Inspection Reports for
Good Samaritan Society – Beatrice
401 S 22nd Street, BEATRICE, NE, 68310
Back to Facility ProfileDeficiencies (last 9 years)
Deficiencies (over 9 years)
9.4 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
124% worse than Nebraska average
Nebraska average: 4.2 deficiencies/year
Deficiencies per year
20
15
10
5
0
Occupancy
Latest occupancy rate
86% occupied
Based on a August 2018 inspection.
Occupancy rate over time
Inspection Report
Renewal
Capacity: 80
Deficiencies: 0
Date: Mar 20, 2019
Visit Reason
The document is a renewal license application and certification for the Good Samaritan Society - Beatrice facility, verifying licensure and compliance with statutory requirements for the Alzheimer's/Special Care Unit.
Findings
The report confirms that the facility meets statutory requirements for licensure renewal with a maximum endorsed capacity of 80 beds. It includes detailed disclosure information about the Alzheimer's Special Care Unit philosophy, criteria for placement and discharge, staffing patterns, training, security features, resident activities, family support, and cost of care.
Report Facts
Maximum endorsed capacity: 80
License expiration date: Mar 31, 2020
Staffing ratios: Optimal staffing levels of nursing/programming staff to residents are 1:5 to 1:8 (days and evenings), and 1:12 to 1:15 (nights)
Cost of care range: $291 - $338 depending on level of care
Training hours: 4
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Correne Adams | Administrator | Named as facility administrator and authorized representative signing the application |
Inspection Report
Complaint Investigation
Census: 69
Capacity: 80
Deficiencies: 19
Date: Aug 6, 2018
Visit Reason
An unannounced visit was conducted to investigate a complaint and annual survey at Good Samaritan Society - Beatrice on August 6-9, 2018, by representatives of the Department of Health and Human Services Division of Public Health.
Complaint Details
The complaint involved allegations that the facility failed to change interventions after residents were identified at risk for falls and failed to use fall interventions to prevent injuries. The facility was found noncompliant with changing interventions but compliant with use of fall interventions. The complaint also involved resident to resident abuse where Resident #74 bent back Resident #26's finger painfully. The facility failed to report and investigate this allegation timely but did report to APS after survey exit. Resident #74 was separated from Resident #26 and monitored.
Findings
The facility was found to have failed to change interventions for residents identified at risk for falls and was cited for this deficiency. The facility failed to ensure residents were free from abuse for 1 resident and failed to report and investigate a resident to resident altercation and allegation of abuse. The facility also failed to complete comprehensive assessments reflecting residents' status, failed to develop and implement complete individualized care plans for 3 residents, failed to provide services to maintain mobility for 1 resident, failed to prevent accident hazards for 1 resident, failed to ensure medication refrigerator temperature monitoring and storage compliance, failed to ensure employee facial hair was completely covered in food prep areas, and had multiple life safety code deficiencies including hazardous area enclosure, cooking facilities, sprinkler system maintenance, corridor doors, smoke barrier doors, evacuation plan, fire drills, essential electrical system maintenance, and gas equipment storage and signage.
Deficiencies (19)
Failed to change interventions for residents identified at risk for falls.
Failed to ensure residents were free from abuse for 1 resident.
Failed to report and investigate a resident to resident altercation and allegation of abuse.
Failed to complete comprehensive assessments reflecting residents' status for 3 residents.
Failed to develop and implement complete individualized care plans for 3 residents.
Failed to provide services to maintain mobility and range of motion for 1 resident.
Failed to ensure resident environment free of accident hazards and provide adequate supervision to prevent accidents for 1 resident.
Failed to monitor and maintain medication refrigerator temperatures daily and failed to ensure medication refrigerators did not contain employee items.
Failed to ensure employee facial hair was completely covered in food preparation areas.
Failed to provide smoke resistant enclosure for hazardous areas; laundry door failed to latch.
Failed to train kitchen staff on procedures to extinguish grease fires.
