Contact Information

GOOD SAMARITAN SOCIETY - FOREST CITY
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
606 SOUTH SEVENTH STREET
FOREST CITY, IA 50436
(641) 585-2232
Non profit - Corporation
Medicare certification date2: April 01, 1994
The is the date the nursing home was certified to participate in the Medicare program.

1 Nursing homes can be run by private for-profit corporations, non-profit corporations, religious affiliated organizations or government entities.

2 Agencies that are Medicare Certified are able to participate in Medicare related programs.


Nursing Home Information

  54 residents

  56 certified beds

  Participates in Medicare and Medicaid

  Continuing Care Retirement Community

  In hospital

  Resident Council only

  Automatic sprinklers in all required areas

Quality rating
Health inspection rating
Staffing rating
Substantiated complaints 2
Facility reported incidents 2
Number of fines None
Number of penalties 1
Number of payment denials 1

Staffing

Staffing for 54 residents Iowa Average National Average
Hours by Registered Nurse (RN) per resident per day 24 minutes 45 minutes 41 minutes
Hours by Licensed Practial Nurse (LPN & LVN) per resident per day 28 minutes 37 minutes 53 minutes
Hours by Certified Nursing Assistant (CNA) per resident per day 2 hours, 31 minutes 2 hours, 23 minutes 2 hours, 20 minutes
Physical therapy (PT) staff hours per resident per day 6 minutes 4 minutes 7 minutes

Staffing hours per resident is the total number of hours worked by the staff divided by the total number of residents. It doesn't necessarily show the number of nursing staff present at any given time or the amount of care given to any one resident.

Ownership

5% OR GREATER DIRECT OWNERSHIP INTEREST

  • THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

DIRECTOR

  • BOLLIG, REBECCA
  • CAMERO, PATRICIA
  • DEUTH, MICHAEL
  • GARD, ALAN
  • GRINDAL, HARALD
  • HALAAS, GWEN
  • KRZMARZICK, HEATHER
  • LAAVEG, LEE
  • MELBY, LISA
  • PHILLIPPE, TIMOTHY
  • RACEK, JOHN
  • ROBINSON, DINA
  • SCHUMANN, JILL
  • THOMPSON, DALE

MANAGING EMPLOYEE

  • HANSON, MEEGAN
  • HERDINA, JOSEPH

OFFICER

  • HAM-QUICK, MISTY
  • HERDINA, JOSEPH
  • HORAZDOVSKY, DAVID
  • KAPUSTA, THOMAS
  • PETERSON, BERGEN
  • SYVERSON, THOMAS
  • TRIBBLE, GEORGE

OPERATIONAL/MANAGERIAL CONTROL

  • HORAZDOVSKY, DAVID

Nursing Home Report

In 2016, GOOD SAMARITAN SOCIETY - FOREST CITY charged a total of $534,751 for 44 Medicare Beneficiaries. The average age of residents at this skilled nursing facility is about 83.

The report covers only calendar year 2016.

Chronic Condition of Residents
Atrial Fibrillation 39% Alzheimer's 45%
Asthma 23% Cancer 25%
Congestive Heart Failure 57% Kidney Disease 45%
COPD 25% Depression 34%
Diabetes 36% Hyperlipidemia n/a
Hypertension n/a Ischemic Heart Disease 61%
Osteoporosis 25% RA / OA 61%
Schizophrenia 9% Stroke 18%
Demographics
Medicare Beneficiaries 44 Average Age 83
Male 13 Female 31
White 44
Black 0
Asian 0
Hispanic 0
American Indian 0
Other 0

Health & Fire Inspection

Most recent health inspection: Jul 26, 2018; fire safety inspection: Jul 31, 2018

Health Deficiencies as of 07/26/2018
Freedom from Abuse, Neglect, and Exploitation None
Quality of Life and Care None
Resident Assessment and Care Planning None
Nursing and Physician Services None
Resident Rights None
Nutrition and Dietary Deficiencies None
Pharmacy Service None
Environmental Deficiencies 1
Administration Deficiencies 1
Fire Deficiencies as of 07/31/2018
Emergency Preparedness None
Automatic Sprinkler Systems None
Construction Deficiencies None
Services Deficiencies None
Corridor Walls and Doors None
Egress Deficiencies 2
Electrical Deficiencies None
Emergency Plans and Fire Drills None
Fire Alarm Systems None
Smoke Deficiencies 4
Interior Deficiencies None
Gas, Vacuum, and Electrical Systems 1
Hazardous Area None
Illumination and Emergency Power None
Laboratories Deficiencies None
Medical Gases and Anesthetizing Areas None
Smoking Regulations None
Miscellaneous Regulations 1

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See also