Contact Information

GOOD SAMARITAN SOCIETY - FONTANELLE
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
326 SUMMERSET BOX 38
FONTANELLE, IA 50846
(641) 745-4191
Non profit - Corporation
Medicare certification date2: December 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

  35 residents

  46 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 1
Facility reported incidents None
Number of fines None
Number of penalties None
Number of payment denials None

Staffing

Staffing for 35 residents Iowa Average National Average
Hours by Registered Nurse (RN) per resident per day 55 minutes 45 minutes 41 minutes
Hours by Licensed Practial Nurse (LPN & LVN) per resident per day 25 minutes 37 minutes 53 minutes
Hours by Certified Nursing Assistant (CNA) per resident per day 1 hour, 43 minutes 2 hours, 23 minutes 2 hours, 20 minutes
Physical therapy (PT) staff hours per resident per day 4 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
  • BUCKNEBERG, NORVAL
  • 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

  • HERDINA, JOSEPH
  • WHEATLEY, MALLORY

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 - FONTANELLE charged a total of $325,478 for 14 Medicare Beneficiaries. The average age of residents at this skilled nursing facility is about 79.

The report covers only calendar year 2016.

Chronic Condition of Residents
Atrial Fibrillation 50% Alzheimer's 14%
Asthma 29% Cancer 0%
Congestive Heart Failure 50% Kidney Disease 64%
COPD 21% Depression 29%
Diabetes 36% Hyperlipidemia 71%
Hypertension n/a Ischemic Heart Disease 36%
Osteoporosis 29% RA / OA 43%
Schizophrenia 14% Stroke 21%
Demographics
Medicare Beneficiaries 14 Average Age 79
Male n/a Female n/a
White 14
Black 0
Asian 0
Hispanic 0
American Indian 0
Other 0

Health & Fire Inspection

Most recent health inspection: May 03, 2018; fire safety inspection: May 08, 2018

Health Deficiencies as of 05/03/2018
Freedom from Abuse, Neglect, and Exploitation None
Quality of Life and Care 3
Resident Assessment and Care Planning 2
Nursing and Physician Services None
Resident Rights 2
Nutrition and Dietary Deficiencies None
Pharmacy Service 1
Environmental Deficiencies None
Administration Deficiencies 1
Fire Deficiencies as of 05/08/2018
Emergency Preparedness 2
Automatic Sprinkler Systems None
Construction Deficiencies None
Services Deficiencies None
Corridor Walls and Doors None
Egress Deficiencies 1
Electrical Deficiencies None
Emergency Plans and Fire Drills None
Fire Alarm Systems None
Smoke Deficiencies 4
Interior Deficiencies None
Gas, Vacuum, and Electrical Systems 2
Hazardous Area None
Illumination and Emergency Power None
Laboratories Deficiencies None
Medical Gases and Anesthetizing Areas None
Smoking Regulations None
Miscellaneous Regulations 2

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See also