Allowed storage to encroach within 5 inches of fire sprinkler deflectors.
Failed to ensure corridor doors resist passage of smoke; gaps observed between door and frame.
Failed to ensure smoke separation doors were capable of resisting passage of smoke; double doors failed to close and latch.
Failed to include a smoke compartment evacuation plan.
Failed to activate fire alarm system during fire drills.
Allowed emergency generator fuel particle count to exceed acceptable limits and failed to document transfer time within 10 seconds.
Failed to post 'Oxygen in Use, No Smoking' signs on rooms where oxygen was administered.
Failed to segregate and label full and empty oxygen cylinders.
Report Facts
Deficiencies cited: 17
Facility census: 69
Total licensed capacity: 80
Restorative therapy refusals: 7
Restorative therapy refusals: 8
Restorative therapy refusals: 1
Fall risk score: 20
Fire drills not activating alarm: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Dan Taylor | RN, Training Coordinator | Signed complaint investigation letter |
| Correne Adams | Administrator | Facility administrator named in complaint and findings |
| Staff C | MDS Coordinator | Acknowledged MDS inaccuracies and restorative therapy responsibility |
| Staff B | Interviewed about restorative therapy refusals | |
| Staff G | Provided grievance and abuse/neglect logs | |
| Maintenance Director | Responsible for maintenance corrections and staff training | |
| Dietary Director | Responsible for dietary staff training and audits | |
| Maintenance A | Verified door and sprinkler system deficiencies | |
| Administrator A | Acknowledged hazardous area door deficiency |
Inspection Report
Complaint Investigation
Deficiencies: 1
Date: Mar 15, 2018
Visit Reason
An unannounced visit was conducted to investigate a complaint that the facility fails to maintain a safe environment.
Complaint Details
The complaint was substantiated as the facility was found non-compliant with Federal tag F805 and State Licensure Number 175 NAC 12-006.11A2 due to unsafe environment related to kitchen access for residents on special diets.
Findings
The facility failed to maintain a safe environment by allowing residents on special diets to potentially enter the kitchen area, with the kitchen door propped open and no locks on food drawers. This posed a risk to residents on Level 2 Mechanical diets.
Deficiencies (1)
Facility failed to maintain a safe environment by failing to protect residents on special diets from potentially entering the kitchen area, with the kitchen door propped open and no locks on drawers.
Report Facts
Residents on Level 2 Mechanical diets: 2
Residents on the unit: 18
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Dan Taylor | RN, Training Coordinator, Office of LTC Facilities - Licensure Unit - Division of Public Health - DHHS | Signed the complaint investigation letter |
| Director of Food (DOF) | Interviewed regarding residents on Level 2 Mechanical diets | |
| LPN-A (Licensed Practical Nurse) | Interviewed about kitchen door being open and food storage | |
| DNS (Director of Nursing Service) | Interviewed about resident behavior and kitchen door safety |
Inspection Report
Complaint Investigation
Census: 69
Capacity: 80
Deficiencies: 10
Date: Sep 11, 2017
Visit Reason
An unannounced visit was conducted to investigate a complaint and annual survey at Good Samaritan Society - Beatrice from September 11 to September 13, 2017.
Complaint Details
The complaint involved allegations of failure to supervise residents, failure to report injuries requiring treatment within 24 hours, failure to submit investigations within 5 working days, and failure to put interventions in place to prevent injuries. The facility was found to have failed in reporting and investigation of misappropriation of resident property.
Findings
The facility was found deficient for failure to report and investigate misappropriation of resident property, incomplete comprehensive assessments for two residents, failure to update care plans to reflect current resident needs, failure to implement non-pharmacological interventions prior to administering antianxiety medication, failure to thoroughly investigate falls including potential hazards, and failure to properly store medications with expired or undated items available for use.
Deficiencies (10)
Failure to report and conduct a thorough investigation of an alleged violation of misappropriation of resident property involving a missing gold necklace.
