Blackduck, MN

Good Samaritan Society - Blackduck

2-star overall rating with 2-star inspections with 9 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle

172 Summit Avenue West, Blackduck, MN

(218) 835-3410

Compare this facility

Overall

2 / 5

CMS overall stars

Health inspections

2 / 5

Survey and complaint cycles

Staffing

4 / 5

RN + nurse staffing

Quality measures

2 / 5

Resident outcomes and process measures

Quick facts

Facility snapshot

Beds

30

Certified beds

Average residents

26

Average occupied residents

Ownership

Non-Profit

Publicly displayed owner type

Chain

Good Samaritan Society

Operator or chain grouping

Approved since

1992-04-01

CMS approved date

Coverage

Medicare + Medicaid

Participation flags

Chain footprint

89 facilities

Chain averages 3 overall / 3 health / 4 staffing / 3 quality stars

Changed ownership

No

Within the last 12 months

Family council

Yes

Resident and family council reported

Sprinklers

Yes

Automatic sprinklers in all required areas

Staffing

Hours and turnover

RN hours / resident day

1.17

Registered nurse staffing · state 1.06 · national 0.68

LPN hours / resident day

0.45

Licensed practical nurse staffing · state 0.62 · national 0.87

Aide hours / resident day

2.77

Nurse aide staffing · state 2.56 · national 2.35

Total nurse hours

4.39

All reported nurse hours · state 4.23 · national 3.89

Licensed hours

1.62

RN + LPN hours · state 1.68 · national 1.54

Weekend hours

4.09

Weekend nurse staffing · state 3.68 · national 3.43

Weekend RN hours

1.10

Weekend registered nurse coverage · state 0.68 · national 0.47

Physical therapist

0.02

Reported PT staffing · state 0.08 · national 0.07

Adjusted RN hours

1.12

CMS adjusted RN staffing hours

Adjusted total hours

4.20

CMS adjusted total nurse staffing hours

Case-mix index

1.43

Higher values indicate more complex resident acuity

RN turnover

33%

Annual RN turnover · state 39% · national 45%

Total nurse turnover

45%

Annual nurse turnover · state 42% · national 46%

SNF VBP

Value-based purchasing

Program rank

5,048

Lower is better among SNFs in the FY 2026 VBP program.

Performance score

37.58

Composite VBP score used to determine payment impact.

Payment multiplier

0.9908

Above 1.000 increases Medicare payment; below 1.000 reduces it.

Program components

How the VBP score is built

Readmission

Not reported

This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.

Healthcare-associated infections

Not reported

This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.

Total nurse turnover

5.46

Baseline 37.04% · Performance 41.38% · Measure score 5.46 · Achievement 5.46 · Improvement 0

Adjusted total nurse staffing

2.06

Performance 3.66 hours · Measure score 2.06 · Achievement 2.06 · This facility did not have sufficient data to calculate a baseline period measure result.

SNF QRP

Medicare quality reporting measures

Measure	Facility	National	Note
Potentially preventable 30-day readmission	Not Available	10.72%	Not Available · Eligible stays 19 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly.
Discharge to community	Not Available	50.57%	Not Available · Eligible stays 19 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly.
Medicare spending per beneficiary	Not Available	1.02	Too few residents or stays to report publicly.
Drug regimen review with follow-up	Not Available	95.27%	Numerator Not Available · Denominator 3 · Too few residents or stays to report publicly.
Falls with major injury	Not Available	0.77%	Numerator Not Available · Denominator 3 · Too few residents or stays to report publicly.
Discharge self-care score	Not Available	53.69%	Numerator Not Available · Denominator 3 · Too few residents or stays to report publicly.
Discharge mobility score	Not Available	50.94%	Numerator Not Available · Denominator 3 · Too few residents or stays to report publicly.
Pressure ulcers or injuries, new or worsened	Not Available	2.29%	Numerator Not Available · Denominator 3 · Adjusted rate Not Available · Too few residents or stays to report publicly.
Healthcare-associated infections requiring hospitalization	Not Available	7.12%	Not Available · Eligible stays 12 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly.
Staff COVID-19 vaccination coverage	6.35%	8.2% 1.8 pts worse	Numerator 4 · Denominator 63
Staff flu vaccination coverage	85.07%	42% 43.1 pts better	Numerator 57 · Denominator 67
Discharge function score	Not Available	56.45%	Numerator Not Available · Denominator 3 · Too few residents or stays to report publicly.
Transfer of health information to provider	Not Available	95.95%	Numerator Not Available · Denominator Not Available · Newly certified or not enough cases to report.
Transfer of health information to patient	Not Available	96.28%	Numerator Not Available · Denominator 3 · Too few residents or stays to report publicly.
Resident COVID-19 vaccinations up to date	Not Available	25.2%	Numerator Not Available · Denominator Not Available · Newly certified or not enough cases to report.

