Nursing Home
GOOD SAMARITAN SOCIETY-QUIBURI MISSION
Non profit – Corporation
- 850 SOUTH HIGHWAY 80
23
Total Number of Health Deficiencies

N/A
Number of Administrators Who have Left the Nursing Home
31.3%
Nurse turnover

Turnover in nursing staff may signal problems at the facility and decreases continuity of care.
The percentage of nursing staff who stopped working at the home over a 12-month period.
State Average: 51.8%
Resident
With a Resident and Family Council

Family councils are one of the most powerful ways for families to protect their loved ones. For more information on family councils, visit NursingHomeFamilyGroups.com.
N
Provider Changed Ownership in Last 12 Months
50.9
Average residents/day
Average number of residents based on daily census.
31.3%
Nurse turnover

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The percentage of nursing staff who stopped working at the home over a 12-month period.
State Average: 51.8%
N/A
Total Number of Penalties

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N/A
Number of Administrators Who have Left the Nursing Home

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1
Number of Substantiated Complaints

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Reported total of substantiated complaints
N/A
Number of Fines

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Reported nursing home abuse
0.00
Total Amount of Fines in Dollars

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Total Number of Health Deficiencies

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Reported nursing home abuse
12
Total Number of Fire Safety Deficiencies

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Average number of residents based on daily census.
3.79547
Nurse hours/resident/day

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Reported total nurse staffing hours per resident per day.
State Average: 4.1
N
Abuse Icon

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Reported nursing home abuse
N
Provider Changed Ownership in Last 12 Months

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50.9
Average residents/day

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Average number of residents based on daily census.
Direct owners are the layer of ownership closest to the nursing home while indirect owners have a stake in the nursing home but are further removed, like a company that owns the direct owner of a home. All owners listed below are people or companies who have at least a 5% stake in the nursing home. Entities with “managerial control” are those who conduct the day-to-day operations of the nursing home.
Direct owners
Indirect owners
Managerial control
Kunkel, Joann since 06/20/2013
Micka, Michelle since 01/06/2019
Morrison, Tony since 08/05/2019
Munson, Jolyn since 02/25/2013
Swenson, Stephanie since 11/01/2019
The Evangelical Lutheran Good Samaritan Society since 01/01/2019
Vanden Hull, Eric since 01/01/2019
Managing employee(s)
Peterson, Danielle
Vandivort, Monica
Legal Business Name
Affiliated Entity Name
Ownership Type
Ownership Change in the Past 12 Months
Inspection Reports
29 Total Deficiencies
Inspection reports document deficiencies, which are nursing homes’ failures to meet care requirements. The Centers for Medicare and Medicaid Services releases the last three standard inspection reports, as well as the last 36 months of complaint and infection-control reports.
Resident Rights Deficiencies — F0550
Failure to: Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D
Quality of Life and Care Deficiencies — F0700
Failure to: Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D
Quality of Life and Care Deficiencies — F0690
Failure to: Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D
Resident Rights Deficiencies — F0623
Failure to: Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Some people affected
Seriousness
E
Administration Deficiencies — F0838
Failure to: Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations and emergencies.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D
Pharmacy Service Deficiencies — F0757
Failure to: Ensure each resident’s drug regimen must be free from unnecessary drugs.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D
Resident Assessment and Care Planning Deficiencies — F0661
Failure to: Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D
Resident Assessment and Care Planning Deficiencies — F0644
Failure to: Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D
Resident Rights Deficiencies — F0582
Failure to: Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D
Administration Deficiencies — F0838
Failure to: Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations and emergencies.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D
Pharmacy Service Deficiencies — F0758
Failure to: 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.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Some people affected
Seriousness
E
Pharmacy Service Deficiencies — F0757
Failure to: Ensure each resident’s drug regimen must be free from unnecessary drugs.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D
Quality of Life and Care Deficiencies — F0742
Failure to: Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D
Nursing and Physician Services Deficiencies — F0725
Failure to: Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Some people affected
Seriousness
E
Quality of Life and Care Deficiencies — F0689
Failure to: Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D
Quality of Life and Care Deficiencies — F0686
Failure to: Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D
Quality of Life and Care Deficiencies — F0684
Failure to: Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D
Resident Assessment and Care Planning Deficiencies — F0656
Failure to: Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Some people affected
Seriousness
E
Resident Assessment and Care Planning Deficiencies — F0644
Failure to: Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Some people affected
Seriousness
E
Resident Assessment and Care Planning Deficiencies — F0641
Failure to: Ensure each resident receives an accurate assessment.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D
Resident Rights Deficiencies — F0582
Failure to: Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Severity
No actual harm, with potential for minimal harm
Scope
Some people affected
Seriousness
B
Resident Rights Deficiencies — F0550
Failure to: Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D
Quality of Life and Care Deficiencies — F0791
Failure to: Provide or obtain dental services for each resident.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Some people affected
Seriousness
E
Quality of Life and Care Deficiencies — F0688
Failure to: Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Some people affected
Seriousness
E
Quality of Life and Care Deficiencies — F0685
Failure to: Assist a resident in gaining access to vision and hearing services.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Some people affected
Seriousness
E
Resident Assessment and Care Planning Deficiencies — F0645
Failure to: PASARR screening for Mental disorders or Intellectual Disabilities
Severity
No actual harm, with a potential for more than minimal harm
Scope
Some people affected
Seriousness
E
Freedom from Abuse, Neglect, and Exploitation Deficiencies — F0610
Failure to: Respond appropriately to all alleged violations.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D
Freedom from Abuse, Neglect, and Exploitation Deficiencies — F0609
Failure to: Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D
Freedom from Abuse, Neglect, and Exploitation Deficiencies — F0607
Failure to: Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D
Inspection Reports
3 Total Deficiencies
Inspection reports document deficiencies, which are nursing homes’ failures to meet care requirements. The Centers for Medicare and Medicaid Services releases the last three standard inspection reports, as well as the last 36 months of complaint and infection-control reports.
Resident Rights Deficiency — F0584
Failure to: Honor the resident’s right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D
Resident Assessment and Care Planning Deficiency — F0842
Failure to: Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
D
Nursing and Physician Services Deficiency — F0732
Failure to: Post nurse staffing information every day.
Severity
No actual harm, with a potential for more than minimal harm
Scope
Few people affected
Seriousness
B
Data last updated
All data updated December 2024
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