Failure to complete the annual Minimum Data Set (MDS) for 2 of 23 residents.
Failure to complete the quarterly Minimum Data Set (MDS) for 1 of 23 residents.
Failure to review and revise a comprehensive plan of care for toileting for 1 resident.
Failure to implement care plan intervention for unnecessary medication use for 1 resident, including failure to attempt and document non-pharmacological interventions prior to administration of antianxiety medication.
Failure to ensure that outdated medications and medications without date opened were not available for resident use for 3 residents.
Failure to provide a way to unlock the courtyard gate from the egress side, preventing occupants from exiting during an emergency.
Failure to ensure all internal seams and joints of the hood and exhaust system for commercial cooking equipment were sealed and grease tight.
Failure to conduct a 3 year air leakage test on the fire sprinkler dry system.
Failure to ensure smoke separation doors were capable of resisting the passage of smoke in 2 of 6 smoke compartments.
Report Facts
Deficiencies cited: 10
Residents reviewed: 23
Facility census: 69
Facility total capacity: 80
Falls experienced: 19
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Annie | Director of Nursing | Verified staff should document non-pharmacological interventions prior to administering PRN Ativan. |
| Michelle Bohay | RN Unit Manager | Acknowledged all sections of the MDS should be completed regardless of vacations or absences. |
| Staff D | Unit Manager | Confirmed care plan for Resident #51 was not updated to reflect current toileting needs and reviewed fall investigations. |
| Staff B | Social Services | Did not have a grievance form for missing necklace for Resident #93 and was not informed of missing item. |
| Staff G | Interviewed about missing gold necklace and failure to file grievance. | |
| LPN Z | Licensed Practical Nurse | Confirmed outdated suppositories available for Resident 77 and lack of dating on opened medications. |
| LPN H | Licensed Practical Nurse | Confirmed lack of date opened on Lidocaine and nasal spray for Residents 18 and 99. |
| Maintenance A | Acknowledged lack of keypad on courtyard gate and loose caulking on kitchen hood seams. | |
| NHA-A | Administrator | Acknowledged expectation that all MDS assessments be completed accurately and timely. |
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Apr 26, 2017
Visit Reason
An unannounced visit was conducted to investigate a complaint alleging the facility fails to ensure residents are free from abuse.
Complaint Details
The complaint alleged failure to ensure residents are free from abuse. The allegation was not substantiated as no violations were found.
Findings
The facility was found to ensure residents are free from abuse with no violations related to this issue. Reviews of grievances, investigations, observations, interviews, and policies showed no concerns of abuse or mistreatment.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Eve Lewis | Program Manager | Signed the report as Program Manager - Office of LTC Facilities - Licensure Unit - Division of Public Health - DHHS |
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Apr 6, 2017
Visit Reason
An unannounced visit was conducted to investigate a complaint at Good Samaritan Society - Beatrice on April 6, 2017, regarding allegations that the facility failed to change the plan of care for residents at risk for falls and failed to submit investigations within 5 working days.
Complaint Details
The complaint involved two allegations: failure to change the plan of care for residents at risk for falls and failure to submit investigations within 5 working days. Both allegations were found to be unsubstantiated.
Findings
The investigation found no violations; the facility did change the plan of care for residents at risk for falls and submitted investigations within the required 5 working days.
Report Facts
Working days for investigation submission: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Eve Lewis | Program Manager | Signed the report as Program Manager - Office of LTC Facilities - Licensure Unit - Division of Public Health - DHHS |
Inspection Report
Renewal
Capacity: 80
Deficiencies: 0
Date: Mar 27, 2017
Visit Reason
The document is a nursing home licensure renewal application and related certification for Good Samaritan Society - Beatrice, verifying the renewal of the SNF/NF dual certification and Alzheimer's/Special Care Unit endorsement.
