Contact Information

GOOD SAMARITAN SOCIETY - MOUNT CARROLL
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
1006 NORTH LOWDEN P.O. BOX 111
MOUNT CARROLL, IL 61053
(815) 244-7715
Non profit - Corporation
Medicare certification date2: December 01, 1993
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

  48 residents

  72 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 3
Number of fines None
Number of penalties None
Number of payment denials None

Staffing

Staffing for 48 residents Illinois Average National Average
Hours by Registered Nurse (RN) per resident per day 1 hour, 1 minute 46 minutes 41 minutes
Hours by Licensed Practial Nurse (LPN & LVN) per resident per day 5 minutes 38 minutes 53 minutes
Hours by Certified Nursing Assistant (CNA) per resident per day 2 hours, 2 minutes 2 hours, 4 minutes 2 hours, 20 minutes
Physical therapy (PT) staff hours per resident per day 4 minutes 6 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

  • BREWINGTON, LUANN
  • 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 - MOUNT CARROLL charged a total of $1,745,343 for 68 Medicare Beneficiaries. The average age of residents at this skilled nursing facility is about 82.

The report covers only calendar year 2016.

Chronic Condition of Residents
Atrial Fibrillation 32% Alzheimer's 28%
Asthma 41% Cancer 18%
Congestive Heart Failure 50% Kidney Disease 69%
COPD 38% Depression 34%
Diabetes 54% Hyperlipidemia 71%
Hypertension n/a Ischemic Heart Disease 60%
Osteoporosis 13% RA / OA 56%
Schizophrenia 1% Stroke 10%
Demographics
Medicare Beneficiaries 68 Average Age 82
Male 22 Female 46
White 66
Black n/a
Asian 0
Hispanic n/a
American Indian 0
Other 0

Health & Fire Inspection

Most recent health inspection: Jun 07, 2018; fire safety inspection: Jun 13, 2018

Health Deficiencies as of 06/07/2018
Freedom from Abuse, Neglect, and Exploitation 3
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 None
Administration Deficiencies None
Fire Deficiencies as of 06/13/2018
Emergency Preparedness None
Automatic Sprinkler Systems None
Construction Deficiencies None
Services Deficiencies None
Corridor Walls and Doors None
Egress Deficiencies None
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 1

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See also