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HomeMinnesotaGood Samaritan Society - Blackduck

Good Samaritan Society - Blackduck

172 Summit Avenue West, Blackduck, MN 566302188353410
2/5Below Average
Accepts Medicare Accepts Medicaid Sprinkler System
Health
2/5
Staffing
4/5
Quality
2/5
Beds
30
certified

Key Findings

• CMS rates this facility 2/5 stars (below average)

• Has 30 certified beds with an average of 26.2 residents per day (87% occupancy)

• Last health inspection found 9 deficiencies (inspected Jun 13, 2024)

• No fines on record

• Total nursing staff: 4.39 hours per resident per day

• Staff turnover rate: 45.0%

• Part of the Good Samaritan Society chain (90 facilities)

Good Samaritan Society - Blackduck is a 2-star Medicare and Medicaid certified nursing home in Blackduck, Minnesota with 30 certified beds. It has been operating since 1992. The facility scored below average compared to Minnesota facilities.

Beds
30
Avg Residents/Day
26.2
Ownership
Non profit - Corporation
Provider Type
Medicare and Medicaid
In Hospital
No
First Approved
Apr 1, 1992
Sprinklers
Yes
Council
Resident
County
Beltrami
Last Inspection
Jun 13, 2024
Deficiencies (Cycle 1)
9
Weighted Score
71.0
Infection Citations
0

Deficiency Citations (20)

F0641Potential for Harm

Ensure each resident receives an accurate assessment.

Survey: Oct 31, 2025Corrected: NoCycle: 1
F0655Potential for Harm

Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted

Survey: Oct 31, 2025Corrected: NoCycle: 1
F0686Potential for Harm

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

Survey: Oct 31, 2025Corrected: NoCycle: 1
F0623Potential for Harm

Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

Survey: Jun 13, 2024Corrected: NoCycle: 1
F0625Potential for Harm

Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.

Survey: Jun 13, 2024Corrected: NoCycle: 1
F0812Potential for Harm

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Survey: Jun 13, 2024Corrected: NoCycle: 1
F0865Potential for Harm

Have a plan that describes the process for conducting QAPI and QAA activities.

Survey: Jun 13, 2024Corrected: NoCycle: 1
F0880Potential for Harm

Provide and implement an infection prevention and control program.

Survey: Jun 13, 2024Corrected: NoCycle: 1
F0882Potential for Harm

Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.

Survey: Jun 13, 2024Corrected: NoCycle: 1
F0689Potential for Harm

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Survey: Feb 7, 2024Corrected: NoCycle: 2
F0640Potential for Harm

Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.

Survey: Aug 10, 2023Corrected: NoCycle: 2
F0641Minimal Harm

Ensure each resident receives an accurate assessment.

Survey: Aug 10, 2023Corrected: NoCycle: 2
F0661Potential for Harm

Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.

Survey: Aug 10, 2023Corrected: NoCycle: 2
F0756Potential for Harm

Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

Survey: Aug 10, 2023Corrected: NoCycle: 2
F0758Potential for Harm

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.

Survey: Aug 10, 2023Corrected: NoCycle: 2
F0883Potential for Harm

Develop and implement policies and procedures for flu and pneumonia vaccinations.

Survey: Aug 10, 2023Corrected: NoCycle: 2
F0554Potential for Harm

Allow residents to self-administer drugs if determined clinically appropriate.

Survey: Aug 10, 2023Corrected: NoCycle: 3
F0554Potential for Harm

Allow residents to self-administer drugs if determined clinically appropriate.

Survey: Sep 8, 2022Corrected: NoCycle: 3
F0561Potential for Harm

Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.

Survey: Sep 8, 2022Corrected: NoCycle: 3
F0684Potential for Harm

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Survey: Sep 8, 2022Corrected: NoCycle: 3
Total Fines
$0
Number of Fines
0
Payment Denials
0
Total Penalties
0

No penalties on record.

Staffing hours per resident per day. The black line shows the national average.

Nurse Aide2.77 hrs
National avg: 2.35 hrs
LPN0.45 hrs
National avg: 0.86 hrs
RN1.17 hrs
National avg: 0.68 hrs
Total Nursing4.39 hrs
National avg: 3.89 hrs
Weekend Total4.09 hrs
National avg: 0.00 hrs
Physical Therapist0.02 hrs
National avg: 0.07 hrs
Total Turnover
45.0%
RN Turnover
33.3%
Administrators Left
0

Quality measures as percentages of residents. Lower is better for all measures.

