Contact Information

GOOD SAMARITAN SOCIETY - DEVILS LAKE
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
302 7TH AVE NE
DEVILS LAKE, ND 58301
(701) 662-6580
Non profit - Corporation
Medicare certification date2: March 01, 1991
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

  45 residents

  48 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 45 residents North Dakota Average National Average
Hours by Registered Nurse (RN) per resident per day 34 minutes 50 minutes 41 minutes
Hours by Licensed Practial Nurse (LPN & LVN) per resident per day 43 minutes 36 minutes 53 minutes
Hours by Certified Nursing Assistant (CNA) per resident per day 2 hours, 23 minutes 2 hours, 58 minutes 2 hours, 20 minutes
Physical therapy (PT) staff hours per resident per day 2 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
  • ESPINOSA, JAVIER
  • GARD, ALAN
  • HALAAS, GWEN
  • KRZMARZICK, HEATHER
  • LAAVEG, LEE
  • MELBY, LISA
  • PETERSEN, SCOTT
  • PHILLIPPE, TIMOTHY
  • RACEK, JOHN
  • ROBINSON, DINA
  • SCHUMANN, JILL
  • THOMPSON, DALE

MANAGING EMPLOYEE

  • HERDINA, JOSEPH
  • TROTTIER, NATHAN

OFFICER

  • 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 - DEVILS LAKE charged a total of $426,480 for 29 Medicare Beneficiaries. The average age of residents at this skilled nursing facility is about 80.

The report covers only calendar year 2016.

Chronic Condition of Residents
Atrial Fibrillation 24% Alzheimer's 48%
Asthma 34% Cancer 10%
Congestive Heart Failure 55% Kidney Disease 72%
COPD 34% Depression 34%
Diabetes 38% Hyperlipidemia n/a
Hypertension n/a Ischemic Heart Disease 72%
Osteoporosis 21% RA / OA 55%
Schizophrenia 28% Stroke 17%
Demographics
Medicare Beneficiaries 29 Average Age 80
Male n/a Female n/a
White 24
Black 0
Asian 0
Hispanic 0
American Indian n/a
Other n/a

Health & Fire Inspection

Most recent health inspection: Mar 14, 2018; fire safety inspection: Dec 13, 2017

Health Deficiencies as of 03/14/2018
Freedom from Abuse, Neglect, and Exploitation None
Quality of Life and Care 2
Resident Assessment and Care Planning 2
Nursing and Physician Services None
Resident Rights 1
Nutrition and Dietary Deficiencies None
Pharmacy Service 1
Environmental Deficiencies None
Administration Deficiencies None
Fire Deficiencies as of 12/13/2017
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 1
Interior Deficiencies None
Gas, Vacuum, and Electrical Systems None
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