A list of the most recent deficiencies for Good Samaritan Society - Holstein. The list is based on the information provided by CMS from both standard inspections and from complaints filed by residents.
| Deficiency | Type of Deficiency | Deficiency Date | Date Corrected | Resulted from a Complaint? |
|---|---|---|---|---|
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2023-12-28 | 2024-01-28 | N |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2023-12-21 | 2024-01-18 | N |
| Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | Health | 2023-12-21 | 2024-01-18 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2023-12-21 | 2024-01-18 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-12-21 | 2024-01-18 | N |
| Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | Health | 2023-12-21 | 2024-01-18 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2023-12-21 | 2024-01-18 | N |
| Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. | Health | 2023-12-21 | 2024-01-18 | N |
| Ensure each resident receives an accurate assessment. | Health | 2023-12-21 | 2024-01-18 | Y |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2023-12-28 | 2023-12-30 | N |
| Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. | Fire Safety | 2023-12-28 | 2023-12-29 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2023-12-28 | 2023-12-29 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2023-12-28 | 2023-12-28 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2023-12-28 | 2023-12-28 | N |
| Develop and maintain an Emergency Preparedness Program (EP). | Fire Safety | 2022-12-20 | 2023-01-20 | N |
| Provide a written emergency evacuation plan. | Fire Safety | 2022-12-20 | 2023-01-20 | N |
| Have simulated fire drills held at unexpected times. | Fire Safety | 2022-12-20 | 2023-01-20 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2022-12-15 | 2023-01-13 | Y |
| Ensure each resident receives an accurate assessment. | Health | 2022-12-15 | 2023-01-13 | Y |
| 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. | Health | 2022-12-15 | 2023-01-13 | Y |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2022-12-20 | 2023-01-13 | N |
| Properly provide smoke detection systems in areas open to corridors. | Fire Safety | 2022-12-20 | 2023-01-09 | N |
| Conduct testing and exercise requirements. | Fire Safety | 2022-12-20 | 2023-01-04 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2022-12-20 | 2023-01-04 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2022-12-20 | 2022-12-30 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2022-12-20 | 2022-12-30 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2022-12-20 | 2022-12-27 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2022-12-20 | 2022-12-20 | N |
| Follow proper procedures when the fire alarm was out of service for more than 4 hours. | Fire Safety | 2020-03-05 | 2020-04-03 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2020-03-05 | 2020-04-03 | N |
| Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours. | Fire Safety | 2020-03-05 | 2020-04-03 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2020-03-05 | 2020-04-03 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2020-03-05 | 2020-04-03 | N |
| Provide a written emergency evacuation plan. | Fire Safety | 2020-03-05 | 2020-04-03 | N |
| Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Fire Safety | 2020-03-05 | 2020-04-03 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2020-03-05 | 2020-04-03 | N |
| Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. | Fire Safety | 2020-03-05 | 2020-04-03 | N |
| Have generator or other power source capable of supplying service within 10 seconds. | Fire Safety | 2020-03-05 | 2020-04-03 | N |
| Have proper medical gas storage and administration areas. | Fire Safety | 2020-03-05 | 2020-04-03 | N |
| Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | Health | 2020-02-27 | 2020-03-26 | N |
| Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Health | 2020-02-27 | 2020-03-26 | N |
| 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. | Health | 2020-02-27 | 2020-03-26 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2020-02-27 | 2020-03-26 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2020-02-27 | 2020-03-26 | N |
| Provide and implement an infection prevention and control program. | Health | 2020-02-27 | 2020-03-26 | N |
| Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. | Fire Safety | 2020-03-05 | 2020-03-18 | N |
| Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Fire Safety | 2020-03-05 | 2020-03-18 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2020-03-05 | 2020-03-17 | N |
| Have properly installed electrical wiring and gas equipment. | Fire Safety | 2020-03-05 | 2020-03-12 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2020-03-05 | 2020-03-11 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2020-03-05 | 2020-03-11 | N |