Findings
The facility is licensed for 80 beds and provides specialized Alzheimer's/Special Care Unit services with a secure environment and appropriate staffing and training. The application certifies compliance with state regulations and outlines the philosophy, criteria for placement and discharge, staffing, training, environment, and resident activities related to dementia care.
Report Facts
Total licensed beds: 80
Cost of care: 272
Cost of care: 295
Staff to resident ratio (days and evenings): 5
Staff to resident ratio (days and evenings): 8
Staff to resident ratio (nights): 12
Staff to resident ratio (nights): 15
Occupancy permit date: Oct 10, 2016
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Correne Adams | Administrator | Named as facility administrator and authorized representative signing the renewal application |
| David J. Horazdovsky | Contact name for owning entity | Contact for Evangelical Lutheran Good Samaritan Society, the legal owning entity |
| Alan Viox | Deputy State Fire Marshal | Inspected the facility for occupancy permit |
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Feb 13, 2017
Visit Reason
An unannounced visit was conducted to investigate a complaint regarding the facility's use and updating of fall interventions to prevent injuries.
Complaint Details
The complaint alleged that the facility failed to use fall interventions to prevent injuries and failed to change fall interventions after residents were identified at risk for falls. Both allegations were found to be unsubstantiated.
Findings
The investigation found that the facility did use fall interventions to prevent injuries and did update these interventions after residents were identified at risk for falls. No violations or concerns were identified related to the allegations.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Dan Taylor | RN, Training Coordinator - Office of LTC Facilities - Licensure Unit - Division of Public Health - DHHS | Signed the report and identified as the Training Coordinator responsible for the investigation. |
Inspection Report
Routine
Census: 75
Capacity: 80
Deficiencies: 7
Date: Oct 3, 2016
Visit Reason
The inspection was conducted as a routine survey to assess compliance with regulatory requirements for skilled nursing facilities, including safety, sanitation, and resident care standards.
Findings
The facility was found to have multiple deficiencies including failure to prevent accident hazards related to hot steam tables, improper food handling practices, life safety code violations such as lack of self-closing doors on hazardous areas, delayed egress door issues, sprinkler system maintenance problems, fire extinguisher placard placement, and electrical receptacle safety concerns near sinks.
Deficiencies (7)
Failed to prevent potential burns from hot steam tables in resident common areas accessible to 47 residents.
Dietary staff used contaminated gloves during preparation of breaded chicken served to 60 residents.
Failed to ensure self-closing devices on all doors to hazardous areas and smoke resistant enclosures, affecting 37 residents.
Delayed egress doors required more than 15 pounds of pressure to activate alarm, affecting 35 residents.
Escutcheon ring on fire sprinkler head obstructed spray pattern, affecting 15 residents.
Failed to post placard near Class K fire extinguisher stating fire protection system must be activated prior to use; no residents affected.
Electrical receptacles within 5 feet of sinks in beauty salons lacked GFCI protection, posing electrical shock hazard to 10 residents.
Report Facts
Residents potentially affected by hot steam tables: 47
Facility census: 75
Total licensed capacity: 80
Residents served contaminated chicken: 60
Residents affected by hazardous door issues: 37
Residents affected by delayed egress door issue: 35
Residents affected by sprinkler obstruction: 15
Residents potentially affected by electrical hazard: 10
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Dietary Team Leader B | Dietary Team Leader | Named in findings related to hot steam tables and contaminated glove use during food preparation |
| Maintenance A | Maintenance Staff | Named in findings related to life safety code deficiencies and sprinkler system issues |
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Jun 20, 2016
Visit Reason
An unannounced visit was conducted to investigate a complaint regarding the facility's failure to change fall interventions after residents were identified at risk for falls and failure to use appropriate interventions to prevent injuries.
Complaint Details
The complaint alleged failure to change fall interventions after residents were identified at risk for falls and failure to use appropriate interventions to prevent injuries. Both allegations were found to be unsubstantiated.
