Good Samaritan Society - Jackson

JACKSON, MN

CMS provider ID 245455CMS 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: 46
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: 5078473100Verified public information · checked Aug 2026

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 1.19 hours per resident day in 2026Q1, calculated from CMS PBJ records.

View staffing evidence

Inspections

The latest standard inspection on Sep 5, 2024 cited 3 deficiencies.

View inspection evidence

Ownership

CMS-published records list 29 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

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 26 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: 29
Organizations shown: 3
Individuals shown: 26
Latest ownership source update: Jul 27, 2026

CMS-published ownership and control parties

SANFORD
Organization · 5% OR GREATER DIRECT OWNERSHIP INTEREST
Published ownership percentage: 100%
Association date reported to CMS: Jan 1, 2019
Other facilities connected through this exact CMS organization identity: 0 across MN.
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
KLINE, RONALD
Individual · ADP OF THE SNF
Association date reported to CMS: Jan 1, 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
MORRISON, TONY
Individual · ADP OF THE SNF
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
SOLHEIM, PAIGE
Individual · ADP OF THE SNF
Association date reported to CMS: Dec 20, 2020
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
BROWN, GEORGE
Individual · CORPORATE DIRECTOR
Association date reported to CMS: Jan 1, 2025
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
MCCAUSLAND, MAUREEN
Individual · CORPORATE DIRECTOR
Association date reported to CMS: Jan 1, 2025
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
SCHIEFFER, KEVIN
Individual · CORPORATE DIRECTOR
Association date reported to CMS: Jan 1, 2025
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
WENZEL, THOMAS
Individual · CORPORATE DIRECTOR
Association date reported to CMS: Jan 1, 2025
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 · CORPORATE OFFICER
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
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
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
KLINE, RONALD
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Jan 1, 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
MORRISON, TONY
Individual · OPERATIONAL/MANAGERIAL CONTROL
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
SOLHEIM, PAIGE
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Dec 20, 2020
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 · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Jan 1, 2019
Other facilities connected through this exact CMS organization identity: 0 across MN.
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: Sep 5, 2024
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: 245455
Source record locator: csv-row:67074:ccn:245455

View official CMS source

Sep 5, 2024 — Fire Safety Standard — 0 linked findings

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

Sep 5, 2024 — Health Standard — 3 linked findings

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 (Oct 8, 2024)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
245455
Source record locator
csv-row:188466:ccn:245455
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 (Oct 8, 2024)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
245455
Source record locator
csv-row:188464:ccn:245455
View official CMS source
F0880 — Infection Control Deficiencies
Provide and implement an infection prevention and control program.
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 (Oct 8, 2024)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
245455
Source record locator
csv-row:188465:ccn:245455
View official CMS source

Jan 31, 2024 — Health Complaint — 1 linked finding

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 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 (Mar 1, 2024)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
245455
Source record locator
csv-row:188471:ccn:245455
View official CMS source

Jul 20, 2023 — Fire Safety Standard — 0 linked findings

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

Jul 20, 2023 — Health Standard — 4 linked findings

F0550 — Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
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 (Aug 25, 2023)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
245455
Source record locator
csv-row:188467:ccn:245455
View official CMS source
F0677 — Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
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 (Aug 25, 2023)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
245455
Source record locator
csv-row:188468:ccn:245455
View official CMS source
F0684 — Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
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 (Aug 25, 2023)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
245455
Source record locator
csv-row:188469:ccn:245455
View official CMS source
F0686 — Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
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 (Aug 25, 2023)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
245455
Source record locator
csv-row:188470:ccn:245455
View official CMS source

Apr 29, 2021 — Fire Safety Standard — 0 linked findings

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

Apr 29, 2021 — Health Standard — 7 linked findings

F0677 — Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
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 (May 28, 2021)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
245455
Source record locator
csv-row:188475:ccn:245455
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 (May 28, 2021)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
245455
Source record locator
csv-row:188476:ccn:245455
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 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 (May 28, 2021)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
245455
Source record locator
csv-row:188472:ccn:245455
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 (May 28, 2021)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
245455
Source record locator
csv-row:188477:ccn:245455
View official CMS source
F0761 — 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.
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 (May 28, 2021)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
245455
Source record locator
csv-row:188473:ccn:245455
View official CMS source
F0804 — Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
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 (May 28, 2021)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
245455
Source record locator
csv-row:188474:ccn:245455
View official CMS source
F0921 — Environmental Deficiencies
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
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 (May 28, 2021)
View source details
Dataset
Health Deficiencies
CMS dataset ID
r5ix-sfxw
CMS source updated
Jul 1, 2026
CMS provider ID
245455
Source record locator
csv-row:188478:ccn:245455
View official CMS source

Tags appearing across inspections

F0677 appears in 2 linked inspections.