Quality measures

Resident outcomes and process scores

Measure	Facility	State	National	Note
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine	98.1%	97.3% 0.8 pts better	93.4% 4.7 pts better	Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 96.4% · Q3 96.4% · Q4 100.0% · 4Q avg 98.1%
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine	72.4%	96.1% 23.7 pts worse	95.5% 23.1 pts worse	Long Stay · 2024Q3-2025Q2 · 4Q avg 72.4%
Percentage of long-stay residents experiencing one or more falls with major injury	3.7%	3.9% 0.2 pts better	3.3% 0.4 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 3.6% · Q3 3.6% · Q4 8.3% · 4Q avg 3.7% · Used in QM five-star
Percentage of long-stay residents who have depressive symptoms	12.9%	4.3% 8.6 pts worse	11.4% 1.5 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 3.7% · Q2 3.8% · Q3 18.5% · Q4 28.6% · 4Q avg 12.9%
Percentage of long-stay residents who lose too much weight	2.2%	4.1% 1.9 pts better	5.4% 3.2 pts better	Long Stay · 2024Q4-2025Q3 · Q1 4.3% · Q2 0.0% · Q3 0.0% · Q4 4.3% · 4Q avg 2.2%
Percentage of long-stay residents who received an antianxiety or hypnotic medication	2.0%	12.4% 10.4 pts better	19.6% 17.6 pts better	Long Stay · 2024Q4-2025Q3 · Q1 4.2% · Q2 0.0% · Q3 0.0% · Q4 4.2% · 4Q avg 2.0%
Percentage of long-stay residents who received an antipsychotic medication	13.5%	17.5% 4 pts better	16.7% 3.2 pts better	Long Stay · 2024Q4-2025Q3 · Q1 18.2% · Q2 16.0% · Q3 8.3% · 4Q avg 13.5% · Used in QM five-star
Percentage of long-stay residents who were physically restrained	0.0%	0.1% 0.1 pts better	0.1% 0.1 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0%
Percentage of long-stay residents whose ability to walk independently worsened	14.1%	22.5% 8.4 pts better	16.3% 2.2 pts better	Long Stay · 2024Q4-2025Q3 · 4Q avg 14.1% · Used in QM five-star
Percentage of long-stay residents whose need for help with daily activities has increased	17.2%	18.6% 1.4 pts better	14.9% 2.3 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 20.8% · Q2 10.0% · Q3 22.7% · Q4 14.3% · 4Q avg 17.2% · Used in QM five-star
Percentage of long-stay residents with a catheter inserted and left in their bladder	5.1%	2.3% 2.8 pts worse	1.0% 4.1 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 6.1% · Q2 8.6% · Q3 4.9% · Q4 0.0% · 4Q avg 5.1% · Used in QM five-star
Percentage of long-stay residents with a urinary tract infection	2.0%	2.6% 0.6 pts better	1.7% 0.3 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 3.8% · Q2 3.7% · Q3 0.0% · Q4 0.0% · 4Q avg 2.0% · Used in QM five-star
Percentage of long-stay residents with new or worsened bowel or bladder incontinence	36.4%	24.8% 11.6 pts worse	19.8% 16.6 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 21.2% · Q2 45.3% · Q4 50.1% · 4Q avg 36.4%
Percentage of long-stay residents with pressure ulcers	2.2%	5.4% 3.2 pts better	5.1% 2.9 pts better	Long Stay · 2024Q4-2025Q3 · Q1 2.6% · Q2 0.0% · Q3 3.1% · Q4 3.3% · 4Q avg 2.2% · Used in QM five-star
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine	20.5%	88.6% 68.1 pts worse	81.7% 61.2 pts worse	Short Stay · 2024Q4-2025Q3 · Q4 9.1% · 4Q avg 20.5%
Percentage of short-stay residents who newly received an antipsychotic medication	0.0%	1.9% 1.9 pts better	1.6% 1.6 pts better	Short Stay · 2024Q4-2025Q3 · 4Q avg 0.0% · Used in QM five-star

Survey summary

Recent inspection cycles

Cycle 1 Health 2024-06-13 · Fire 2024-06-13

9 health deficiencies

Top issue: Infection Control (2 deficiencies)

2 fire-safety deficiencies

Top issue: Gas and Vacuum and Electrical Systems (1 deficiency)

Cycle 2 Health 2023-08-10 · Fire 2023-08-10

6 health deficiencies

Top issue: Resident Assessment and Care Planning (3 deficiencies)

9 fire-safety deficiencies

Top issue: Smoke (5 deficiencies)

Cycle 3 Health 2022-09-08 · Fire 2022-09-08

5 health deficiencies

Top issue: Resident Rights (3 deficiencies)

3 fire-safety deficiencies

Top issue: Smoke (2 deficiencies)

Fire safety

Fire-safety citations

E · Potential for more than minimal harm 2024-06-13

K321 · Smoke Deficiencies

Fire Safety

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

Corrected 2024-07-15

D · Potential for more than minimal harm 2024-06-13

K920 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Ensure proper usage of power strips and extension cords.

