Good Samaritan Society - Blackduck
Blackduck, Beltrami County, Minnesota · CCN 245600 · Non-profit (Corporation) · part of Good Samaritan Society (92 facilities, chain average 3 stars)
CMS rates Good Samaritan Society - Blackduck 1 of 5 overall as of August 2026. 30 certified beds, 28 residents a day on average. 23 citations on record from the current inspection cycles, 1 at immediate jeopardy; 1 fine totalling $22,205.
CMS’s ratings
The Five-Star Quality Rating System, as CMS publishes it. Where CMS gives no rating, the reason CMS gives is printed instead.
| Overall | ★☆☆☆☆ 1 of 5 |
|---|---|
| Health inspections | ★★☆☆☆ 2 of 5 |
| Staffing | ★★★★☆ 4 of 5 |
| Quality measures | ★☆☆☆☆ 1 of 5 |
| Quality: long-stay / short-stay | 1 / — of 5 |
Staffing
| Total nurse staffing | 4.0083 hours per resident per day |
|---|---|
| Registered nurses | 0.74131 hours per resident per day |
| Weekend total | 3.72873 hours per resident per day |
| Nursing staff turnover | 53.7% (registered nurses 50%) |
| Administrators who left | 0 |
Citations from health inspections
Each is a finding by a state surveyor on the date shown, in CMS’s words. The severity is CMS’s scope-and-severity grid, spelled out: harm on the left, how widespread on the right.
| Survey | Finding | Severity | Status |
|---|---|---|---|
| 2026-07-01 complaint survey |
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. Nutrition and Dietary Deficiencies · tag F0803 |
J Immediate jeopardy to resident health or safety; isolated | Past Non-Compliance 2026-06-11 |
| 2025-10-31 complaint survey |
Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · tag F0641 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-12-26 |
| 2025-10-31 complaint survey |
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted Resident Assessment and Care Planning Deficiencies · tag F0655 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-12-26 |
| 2025-10-31 complaint survey |
Provide appropriate pressure ulcer care and prevent new ulcers from developing. Quality of Life and Care Deficiencies · tag F0686 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-12-26 |
| 2025-08-20 | Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0605 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-09-24 |
| 2025-08-20 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. Quality of Life and Care Deficiencies · tag F0686 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-09-24 |
| 2025-08-20 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · tag F0689 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-09-24 |
| 2025-08-20 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. Quality of Life and Care Deficiencies · tag F0690 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-09-24 |
| 2025-08-20 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. Pharmacy Service Deficiencies · tag F0756 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-09-24 |
| 2024-06-13 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · tag F0812 |
F No actual harm, with potential for more than minimal harm; widespread | Deficient, Provider has date of correction 2024-07-22 |
| 2024-06-13 | Have a plan that describes the process for conducting QAPI and QAA activities. Administration Deficiencies · tag F0865 |
F No actual harm, with potential for more than minimal harm; widespread | Deficient, Provider has date of correction 2024-07-22 |
| 2024-06-13 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · tag F0880 |
F No actual harm, with potential for more than minimal harm; widespread | Deficient, Provider has date of correction 2024-07-22 |
| 2024-06-13 | Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. Infection Control Deficiencies · tag F0882 |
F No actual harm, with potential for more than minimal harm; widespread | Deficient, Provider has date of correction 2024-07-22 |
| 2024-06-13 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. Resident Rights Deficiencies · tag F0623 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2024-07-22 |
| 2024-06-13 | Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave. Resident Rights Deficiencies · tag F0625 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2024-07-22 |
| 2024-02-07 complaint survey |
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · tag F0689 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2024-03-13 |
| 2023-08-10 | 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. Pharmacy Service Deficiencies · tag F0758 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2023-09-20 |
| 2023-08-10 complaint survey |
Allow residents to self-administer drugs if determined clinically appropriate. Resident Rights Deficiencies · tag F0554 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2023-09-20 |
| 2023-08-10 | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. Resident Assessment and Care Planning Deficiencies · tag F0640 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2023-09-20 |
| 2023-08-10 | Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. Resident Assessment and Care Planning Deficiencies · tag F0661 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2023-09-20 |
| 2023-08-10 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. Pharmacy Service Deficiencies · tag F0756 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2023-09-20 |
| 2023-08-10 | Develop and implement policies and procedures for flu and pneumonia vaccinations. Infection Control Deficiencies · tag F0883 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2023-09-20 |
| 2023-08-10 | Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · tag F0641 |
B No actual harm, with potential for minimal harm; pattern | Deficient, Provider has date of correction 2023-09-20 |
Fines and payment denials
| Date | Penalty | Amount |
|---|---|---|
| 2026-07-01 | Fine | $22,205 |
Who owns and runs it
Every owner, officer and manager CMS lists, as filed. These are the names in CMS’s ownership record; anyone named in the ownership record can ask about it on the about page.
