View source details
Dataset
Penalties
CMS dataset ID
g6vv-u9sr
CMS source updated
Jul 1, 2026
CMS provider ID
105559
Source record locator
csv-row:2018:ccn:105559
View official CMS source

Questions to ask

Questions generated from the evidence above

CMS records show F0609 in 2 inspections in the available record. What changes has the facility made to address this issue?
CMS records show a monetary penalty dated Nov 10, 2023. What changes were made after that enforcement action?

Facility history

Facility History

8 historical events available. Dates and values come from published CMS and official state regulator evidence, not a score.

What changed recently?

Health inspection completed6 deficiencies were recorded.

2025

Dec 11
Health inspection completed
6 deficiencies were recorded.
CMS · Recorded event date · View related evidence
Dec 11
Complaint inspection recorded
1 deficiency was recorded.
CMS · Recorded event date · View related evidence

2024

Feb 1
Health inspection completed
4 deficiencies were recorded.
CMS · Recorded event date · View related evidence

2023

Nov 10
Civil monetary penalty recorded
CMS recorded a $11,629 civil monetary penalty.
CMS · Recorded event date · View related evidence
Nov 10
Complaint inspection recorded
1 deficiencies were recorded. That includes 1 higher-severity deficiency.
CMS · Recorded event date · View related evidence
Aug 10
Complaint inspection recorded
6 deficiencies were recorded. That includes 4 higher-severity deficiencies.
CMS · Recorded event date · View related evidence
Aug 10
Civil monetary penalty recorded
CMS recorded a $234,504 civil monetary penalty.
CMS · Recorded event date · View related evidence

2022

Mar 24
Health inspection completed
4 deficiencies were recorded.
CMS · Recorded event date · View related evidence

Staffing

Reported nursing staffing at a glance

CMS staffing rating: 5 of 5 stars. CMS calculates that rating separately using its published methodology. The values below are calculations from daily PBJ records for 2026Q1 (current source quarter).

Inspect a PBJ quarter

Total nursing: 3.416
RN categories: 0.813
LPN/LVN categories: 0.527
CNA: 2.076

Weekday and weekend calculations

2026Q1 reported hours per resident day
Measure	Monday–Friday	Saturday–Sunday
Total nursing	3.505	3.198
RN categories	0.895	0.614

Contract staff accounted for 0% of reported nursing hours included in this quarter calculation.

Reported RN-category hours per resident day were 0.076 higher than the prior loaded quarter.

Staffing over time

Solid bar: Total nursing · Outlined bar: RN categories

Calculated reported hours per resident day by PBJ quarter
Quarter	Total nursing	RN categories	LPN/LVN	CNA	Contract share	Days
2025Q2	3.567	0.845	0.604	2.118	0%	91
2025Q3	3.572	0.829	0.599	2.143	0%	92
2025Q4	3.535	0.737	0.645	2.153	0%	92
2026Q1	3.416	0.813	0.527	2.076	0%	90

Questions to ask

PBJ records show lower calculated RN-category hours per resident day on weekends this quarter. How does the facility plan RN coverage on Saturdays and Sundays?

Staffing source and calculation details

Source: Centers for Medicare & Medicaid Services (CMS)
Dataset: Payroll Based Journal Daily Nurse Staffing
CMS dataset ID: 7e0d53ba-8f02-4c66-98a5-14a1c997c50d
Quarter: 2026Q1
Coverage: Jan 1, 2026–Mar 31, 2026
Days represented: 90 (90 with positive MDS census)
CMS source updated: Jul 29, 2026
Calculation version: pbj-quarter-ratio-of-sums-v1

Hours-per-resident-day values are calculated by this platform from CMS-published daily PBJ hours and MDS census. For each displayed period, included hours are summed and divided by the summed census for days with a positive census. They are not CMS case-mix-adjusted staffing measures or a staffing rating.

View official CMS PBJ source

What we can verify today

Current Provider Information facts

These measures come from the current successfully ingested CMS Nursing Home Provider Information release.

CMS reports a 2-star overall rating.
CMS reports a 1-star health inspection rating.
CMS reports a 5-star staffing rating.
CMS reports a 4-star quality-measure rating.

Planned evidence layers

Additional public-source research

These areas require separate authoritative CMS datasets. No findings are shown until those sources are ingested and reviewed.

Trust participation

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Claims, corrections, and factual context are free. Submissions never replace CMS evidence or affect ranking.