Corrected 2024-07-15

F · Potential for more than minimal harm 2023-08-10

K345 · Smoke Deficiencies

Fire Safety

Have approved installation, maintenance and testing program for fire alarm systems.

Corrected 2023-09-20

F · Potential for more than minimal harm 2023-08-10

K353 · Smoke Deficiencies

Fire Safety

Inspect, test, and maintain automatic sprinkler systems.

Corrected 2023-09-20

F · Potential for more than minimal harm 2023-08-10

K372 · Smoke Deficiencies

Fire Safety

Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

Corrected 2023-09-20

F · Potential for more than minimal harm 2023-08-10

K511 · Services Deficiencies

Fire Safety

Have properly installed electrical wiring and gas equipment.

Corrected 2023-09-20

F · Potential for more than minimal harm 2023-08-10

K712 · Miscellaneous Deficiencies

Fire Safety

Have simulated fire drills held at unexpected times.

Corrected 2023-09-20

F · Potential for more than minimal harm 2023-08-10

K761 · Miscellaneous Deficiencies

Fire Safety

To conduct inspection, testing and maintenance of fire doors by qualified individuals.

Corrected 2023-09-20

E · Potential for more than minimal harm 2023-08-10

K291 · Egress Deficiencies

Fire Safety

Install emergency lighting that can last at least 1 1/2 hours.

Corrected 2023-09-20

D · Potential for more than minimal harm 2023-08-10

K321 · Smoke Deficiencies

Fire Safety

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

Corrected 2023-09-20

D · Potential for more than minimal harm 2023-08-10

K351 · Smoke Deficiencies

Fire Safety

Install an approved automatic sprinkler system.

Corrected 2023-09-20

E · Potential for more than minimal harm 2022-09-08

K351 · Smoke Deficiencies

Fire Safety

Install an approved automatic sprinkler system.

Corrected 2022-10-14

E · Potential for more than minimal harm 2022-09-08

K363 · Smoke Deficiencies

Fire Safety

Install corridor and hallway doors that block smoke.

Corrected 2022-10-14

D · Potential for more than minimal harm 2022-09-08

K511 · Services Deficiencies

Fire Safety

Have properly installed electrical wiring and gas equipment.

Corrected 2022-10-14

Inspection history

Recent health citations

D · Potential for more than minimal harm 2025-10-31

F641 · Resident Assessment and Care Planning Deficiencies

Health

Ensure each resident receives an accurate assessment.

Corrected 2025-12-26

D · Potential for more than minimal harm 2025-10-31

F655 · Resident Assessment and Care Planning Deficiencies

Health

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

Corrected 2025-12-26

D · Potential for more than minimal harm 2025-10-31

F686 · Quality of Life and Care Deficiencies

Health

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

Corrected 2025-12-26

F · Potential for more than minimal harm 2024-06-13

F812 · Nutrition and Dietary Deficiencies

Health

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

Corrected 2024-07-22

F · Potential for more than minimal harm 2024-06-13

F865 · Administration Deficiencies

Health

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

Corrected 2024-07-22

F · Potential for more than minimal harm 2024-06-13

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2024-07-22

F · Potential for more than minimal harm 2024-06-13

F882 · Infection Control Deficiencies

Health

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

Corrected 2024-07-22

D · Potential for more than minimal harm 2024-06-13

F623 · Resident Rights Deficiencies

Health

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

Corrected 2024-07-22

D · Potential for more than minimal harm 2024-06-13

F625 · Resident Rights Deficiencies

Health

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.

Corrected 2024-07-22

D · Potential for more than minimal harm 2024-02-07

F689 · Quality of Life and Care Deficiencies

Health

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

Corrected 2024-03-13

E · Potential for more than minimal harm 2023-08-10

F758 · Pharmacy Service Deficiencies

Health

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.