| Name | Role | Share | Since |
|---|---|---|---|
| Sanford Organization | 5% or greater direct ownership interest | 100% | 2019-01-01 |
| The Evangelical Lutheran Good Samaritan Society Organization | 5% or greater indirect ownership interest | 100% | 2019-01-01 |
| Dtn Staffing Inc. Organization | adp of the snf | — | 2024-08-02 |
| Focusone Solutions Organization | adp of the snf | — | 2024-03-04 |
| Grape Tree Medical Staffing LLC Organization | adp of the snf | — | 2018-04-13 |
| Sanford Organization | adp of the snf | — | 2025-11-07 |
| The Evangelical Lutheran Good Samaritan Society Organization | adp of the snf | — | 2019-01-01 |
| Sanford Organization | operational/managerial control | — | 2019-01-01 |
| The Evangelical Lutheran Good Samaritan Society Organization | operational/managerial control | — | 2019-01-01 |
| Billups, Sherry Individual | adp of the snf | — | 2018-08-14 |
| Bjerke, Brandon Individual | adp of the snf | — | 2021-04-12 |
| Brown, George Individual | adp of the snf | — | 2025-01-01 |
| Dykhouse, Dana Individual | adp of the snf | — | 2024-05-30 |
| Engbrecht, Wesley Individual | adp of the snf | — | 2024-05-30 |
| Fluit, Joel Individual | adp of the snf | — | 2022-10-01 |
| Gassen, William Individual | adp of the snf | — | 2024-05-30 |
| Gulsvig, Neil Individual | adp of the snf | — | 2024-05-30 |
| Herseth Sandlin, Stephanie Individual | adp of the snf | — | 2024-05-30 |
| Lundeen, Mark Individual | adp of the snf | — | 2024-05-30 |
| Mccausland, Maureen Individual | adp of the snf | — | 2025-01-01 |
| Middleton, Aimee Individual | adp of the snf | — | 2022-01-27 |
| Molbert, Lauris Individual | adp of the snf | — | 2024-05-30 |
| Morrison, Tony Individual | adp of the snf | — | 2019-01-01 |
| North, Andrew Individual | adp of the snf | — | 2024-05-30 |
| Olson, Nicholas Individual | adp of the snf | — | 2024-04-08 |
| Sandgren, Deeandra Individual | adp of the snf | — | 2023-07-16 |
| Schema, Nathan Individual | adp of the snf | — | 2022-01-01 |
| Schieffer, Kevin Individual | adp of the snf | — | 2025-01-01 |
| Shulkin, David Individual | adp of the snf | — | 2024-05-30 |
| Teiken, Brent Individual | adp of the snf | — | 2024-05-30 |
| Ventling-Herrmann, Marnie Individual | adp of the snf | — | 2024-05-30 |
| Wenzel, Thomas Individual | adp of the snf | — | 2025-01-01 |
| Brown, George Individual | corporate director | — | 2025-01-01 |
| Dykhouse, Dana Individual | corporate director | — | 2024-05-30 |
| Engbrecht, Wesley Individual | corporate director | — | 2024-05-30 |
| Gassen, William Individual | corporate director | — | 2024-05-30 |
| Gulsvig, Neil Individual | corporate director | — | 2024-05-30 |
| Herseth Sandlin, Stephanie Individual | corporate director | — | 2024-05-30 |
| Lundeen, Mark Individual | corporate director | — | 2024-05-30 |
| Mccausland, Maureen Individual | corporate director | — | 2025-01-01 |
| Molbert, Lauris Individual | corporate director | — | 2024-05-30 |
| North, Andrew Individual | corporate director | — | 2024-05-30 |
| Schieffer, Kevin Individual | corporate director | — | 2025-01-01 |
| Shulkin, David Individual | corporate director | — | 2024-05-30 |
| Teiken, Brent Individual | corporate director | — | 2024-05-30 |
| Ventling-Herrmann, Marnie Individual | corporate director | — | 2024-05-30 |
| Wenzel, Thomas Individual | corporate director | — | 2025-01-01 |
| Fluit, Joel Individual | corporate officer | — | 2022-10-01 |
| Gassen, William Individual | corporate officer | — | 2024-05-30 |
| Middleton, Aimee Individual | corporate officer | — | 2022-01-27 |
| Olson, Nicholas Individual | corporate officer | — | 2024-04-08 |
| Schema, Nathan Individual | corporate officer | — | 2022-01-01 |
| Fluit, Joel Individual | individual is an owner, partner or trustee of any adp of the snf | — | 2026-04-13 |
| Billups, Sherry Individual | operational/managerial control | — | 2018-08-14 |
| Bjerke, Brandon Individual | operational/managerial control | — | 2021-04-12 |
| Morrison, Tony Individual | operational/managerial control | — | 2019-01-01 |
| Sandgren, Deeandra Individual | operational/managerial control | — | 2023-07-16 |
What changed
Nothing has changed in this record since it was first loaded. The next CMS refresh is the next chance.
Tell me when this record changes
One email when the monthly CMS refresh brings a new citation, a fine or payment denial, a rating change, a flag, or a change of ownership for Good Samaritan Society - Blackduck.
Source: Centers for Medicare & Medicaid Services, Provider Data Catalog (public domain), files dated 2026-08-01. Ratings are CMS’s; citations are state surveyors’ findings; nothing here is estimated or a recommendation. Every nursing home in Beltrami County.