Findings
The facility was found to be in compliance with no violations related to the allegations. Fall interventions were changed appropriately and appropriate interventions to prevent injuries were used.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Eve Lewis | Program Manager | Signed the report as Program Manager - Office of LTC Facilities - Licensure Unit - Division of Public Health - DHHS |
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Jun 20, 2016
Visit Reason
An unannounced visit was conducted to investigate a complaint regarding the facility's failure to change fall interventions after residents were identified at risk for falls and failure to use appropriate interventions to prevent injuries.
Complaint Details
The complaint alleged the facility failed to change fall interventions after residents were identified at risk for falls and failed to use appropriate interventions to prevent injuries. Both allegations were found to be unsubstantiated.
Findings
The facility was found to be in compliance with no violations related to the allegations. Fall interventions were changed appropriately and appropriate interventions to prevent injuries were used.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Eve Lewis | Program Manager | Signed the report as Program Manager - Office of LTC Facilities - Licensure Unit - Division of Public Health - DHHS |
Inspection Report
Complaint Investigation
Census: 69
Deficiencies: 2
Date: Mar 7, 2016
Visit Reason
An unannounced visit was conducted to investigate a complaint alleging the facility failed to put interventions into place to prevent injuries.
Complaint Details
The complaint alleged the facility failed to put interventions into place to prevent injuries. The investigation included review of resident records, observations, and interviews, confirming the complaint.
Findings
The facility failed to implement and revise care plan interventions to prevent accidents and injuries for one resident, including inconsistent use of gait belts, fall mats, and horseshoe pillows. Observations and interviews confirmed discrepancies between care plans and actual care provided.
Deficiencies (2)
Failure to review and revise care plan interventions to reflect current status of resident, including assistance levels and use of safety devices.
Failure to ensure resident environment remains free of accident hazards and provide adequate supervision and assistance devices to prevent accidents.
Report Facts
Facility census: 69
Dates of resident falls: 3
Plan of correction completion date: Apr 22, 2016
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Eve Lewis | Program Manager | Signed cover letter for complaint investigation |
| Correne Adams | Administrator | Facility administrator addressed in report |
| Licensed Practical Nurse-B | LPN | Interviewed regarding resident care and fall interventions |
| Medication Aide-A | Medication Aide | Interviewed regarding use of gait belt and resident care |
| Director of Nursing | DON | Interviewed about care plan discrepancies and fall interventions |
| Nurse Manager-C | Nurse Manager | Confirmed resident assistance levels and care plan updates |
Notice
Deficiencies: 0
Date: Sep 22, 2015
Visit Reason
The notice was issued to inform the facility of disciplinary action placing the license on probation for 90 days due to violations related to failure to update interventions addressing recurrent falls resulting in injuries.
Findings
The facility was found in violation of licensure regulations concerning resident rights and skin integrity, specifically failing to update interventions to address recurrent falls which resulted in injuries.
Report Facts
Probation period length: 90
Report submission frequency: 7
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Eve Lewis | Program Manager | Contact for submission of reports and responses related to the Notice |
| Courtney N. Phillips | Chief Executive Officer | Signed the Notice of Disciplinary Action |
| Becky Wisell | Administrator | Signed the Notice of Disciplinary Action |
| Linda Stenvers | Staff Assistant II | Certified mailing of the Notice |
Inspection Report
Complaint Investigation
Census: 73
Capacity: 74
Deficiencies: 9
Date: Aug 11, 2015
Visit Reason
An unannounced visit was conducted to investigate a complaint and annual survey at Good Samaritan Society - Beatrice on August 11, 2015-August 18, 2015. The complaint alleged failure to give appropriate notice for involuntary discharge.
Complaint Details
The complaint alleged the facility failed to give appropriate notice for involuntary discharge. The investigation found no violation related to this issue.
