01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2024-11-26 | 9 | 2024-11-26 | 5 |
| Cycle 2 | 2023-09-07 | 4 | 2023-09-07 | 4 |
| Cycle 3 | 2022-08-18 | 4 | 2022-08-18 | 7 |
CMS CCN 1461112026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Golden Good Shepherd Home
101 Prairie Mills Road · Golden, IL 62339 · Adams County
Certified beds46CMS provider file
Recent citation rows33current CMS citation release
Penalty rows1current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
33 rows in the current release
1 rows carry G–L scope/severity codes; 0 carry J–L. 7 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2024-11-26 · FIREE0037Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish staff and initial training requirements.
Correction field: Deficient, Provider has date of correction · 2025-02-012024-11-26 · FIREE0039Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Correction field: Deficient, Provider has date of correction · 2025-02-012024-11-26 · HEALTHF0550Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Correction field: Deficient, Provider has date of correction · 2024-12-202024-11-26 · HEALTHF0558Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
Correction field: Deficient, Provider has date of correction · 2024-12-212024-11-26 · HEALTHF0578Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Correction field: Deficient, Provider has date of correction · 2024-12-212024-11-26 · HEALTHF0688Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Correction field: Deficient, Provider has date of correction · 2025-02-242024-11-26 · HEALTHF0692Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Correction field: Deficient, Provider has date of correction · 2025-02-242024-11-26 · HEALTHF0758Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2025-02-242024-11-26 · HEALTHF0760Severity G · isolated actual harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2024-12-212024-11-26 · HEALTHF0812Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2024-12-212024-11-26 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2025-02-242024-11-26 · FIREK0761Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Correction field: Deficient, Provider has date of correction · 2025-02-012024-11-26 · FIREK0914Severity E · pattern; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Correction field: Deficient, Provider has date of correction · 2024-12-182024-11-26 · FIREK0918Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Correction field: Deficient, Provider has date of correction · 2025-01-102023-09-07 · FIREE0026Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish roles under a Waiver declared by secretary.
Correction field: Deficient, Provider has date of correction · 2023-10-062023-09-07 · HEALTHF0686Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2023-09-112023-09-07 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2023-09-152023-09-07 · HEALTHF0758Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2023-09-102023-09-07 · HEALTHF0881Severity F · widespread; potential for more than minimal harm
Infection Control Deficiencies
Implement a program that monitors antibiotic use.
Correction field: Deficient, Provider has date of correction · 2023-09-152023-09-07 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2023-09-122023-09-07 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2023-12-042023-09-07 · FIREK0712Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2023-09-112022-08-18 · HEALTHF0600Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Correction field: Deficient, Provider has date of correction · 2022-09-072022-08-18 · HEALTHF0609Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Deficient, Provider has date of correction · 2022-09-0703 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2024-11-26 | Payment Denial | $0 | 60 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- BRUNS, PAULIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 10/15/2024
- CASSENS, CYNTHIAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/1981
- GRONEWOLD, DAVIDIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2015
- HEINECKE, CARLIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 10/15/2024
- POST, CURTISIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 02/07/2012
- WAITE, LINDAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 10/15/2015
- WATERKOTTE, JANAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 11/01/2024
- DIXON, WILLIAMIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2018
- HIGDON, BRITNEYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 09/07/2025
- WAITE, LINDAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 10/15/2015
- BRUNS, PAULIndividual · CORPORATE OFFICERNOT APPLICABLE · since 10/15/2024
- CASSENS, CYNTHIAIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/1981
- GRONEWOLD, DAVIDIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2015
- HEINECKE, CARLIndividual · CORPORATE OFFICERNOT APPLICABLE · since 10/15/2024
- POST, CURTISIndividual · CORPORATE OFFICERNOT APPLICABLE · since 02/07/2012
- DIXON, WILLIAMIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2018
- HIGDON, BRITNEYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 09/07/2025
- WATERKOTTE, JANAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/01/2024
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours3.41per resident day
RN hours0.46per resident day
Weekend nurse hours3.16per resident day
Staff turnover36.4%CMS reported field
06 / LOCAL RECORDS
Open the Illinois ledger →Other published facilities nearby
No second facility in the same city met the directory rule.