01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-05-01 | 22 | 2025-05-01 | 11 |
| Cycle 2 | 2024-04-23 | 2 | 2024-04-23 | 10 |
| Cycle 3 | 2023-05-03 | 10 | 2023-05-03 | 6 |
CMS CCN 2851482026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Good Shepherd Lutheran Home
2242 Wright Street · Blair, NE 68008 · Washington County
Certified beds84CMS provider file
Recent citation rows61current 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
61 rows in the current release
1 rows carry G–L scope/severity codes; 0 carry J–L. 10 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-05-26 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has no plan of correction · complaint2026-05-26 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has no plan of correction · complaint2026-05-26 · 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 correction · complaint2026-05-26 · HEALTHF0689Severity G · isolated actual 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 correction · complaint2026-05-26 · 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 no plan of correction · complaint2026-05-26 · HEALTHF0760Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has no plan of correction · complaint2026-05-26 · 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 no plan of correction · complaint2026-05-26 · HEALTHF0838Severity F · widespread; potential for more than minimal harm
Administration Deficiencies
Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
Correction field: Deficient, Provider has no plan of correction · complaint2026-03-03 · HEALTHF0583Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
Correction field: Deficient, Provider has date of correction · 2026-03-25 · complaint2026-03-03 · 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 · 2026-03-25 · complaint2026-03-03 · 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 · 2026-03-25 · complaint2025-05-01 · FIREE0041Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Implement emergency and standby power systems.
Correction field: Deficient, Provider has date of correction · 2025-05-222025-05-01 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2025-05-22 · complaint2025-05-01 · HEALTHF0605Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Correction field: Deficient, Provider has date of correction · 2025-05-222025-05-01 · 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 · 2025-05-22 · complaint2025-05-01 · HEALTHF0628Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Correction field: Deficient, Provider has date of correction · 2025-05-222025-05-01 · HEALTHF0657Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Correction field: Deficient, Provider has date of correction · 2025-05-22 · complaint2025-05-01 · HEALTHF0759Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
Correction field: Deficient, Provider has date of correction · 2025-05-222025-05-01 · HEALTHF0760Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2025-05-222025-05-01 · 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 · 2025-05-222025-05-01 · HEALTHF0880Severity F · widespread; 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 · 2025-05-222025-05-01 · HEALTHF0921Severity F · widespread; potential for more than minimal harm
Environmental Deficiencies
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Correction field: Deficient, Provider has date of correction · 2025-05-22 · complaint2025-05-01 · HEALTHF0923Severity E · pattern; potential for more than minimal harm
Environmental Deficiencies
Have enough outside ventilation via a window or mechanical ventilation, or both.
Correction field: Deficient, Provider has date of correction · 2025-05-22 · complaint2025-05-01 · FIREK0211Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Correction field: Deficient, Provider has date of correction · 2025-05-2203 / 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
- HERZKA, MATISYOHUIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST50% · since 06/29/2023
- SCHREIBER, ABRAHAMIndividual · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 06/29/2023
- HERZKA, MATISYOHUIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/23/2023
- GIBSON, CANDACEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/29/2023
- SIMONSON, JOHNNIEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/29/2023
- GIBSON, CANDACEIndividual · ADP OF THE SNFNOT APPLICABLE · since 06/29/2023
- HERZKA, MATISYOHUIndividual · ADP OF THE SNFNOT APPLICABLE · since 06/29/2023
- SCHREIBER, ABRAHAMIndividual · ADP OF THE SNFNOT APPLICABLE · since 06/29/2023
- SIMONSON, JOHNNIEIndividual · ADP OF THE SNFNOT APPLICABLE · since 06/29/2023
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 hours3.50per resident day
RN hours0.51per resident day
Weekend nurse hours3.13per resident day
Staff turnover70.3%CMS reported field
06 / LOCAL RECORDS
Open the Blair ledger →