Penalties & enforcement

CMS penalty records in the loaded three-year dataset

No penalty records were found for this provider in the currently loaded CMS Penalties dataset.

Questions to ask

Questions generated from the evidence above

CMS records show F0677 in 2 inspections in the available record. What changes has the facility made to address this issue?

Facility history

Facility History

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

What changed recently?

RN staffing increasedRN staffing increased from 0.98 to 1.19 hours per resident day between 2025Q4 and 2026Q1. Staffing improved across those reported periods.

2026

Mar 2026
RN staffing increased
RN staffing increased from 0.98 to 1.19 hours per resident day between 2025Q4 and 2026Q1. Staffing improved across those reported periods.
0.98 → 1.19
CMS · Reported in a source release · View related evidence

2024

Sep 5
Health inspection completed
3 deficiencies were recorded.
CMS · Recorded event date · View related evidence
Jan 31
Complaint inspection recorded
1 deficiency was recorded.
CMS · Recorded event date · View related evidence

2023

Jul 20
Health inspection completed
4 deficiencies were recorded.
CMS · Recorded event date · View related evidence

2021

Apr 29
Health inspection completed
7 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: 4.073
RN categories: 1.194
LPN/LVN categories: 0.584
CNA: 2.129

Weekday and weekend calculations

2026Q1 reported hours per resident day
Measure	Monday–Friday	Saturday–Sunday
Total nursing	4.354	3.379
RN categories	1.377	0.743

Contract staff accounted for 1% of reported nursing hours included in this quarter calculation.

Reported RN-category hours per resident day were 0.219 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	3.733	0.942	0.6	2.11	0%	91
2025Q3	3.81	0.993	0.611	2.161	0.3%	92
2025Q4	3.946	0.975	0.699	2.146	1.1%	92
2026Q1	4.073	1.194	0.584	2.129	1%	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?
PBJ records show that some reported nursing hours were contract hours. How does the facility orient and integrate contract staff?

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 4-star overall rating.
CMS reports a 3-star health inspection rating.
CMS reports a 5-star staffing rating.
CMS reports a 3-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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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

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

Verified public facility information

Source organization: Public facility listing
Dataset identifier: commercial-corroboration:public-listing
Source updated: Aug 18, 2026
Retrieved: Aug 18, 2026
Supports: Independently verified public website, phone, or publicly used name. Not a CMS rating or regulatory status.

How sources work

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

KLINE, RONALD

MORRISON, TONY

SOLHEIM, PAIGE

BROWN, GEORGE

DYKHOUSE, DANA

ENGBRECHT, WESLEY

GASSEN, WILLIAM

GULSVIG, NEIL

HERSETH SANDLIN, STEPHANIE

LUNDEEN, MARK

MCCAUSLAND, MAUREEN

MOLBERT, LAURIS

NORTH, ANDREW

SCHIEFFER, KEVIN

SHULKIN, DAVID

TEIKEN, BRENT

VENTLING-HERRMANN, MARNIE

WENZEL, THOMAS

FLUIT, JOEL

GASSEN, WILLIAM

MIDDLETON, AIMEE

OLSON, NICHOLAS

SCHEMA, NATHAN

KLINE, RONALD

MORRISON, TONY

SOLHEIM, PAIGE

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

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

F0759 — Pharmacy Service Deficiencies

F0812 — Nutrition and Dietary Deficiencies

F0880 — Infection Control Deficiencies

F0609 — Freedom from Abuse, Neglect, and Exploitation Deficiencies

F0550 — Resident Rights Deficiencies

F0677 — Quality of Life and Care Deficiencies

F0684 — Quality of Life and Care Deficiencies

F0686 — Quality of Life and Care Deficiencies

F0677 — Quality of Life and Care Deficiencies

F0693 — Quality of Life and Care Deficiencies

F0755 — Pharmacy Service Deficiencies

F0758 — Pharmacy Service Deficiencies

F0761 — Pharmacy Service Deficiencies

F0804 — Nutrition and Dietary Deficiencies

F0921 — Environmental Deficiencies

Tags appearing across inspections

CMS penalty records in the loaded three-year dataset

Questions generated from the evidence above

Facility History

What changed recently?

2026

2024

2023

2021

Reported nursing staffing at a glance

Weekday and weekend calculations

Staffing over time