Findings
The facility gave appropriate notice for involuntary discharge and complied with its policy. Deficiencies were found related to privacy violations by posting residents' pictures without permission, failure to assess bruises for underlying causes and prevent further bruising for two residents, failure to identify causes of a fall with injury for one resident, and failure to post nurse staffing information in a publicly accessible area.
Deficiencies (9)
Facility failed to protect privacy and dignity by posting pictures of five residents at risk for elopement without signed releases.
Facility failed to assess bruises for underlying cause and identify interventions to prevent further bruising for two residents.
Facility failed to identify underlying cause of a fall with injury and implement interventions to prevent future falls for one resident.
Facility failed to post nurse staffing information in a public area easily visible to residents and visitors and failed to maintain 18 months of records.
Facility failed to seal smoke barrier penetrations in one of eleven smoke barriers.
Facility failed to ensure that doors in a means of egress were readily accessible for one set of smoke barrier doors; magnetic delayed egress lock failed to release after 15 seconds.
Facility failed to secure an oxygen bottle to prevent it from tipping over in one smoke compartment.
Facility failed to maintain emergency generator inspection and testing documentation as required by NFPA 110.
Facility failed to conduct fire drills for two of three shifts in accordance with NFPA 101.
Report Facts
Facility census: 73
Total capacity: 74
Number of residents with privacy violation: 5
Number of residents with bruising deficiency: 2
Number of residents with fall deficiency: 1
Number of smoke barriers: 11
Number of smoke barriers with penetration issue: 1
Number of smoke barrier doors with egress issue: 1
Number of oxygen bottles unsecured: 1
Number of shifts without fire drills: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Dan Taylor | RN, Training Coordinator - Office of LTC Facilities - Licensure Unit | Signed complaint investigation letter |
| Correne Adams | Administrator | Facility administrator named in multiple findings and correspondence |
| Lori Wehrs | Registered Nurse | Surveyor involved in complaint and annual survey |
| Victoria Smith | Registered Nurse | Surveyor involved in complaint and annual survey |
| Rebecca Young | Registered Nurse | Surveyor involved in complaint and annual survey |
| Dain M. Weiss | RN, BSN, Program Manager | Conducted informal conference and signed summary report |
| Eve Lewis | Program Manager, Office of Long Term Care Facilities | Sent informal conference confirmation letter |
Inspection Report
Complaint Investigation
Census: 75
Capacity: 75
Deficiencies: 12
Date: Jul 31, 2014
Visit Reason
An unannounced visit was conducted to investigate a complaint and annual survey at Good Samaritan Society - Beatrice on July 28, 2014-July 31, 2014.
Complaint Details
The complaint investigation included allegations that the facility failed to allow residents to use mobility devices as they chose, failed to protect residents from misappropriation, failed to follow policy for investigating missing narcotics, failed to ensure controlled substance counts were complete and accurate, failed to ensure residents received correct medications, and failed to ensure medications were available as ordered.
Findings
The facility was found to have multiple deficiencies including medication misappropriation, failure to ensure medications were available and administered correctly, insufficient nursing staff especially on weekends, failure to maintain sanitary food service practices, life safety code violations including smoke door latching failure, obstructed sprinkler heads, blocked exit corridors, unlocked oxygen storage rooms, and electrical safety issues with power strips.
Deficiencies (12)
Facility failed to ensure prescription medication for one resident was not misappropriated and used for another resident (F224).
Facility failed to assess pain and obtain x-ray as ordered and coordinate hospice services to ensure medication availability (F309).
Facility failed to provide sufficient nursing staff on all shifts to meet planned staffing patterns (F353).
Facility failed to serve food following sanitary practices including lack of sanitizing solution and failure to ensure handwashing (F371).
Facility failed to ensure one resident received medication according to healthcare practitioner's order (F425).
Facility failed to maintain a corridor door to resist passage of smoke (K018).
Facility failed to notify occupants how to unlock magnetically locked double doors in path of egress (K038).
Facility failed to provide unobstructed sprinkler coverage in kitchen due to boxes blocking sprinkler head (K062).