Ownership Type
Non profit - Corporation
Recent Change
No

Owners & Managers (28)

NameRoleTypeOwnership %Since
SANFORD5% OR GREATER DIRECT OWNERSHIP INTERESTOrganization100%Jan 1, 2019
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY5% OR GREATER INDIRECT OWNERSHIP INTERESTOrganization100%Jan 1, 2019
SANFORDOPERATIONAL/MANAGERIAL CONTROLOrganizationN/AJan 1, 2019
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETYOPERATIONAL/MANAGERIAL CONTROLOrganizationN/AJan 1, 2019
BILLUPS, SHERRYOPERATIONAL/MANAGERIAL CONTROLIndividualN/AAug 14, 2018
BJERKE, BRANDONOPERATIONAL/MANAGERIAL CONTROLIndividualN/AApr 12, 2021
MORRISON, TONYOPERATIONAL/MANAGERIAL CONTROLIndividualN/AJan 1, 2019
SANDGREN, DEEANDRAOPERATIONAL/MANAGERIAL CONTROLIndividualN/AJul 16, 2023
BROWN, GEORGECORPORATE DIRECTORIndividualN/AJan 1, 2025
DYKHOUSE, DANACORPORATE DIRECTORIndividualN/AMay 30, 2024
ENGBRECHT, WESLEYCORPORATE DIRECTORIndividualN/AMay 30, 2024
GASSEN, WILLIAMCORPORATE DIRECTORIndividualN/AMay 30, 2024
GULSVIG, NEILCORPORATE DIRECTORIndividualN/AMay 30, 2024
HERSETH SANDLIN, STEPHANIECORPORATE DIRECTORIndividualN/AMay 30, 2024
LUNDEEN, MARKCORPORATE DIRECTORIndividualN/AMay 30, 2024
MCCAUSLAND, MAUREENCORPORATE DIRECTORIndividualN/AJan 1, 2025
MOLBERT, LAURISCORPORATE DIRECTORIndividualN/AMay 30, 2024
NORTH, ANDREWCORPORATE DIRECTORIndividualN/AMay 30, 2024
SCHIEFFER, KEVINCORPORATE DIRECTORIndividualN/AJan 1, 2025
SHULKIN, DAVIDCORPORATE DIRECTORIndividualN/AMay 30, 2024
TEIKEN, BRENTCORPORATE DIRECTORIndividualN/AMay 30, 2024
VENTLING-HERRMANN, MARNIECORPORATE DIRECTORIndividualN/AMay 30, 2024
WENZEL, THOMASCORPORATE DIRECTORIndividualN/AJan 1, 2025
FLUIT, JOELCORPORATE OFFICERIndividualN/AOct 1, 2022
GASSEN, WILLIAMCORPORATE OFFICERIndividualN/AMay 30, 2024
MIDDLETON, AIMEECORPORATE OFFICERIndividualN/AJan 27, 2022
OLSON, NICHOLASCORPORATE OFFICERIndividualN/AApr 8, 2024
SCHEMA, NATHANCORPORATE OFFICERIndividualN/AJan 1, 2022

Frequently Asked Questions

What is the CMS rating for Good Samaritan Society - Blackduck?▾
Good Samaritan Society - Blackduck has an overall CMS rating of 2 out of 5 stars, with a health inspection rating of 2/5, staffing rating of 4/5, and quality measures rating of 2/5. This facility is rated below average.
Has Good Samaritan Society - Blackduck had any health inspection violations?▾
Good Samaritan Society - Blackduck had 9 deficiency citations in its most recent health inspection (Jun 13, 2024). The facility has no fines on record.
What are the staffing levels at Good Samaritan Society - Blackduck?▾
Good Samaritan Society - Blackduck provides 4.39 total nursing staff hours per resident per day, including 1.17 RN hours, 0.45 LPN hours, and 2.77 nurse aide hours. The total staff turnover rate is 45.0%.
How many beds does Good Samaritan Society - Blackduck have?▾
Good Samaritan Society - Blackduck has 30 certified beds with an average of 26.2 residents per day, resulting in approximately 87% occupancy. The facility is Non profit - Corporation owned and is part of the Good Samaritan Society chain.

Part of Good Samaritan Society

This chain operates 90 facilities. View all →