Corrected 2023-09-20

D · Potential for more than minimal harm 2023-08-10

F554 · Resident Rights Deficiencies

Health

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

Corrected 2023-09-20

D · Potential for more than minimal harm 2023-08-10

F640 · Resident Assessment and Care Planning Deficiencies

Health

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

Corrected 2023-09-20

D · Potential for more than minimal harm 2023-08-10

F661 · Resident Assessment and Care Planning Deficiencies

Health

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

Corrected 2023-09-20

D · Potential for more than minimal harm 2023-08-10

F756 · Pharmacy Service Deficiencies

Health

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

Corrected 2023-09-20

D · Potential for more than minimal harm 2023-08-10

F883 · Infection Control Deficiencies

Health

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

Corrected 2023-09-20

B · Minimal harm 2023-08-10

F641 · Resident Assessment and Care Planning Deficiencies

Health

Ensure each resident receives an accurate assessment.

Corrected 2023-09-20

D · Potential for more than minimal harm 2022-09-08

F554 · Resident Rights Deficiencies

Health

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

Corrected 2022-10-28

D · Potential for more than minimal harm 2022-09-08

F561 · Resident Rights Deficiencies

Health

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

Corrected 2022-10-28

D · Potential for more than minimal harm 2022-09-08

F684 · Quality of Life and Care Deficiencies

Health

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

Corrected 2022-10-28

Penalties and ownership

What sits behind the stars

Ownership

Sanford

5% Or Greater Direct Ownership Interest · Organization

100% 89 facilities 2019-01-01

The Evangelical Lutheran Good Samaritan Society

5% Or Greater Indirect Ownership Interest · Organization

100% 88 facilities 2019-01-01

Billups, Sherry

Operational/Managerial Control · Individual

0% 1 facilities 2018-08-14

Bjerke, Brandon

Operational/Managerial Control · Individual

0% 1 facilities 2021-04-12

Brown, George

Corporate Director · Individual

0% 64 facilities 2025-01-01

Dykhouse, Dana

Corporate Director · Individual

0% 85 facilities 2024-05-30

Engbrecht, Wesley

Corporate Director · Individual

0% 89 facilities 2024-05-30

Fluit, Joel

Corporate Officer · Individual

0% 88 facilities 2022-10-01

Gassen, William

Corporate Director · Individual

0% 89 facilities 2024-05-30

Gassen, William

Corporate Officer · Individual

0% 89 facilities 2024-05-30

Gulsvig, Neil

Corporate Director · Individual

0% 89 facilities 2024-05-30

Herseth Sandlin, Stephanie

Corporate Director · Individual

0% 86 facilities 2024-05-30

Lundeen, Mark

Corporate Director · Individual

0% 89 facilities 2024-05-30

Mccausland, Maureen

Corporate Director · Individual

0% 61 facilities 2025-01-01

Middleton, Aimee

Corporate Officer · Individual

0% 88 facilities 2022-01-27

Molbert, Lauris

Corporate Director · Individual

0% 89 facilities 2024-05-30

Morrison, Tony

Operational/Managerial Control · Individual

0% 89 facilities 2019-01-01

North, Andrew

Corporate Director · Individual

0% 89 facilities 2024-05-30

Olson, Nicholas

Corporate Officer · Individual

0% 87 facilities 2024-04-08

Sandgren, Deeandra

Operational/Managerial Control · Individual

0% 30 facilities 2023-07-16

Sanford

Operational/Managerial Control · Organization

0% 89 facilities 2019-01-01

Schema, Nathan

Corporate Officer · Individual

0% 88 facilities 2022-01-01

Schieffer, Kevin

Corporate Director · Individual

0% 61 facilities 2025-01-01

Shulkin, David

Corporate Director · Individual

0% 85 facilities 2024-05-30

Teiken, Brent

Corporate Director · Individual

0% 89 facilities 2024-05-30

The Evangelical Lutheran Good Samaritan Society

Operational/Managerial Control · Organization

0% 88 facilities 2019-01-01

Ventling-Herrmann, Marnie

Corporate Director · Individual

0% 89 facilities 2024-05-30

Wenzel, Thomas

Corporate Director · Individual

0% 61 facilities 2025-01-01

Nearby options

Other facilities in reach

#1

Neilson Place

Bemidji, MN

1-star overall rating with 1-star inspections with abuse icon flag with $36,342 in total fines with 14 recent health deficiencies with 4 fire-safety deficiencies in the latest cycle

Overall: 1 / 5
Health: 1 / 5
Staffing: 4 / 5
Fines: $36,342

#2

Havenwood Care Center

Bemidji, MN

1-star overall rating with 1-star inspections with $21,590 in total fines with 21 recent health deficiencies with 11 fire-safety deficiencies in the latest cycle

Overall: 1 / 5
Health: 1 / 5
Staffing: 4 / 5
Fines: $21,590

#3