Facility failed to maintain corridors free of obstructions (benches and lamps in exit corridors) (K072).
Facility failed to provide lockable doors to oxygen storage rooms (K076).
Facility failed to maintain emergency generator testing as required (K144).
Facility failed to use electrical equipment in accordance with NFPA 70; power strips not meeting UL standards found in resident rooms (K147).
Report Facts
Facility census: 75
Medication discrepancy: 30
Medication discrepancy: 15
Unfilled nursing shifts: 33
Unfilled nursing shifts: 38
Unfilled nursing shifts: 27
Residents affected by smoke door: 24
Oxygen cylinders: 12
Load bank test date: 2013
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Correne Adams | Administrator | Named in introductory letter and plan of correction |
| Eve Lewis | Program Manager, Office of Long Term Care Facilities | Signed complaint investigation letter |
| Maintenance A | Acknowledged door latch failure, sprinkler obstruction, unlocked oxygen storage, and power strip issues | |
| LPN B | Licensed Practical Nurse | Interviewed regarding medication borrowing incident |
| LPN E | Licensed Practical Nurse | Interviewed regarding medication borrowing incident |
| Director of Nursing | Director of Nursing | Interviewed regarding medication borrowing and hospice notification |
| RN L | Registered Nurse | Interviewed regarding Resident 44 fall and pain assessment |
| LPN D | Licensed Practical Nurse | Interviewed regarding Resident 44 x-ray and medication administration |
| Cook Z | Observed during meal service with sanitary violations | |
| Assistant Dietary Manager | Interviewed regarding sanitizer solution failure |
Inspection Report
Annual Inspection
Census: 69
Capacity: 72
Deficiencies: 12
Date: Jun 11, 2013
Visit Reason
Annual inspection of Good Samaritan Society - Beatrice to assess compliance with Nebraska Administrative Code and federal regulations including resident care, safety, housekeeping, staffing, and medication management.
Findings
The facility was found deficient in multiple areas including failure to promptly resolve resident grievances related to cold food, call light response times, and pain medication delays; inadequate housekeeping resulting in unsanitary conditions and odors; insufficient nursing staff leading to delayed resident assistance; unsecured medications and controlled substances; and life safety code violations including improperly latching corridor and smoke barrier doors, obstructed hazardous area doors, blocked exit access, unmaintained kitchen hood suppression systems, missing oxygen use signage, and improperly placed alcohol-based hand sanitizers.
Deficiencies (12)
Failure to make prompt efforts to resolve resident grievances regarding cold food, call light response times, and pain medication delays.
Failure to provide housekeeping services to maintain a clean, sanitary, and odor-free environment, including unclean resident bathrooms and pervasive urine odor.
Failure to ensure resident environment remains free of accident hazards, including unsecured chemicals accessible to dementia residents.
Insufficient 24-hour nursing staff to meet resident needs for toileting, pain medication, and timely assistance.
Failure to store and secure medications properly, including unlocked medication refrigerators and unattended medications during medication pass.
Corridor doors failed to fit tightly and latch to resist passage of smoke, affecting approximately 40 residents.
Smoke barrier doors failed to latch properly or were tied open, risking smoke migration.
Hazardous area doors failed to latch properly, including exercise room door and mechanical/oxygen storage rooms.
Exit access was obstructed by a mirror placed in a corridor, potentially confusing egress direction.
Kitchen hood suppression systems were not inspected bi-annually as required.
Missing 'oxygen in use' signage where oxygen was in use, increasing fire risk.
Alcohol-based hand sanitizers were installed adjacent to electrical ignition sources in resident rooms.