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How corrections work

Source register

See where this record came from

Provider Information

Source organization: Centers for Medicare & Medicaid Services (CMS)
Dataset identifier: 4pq5-n9py
Source updated: Jul 29, 2026
Retrieved: Aug 14, 2026
Supports: Overview, facility facts, and CMS ratings

View official CMS source

Inspection Dates

Source organization: Centers for Medicare & Medicaid Services (CMS)
Dataset identifier: svdt-c123
Source updated: Jul 1, 2026
Retrieved: Aug 14, 2026
Supports: Inspections and facility history

View official CMS source

Health Deficiencies

Source organization: Centers for Medicare & Medicaid Services (CMS)
Dataset identifier: r5ix-sfxw
Source updated: Jul 1, 2026
Retrieved: Aug 14, 2026
Supports: Health deficiencies and facility history

View official CMS source

Penalties

Source organization: Centers for Medicare & Medicaid Services (CMS)
Dataset identifier: g6vv-u9sr
Source updated: Jul 1, 2026
Retrieved: Aug 14, 2026
Supports: Penalties, enforcement, and facility history

View official CMS source

Payroll Based Journal Daily Nurse Staffing

Source organization: Centers for Medicare & Medicaid Services (CMS)
Dataset identifier: 7e0d53ba-8f02-4c66-98a5-14a1c997c50d
Coverage: Apr 1, 2025–Mar 31, 2026
Source updated: Jul 29, 2026
Retrieved: Aug 15, 2026
Supports: PBJ staffing cards, history, and transparent calculations

View official CMS source

Ownership

Source organization: Centers for Medicare & Medicaid Services (CMS)
Dataset identifier: y2hd-n93e
Source updated: Jul 1, 2026
Retrieved: Aug 15, 2026
Supports: Ownership parties, organization connections, and ownership history

View official CMS source

Skilled Nursing Facility Enrollments

Source organization: Centers for Medicare & Medicaid Services (CMS)
Dataset identifier: 5f2c306f-3b1c-42cd-b037-187b2ce22126
Source updated: Jul 27, 2026
Retrieved: Aug 15, 2026
Supports: Ownership parties, organization connections, and ownership history

View official CMS source

Nursing Home Chain Performance Measures

Source organization: Centers for Medicare & Medicaid Services (CMS)
Dataset identifier: 97ecfad1-d3f1-4d42-b774-d74661d830bc
Coverage: Wed Jul
Source updated: Aug 12, 2026
Retrieved: Aug 16, 2026
Supports: CMS chain context, performance, and monthly history

View official CMS source

No paid placements. Facilities cannot pay to rank higher. We cite. You decide.

CMS rating overview

CMS overall

Health inspection

Staffing

Quality-measure

Contact

What to review

Staffing

Inspections

Ownership

Chain context

Ownership & Operation

Who is behind this facility?

Related facilities

Facilities currently connected to this organization

Who CMS records show is connected to this facility

CMS-published ownership and control parties

SANFORD

CHAPPEL, CHRISTOPHER

CAIN, JAMES

DYKHOUSE, DANA

ENGBRECHT, WESLEY

GASSEN, WILLIAM

GULSVIG, NEIL

HERSETH SANDLIN, STEPHANIE

LUNDEEN, MARK

MOLBERT, LAURIS

NORTH, ANDREW

SHULKIN, DAVID

TEIKEN, BRENT

VENTLING-HERRMANN, MARNIE

GASSEN, WILLIAM

MIDDLETON, AIMEE

OLSON, NICHOLAS

ROGERS, MICHAEL

SCHEMA, NATHAN

FLUIT, JOEL

MORRISON, TONY

SPIES, DORENE

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

What this means

Questions to ask

CMS groups this facility with GOOD SAMARITAN SOCIETY

CMS-published history

Questions to ask

What CMS inspection records show

Latest recorded inspection

F0585 — Resident Rights Deficiencies

F0641 — Resident Assessment and Care Planning Deficiencies

F0644 — Resident Assessment and Care Planning Deficiencies

F0679 — Quality of Life and Care Deficiencies

F0759 — Pharmacy Service Deficiencies

F0803 — Nutrition and Dietary Deficiencies

F0812 — Nutrition and Dietary Deficiencies

F0610 — Freedom from Abuse, Neglect, and Exploitation Deficiencies

F0645 — Resident Assessment and Care Planning Deficiencies

F0755 — Pharmacy Service Deficiencies

F0758 — Pharmacy Service Deficiencies

F0698 — Quality of Life and Care Deficiencies

F0600 — Freedom from Abuse, Neglect, and Exploitation Deficiencies

F0609 — Freedom from Abuse, Neglect, and Exploitation Deficiencies

F0657 — Resident Assessment and Care Planning Deficiencies

F0689 — Quality of Life and Care Deficiencies

F0693 — Quality of Life and Care Deficiencies

F0835 — Administration Deficiencies

F0607 — Freedom from Abuse, Neglect, and Exploitation Deficiencies

F0609 — Freedom from Abuse, Neglect, and Exploitation Deficiencies

F0623 — Resident Rights Deficiencies

F0732 — Nursing and Physician Services Deficiencies

Tags appearing across inspections

CMS penalty records in the loaded three-year dataset

Fine — Nov 10, 2023

Fine — Aug 10, 2023

Questions generated from the evidence above

Facility History

What changed recently?

2025

2024

2023

2022