Good Shepherd Lutheran Home

Inspection findings

1. May 12, 2026 Health · 2 findings
   • Not serious Scope/severity C

     F0628 Resident Rights Deficiencies

     Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.

     Corrected Jun 26, 2026 · CMS health inspection

   • Not serious Scope/severity D

     F0677 Quality of Life and Care Deficiencies

     Provide care and assistance to perform activities of daily living for any resident who is unable.

     Corrected Jun 26, 2026 · CMS health inspection

2. Mar 12, 2025 Fire Safety · 3 findings
   • Not serious Scope/severity F

     K0353 Smoke Deficiencies

     Inspect, test, and maintain automatic sprinkler systems.

     Corrected Mar 28, 2025 · CMS fire safety

   • Not serious Scope/severity F

     K0374 Smoke Deficiencies

     Install smoke barrier doors that can resist smoke for at least 20 minutes.

     Corrected Apr 1, 2025 · CMS fire safety

   • Not serious Scope/severity F

     K0761 Miscellaneous Deficiencies

     To conduct inspection, testing and maintenance of fire doors by qualified individuals.

     Corrected Apr 1, 2025 · CMS fire safety

3. Feb 12, 2025 Health · 1 finding
   • Not serious Scope/severity D Complaint

     F0684 Quality of Life and Care Deficiencies

     Provide appropriate treatment and care according to orders, resident’s preferences and goals.

     Corrected Mar 6, 2025 · CMS health inspection

4. Jan 25, 2024 Health · 9 findings
   • Not serious Scope/severity D

     F0554 Resident Rights Deficiencies

     Allow residents to self-administer drugs if determined clinically appropriate.

     Corrected Feb 29, 2024 · CMS health inspection

   • Not serious Scope/severity D

     F0759 Pharmacy Service Deficiencies

     Ensure medication error rates are not 5 percent or greater.

     Corrected Feb 29, 2024 · CMS health inspection

   • Not serious Scope/severity D

     K0291 Egress Deficiencies

     Install emergency lighting that can last at least 1 1/2 hours.

     Corrected Feb 9, 2024 · CMS fire safety

   • Not serious Scope/severity D

     K0324 Smoke Deficiencies

     Provide properly protected cooking facilities.

     Corrected Mar 1, 2024 · CMS fire safety

   • Not serious Scope/severity F

     K0345 Smoke Deficiencies

     Have approved installation, maintenance and testing program for fire alarm systems.

     Corrected Feb 14, 2024 · CMS fire safety

   • Not serious Scope/severity F

     K0353 Smoke Deficiencies

     Inspect, test, and maintain automatic sprinkler systems.

     Corrected Feb 16, 2024 · CMS fire safety

   • Not serious Scope/severity D

     K0355 Smoke Deficiencies

     Properly select, install, inspect, or maintain portable fire extinguishes.

     Corrected Feb 9, 2024 · CMS fire safety

   • Not serious Scope/severity F

     K0374 Smoke Deficiencies

     Install smoke barrier doors that can resist smoke for at least 20 minutes.

     CMS fire safety

   • Not serious Scope/severity F

     K0923 Gas, Vacuum, and Electrical Systems Deficiencies

     Have proper medical gas storage and administration areas.

     Corrected Feb 9, 2024 · CMS fire safety

5. Jul 5, 2022 MDH complaint investigation · 1 finding
   • Severity not stated

     H53932105C Substantiated complaint (MDH Office of Health Facility Complaints)

     MDH substantiated this complaint. The finding and its severity are in MDH's investigation report (linked).

     Statement of deficiencies (PDF)

6. Dec 28, 2021 MDH complaint investigation · 1 finding
   • Severity not stated

     H5393007C Substantiated complaint (MDH Office of Health Facility Complaints)

     MDH substantiated this complaint. The finding and its severity are in MDH's investigation report (linked).

     Statement of deficiencies (PDF)

Owners and managers (as published by CMS)

• BENSON, RANDY — corporate director, NOT APPLICABLE, since 04/01/2024
• COLBENSON, SAMANTHA — operational/managerial control, NOT APPLICABLE, since 04/11/2021
• COLBENSON, SAMANTHA — adp of the snf, NOT APPLICABLE, since 04/11/2021
• COOK, SONJA — corporate director, NOT APPLICABLE, since 05/01/2023
• CULHANE, JOHN — corporate director, NOT APPLICABLE, since 04/01/2024
• CULHANE, JOHN — corporate officer, NOT APPLICABLE, since 04/01/2024
• DVORAK, LUANNE — corporate director, NOT APPLICABLE, since 04/01/2021
• EBNER, WENDY — corporate director, NOT APPLICABLE, since 04/01/2024
• HATLEVIG, DEAN — corporate director, NOT APPLICABLE, since 04/01/2024
• INGRAM, KATHRYN — corporate director, NOT APPLICABLE, since 04/01/2023
• MODJESKI, NICHOLAS — adp of the snf, NOT APPLICABLE, since 04/01/2024
• PRONK, JUDITH — corporate director, NOT APPLICABLE, since 04/01/2024
• SNYDER, NANCY — corporate director, NOT APPLICABLE, since 04/01/2021
• SNYDER, NANCY — corporate officer, NOT APPLICABLE, since 04/01/2021
• SPECE, RHONDA — operational/managerial control, NOT APPLICABLE, since 02/18/2000
• SPECE, RHONDA — adp of the snf, NOT APPLICABLE, since 02/12/2018
• SPECE, RHONDA — corporate officer, NOT APPLICABLE, since 02/12/2018
• ZOELLE-JOHNSON, BARBARA — corporate director, NOT APPLICABLE, since 05/01/2023
• ZOELLE-JOHNSON, BARBARA — corporate officer, NOT APPLICABLE, since 04/01/2024
• A & H PHARMACIST CONSULTANT SERVICE — adp of the snf, NOT APPLICABLE, since 10/01/2024
• CLIFTONLARSONALLEN LLP — adp of the snf, NOT APPLICABLE, since 10/01/2025
• GRAPE TREE MEDICAL STAFFING LLC — adp of the snf, NOT APPLICABLE, since 10/01/2024
• ONESTAFF MEDICAL — adp of the snf, NOT APPLICABLE, since 10/01/2024
• PRIME TIME HEALTHCARE LLC — adp of the snf, NOT APPLICABLE, since 10/01/2024
• TRIAGE LLC — adp of the snf, NOT APPLICABLE, since 10/01/2024
• USDA DEPARTMENT OF AGRICULTURE RURAL DEVELOPMENT — 5% or greater mortgage interest, NOT APPLICABLE, since 10/01/2024