01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-07-09 | 9 | 2026-07-09 | 3 |
| Cycle 2 | 2025-04-17 | 9 | 2025-04-17 | 2 |
| Cycle 3 | 2024-05-02 | 6 | 2024-05-02 | 3 |
CMS CCN 2452692026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Good Shepherd Lutheran Home
1115 4Th Avenue North · Sauk Rapids, MN 56379 · Benton County
Certified beds146CMS provider file
Recent citation rows32current CMS citation release
Penalty rows0current 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
32 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 2 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-07-09 · HEALTHF0554Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Allow residents to self-administer drugs if determined clinically appropriate.
Correction field: Deficient, Provider has no plan of correction2026-07-09 · HEALTHF0561Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Correction field: Deficient, Provider has no plan of correction2026-07-09 · HEALTHF0572Severity F · widespread; potential for more than minimal harm
Resident Rights Deficiencies
Give residents a notice of rights, rules, services and charges.
Correction field: Deficient, Provider has no plan of correction2026-07-09 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has no plan of correction2026-07-09 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has no plan of correction2026-07-09 · 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 no plan of correction2026-07-09 · HEALTHF0700Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Correction field: Deficient, Provider has no plan of correction2026-07-09 · HEALTHF0755Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Correction field: Deficient, Provider has no plan of correction2026-07-09 · HEALTHF0761Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Correction field: Deficient, Provider has no plan of correction2026-07-09 · FIREK0324Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has no plan of correction2026-07-09 · FIREK0351Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Install an approved automatic sprinkler system.
Correction field: Deficient, Provider has no plan of correction2026-07-09 · FIREK0921Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure that testing and maintenance of electrical equipment is performed.
Correction field: Deficient, Provider has no plan of correction2025-04-17 · HEALTHF0554Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Allow residents to self-administer drugs if determined clinically appropriate.
Correction field: Deficient, Provider has date of correction · 2025-06-112025-04-17 · HEALTHF0658Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
Correction field: Deficient, Provider has date of correction · 2025-06-112025-04-17 · 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 · 2025-06-112025-04-17 · HEALTHF0732Severity F · widespread; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
Correction field: Deficient, Provider has date of correction · 2025-06-112025-04-17 · HEALTHF0761Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Correction field: Deficient, Provider has date of correction · 2025-06-112025-04-17 · HEALTHF0804Severity D · isolated; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Correction field: Deficient, Provider has date of correction · 2025-06-112025-04-17 · HEALTHF0812Severity E · pattern; 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 · 2025-06-112025-04-17 · HEALTHF0867Severity F · widespread; potential for more than minimal harm
Administration Deficiencies
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Correction field: Deficient, Provider has date of correction · 2025-06-112025-04-17 · 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 · 2025-06-112025-04-17 · FIREK0353Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2025-05-302025-04-17 · FIREK0363Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2025-05-302024-05-02 · FIREE0020Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish policies and procedures including evacuation.
Correction field: Deficient, Provider has date of correction · 2024-06-1203 / 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 |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- BACON, DENNISIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/27/2023
- CLOETER, PAULIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/30/2020
- KIRCHOFF, BARRYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/17/2021
- LEONARD, CHARLESIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/29/2025
- LOIDOLT, GARRYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/29/2025
- MACHULA, JENNIFERIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/30/2020
- PERLEBERG, LOISIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/16/2022
- SCAPANSKI, CHERYLIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 11/10/2022
- STROHSCHEIN, DAVIDIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/27/2019
- ZOELLER, DAVIDIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/17/2018
- FITCH, MIKEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 04/17/2018
- STORDAHL, MICHAELIndividual · CORPORATE OFFICERNOT APPLICABLE · since 12/28/2018
- BARBER, JACQUELYNIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/27/2008
- MARTINI, KRISTAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 09/20/2002
- SCHOEPHOERSTER, GEORGEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/07/2017
- STORDAHL, MICHAELIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/28/2018
- AEGIS THERAPIES, INC.Organization · ADP OF THE SNFNOT APPLICABLE · since 01/01/2018
- GRAPE TREE MEDICAL STAFFING LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 11/14/2022
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 hours4.92per resident day
RN hours0.80per resident day
Weekend nurse hours4.36per resident day
Staff turnover38.6%CMS reported field
06 / LOCAL RECORDS
Open the Minnesota ledger →Other published facilities nearby
No second facility in the same city met the directory rule.