Report Facts
Facility census: 69
Facility total capacity: 72
Call lights not answered within 6 minutes: 118
Average call light response time: 10.85
Residents on Special Care Unit: 18
Residents affected by door latching issues: 40
Residents affected by oxygen signage issue: 20
Residents affected by hand sanitizer placement: 40
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Maintenance Staff A | Confirmed findings related to door latching, hazardous area doors, exit access mirror, oxygen signage, and hand sanitizer placement | |
| Director of Nursing (DON) | Director of Nursing | Interviewed regarding medication storage and narcotic count procedures |
| Licensed Practical Nurse (LPN) A | Licensed Practical Nurse | Observed answering call lights |
| Licensed Practical Nurse (LPN) B | Licensed Practical Nurse | Observed medication pass and leaving medications unattended |
| Licensed Practical Nurse (LPN) C | Licensed Practical Nurse | Interviewed about medication pass practices |
| Housekeeper J | Interviewed about housekeeping cart and chemical storage |
Inspection Report
Annual Inspection
Census: 62
Deficiencies: 6
Date: Feb 23, 2012
Visit Reason
Annual inspection of Good Samaritan Society - Beatrice to assess compliance with licensure regulations and Life Safety Code standards.
Findings
The facility was found deficient in developing comprehensive care plans for residents with specific medical needs, updating care plans to reflect current resident status, providing appropriate catheter and perineal care, and maintaining infection control practices. Additionally, life safety code violations were noted related to sprinkler system maintenance and electrical equipment use.
Deficiencies (6)
Failed to develop a comprehensive care plan related to the placement of a Foley catheter and nephrostomy tube for one resident.
Failed to review and revise care plans to reflect resident transfers and measurable goals for incontinence.
Failed to provide complete and thorough perineal care for three residents.
Failed to maintain infection control to prevent spread of organisms related to cleaning of body fluids from carpeted surface.
Failed to maintain sprinkler system by ensuring sprinkler heads are free of corrosion, paint, or foreign material.
Failed to use electrical wiring and equipment in accordance with NFPA 70, National Electric Code, due to improper use of power tap.
Report Facts
Resident sample size: 35
Facility census: 62
Resident census: 61
Employees mentioned
| Name | Title | Context |
|---|---|---|
| MA E | Medication Aide | Named in deficient perineal care and infection control findings |
| RN K | Registered Nurse | Named in deficient perineal care and infection control findings |
| LPN L | Licensed Practical Nurse | Named in deficient perineal care findings |
| MA B | Medication Aide | Named in deficient perineal care findings |
| MA C | Medication Aide | Named in deficient perineal care findings |
| NA F | Nurses' Aide | Named in deficient perineal care findings |
| NA G | Nurses' Aide | Named in deficient perineal care findings |
| Maintenance Staff A | Named in sprinkler and electrical equipment findings | |
| Hsk M | Housekeeper | Named in infection control cleaning deficiency |
Inspection Report
Complaint Investigation
Census: 66
Deficiencies: 3
Date: May 26, 2011
Visit Reason
The inspection was conducted due to complaints regarding delayed call light answering and failure to resolve resident grievances, as well as concerns about care plan revisions and medication administration.
Complaint Details
The complaint investigation found substantiated issues including delayed call light answering for Residents 11 and 12, inadequate care plan revisions for Residents 2 and 7, and medication administration errors for Residents 9 and 10.
Findings
The facility failed to promptly resolve grievances related to delayed call light responses for two residents, failed to review and revise care plans for two residents related to behaviors and falls, and failed to administer medications according to physician orders for two residents.
Deficiencies (3)
Failure to resolve concerns from 2 residents related to delayed call light answering and provide resolution following Neighborhood Council meetings.
Failure to review and revise 2 residents' care plans related to behaviors and falls.
Failure to administer medications for 2 residents according to their health practitioners' orders.
Report Facts
Facility census: 66
Sample size: 12
Call light delay times (minutes): 35
Call light delay times (minutes): 25
Call light delay times (minutes): 17
Call light delay times (minutes): 13
Falls: 21
Fall Risk score: 22
Medication sample size: 12
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Correne Adams | Executive Director | Signed the plan of correction letter dated June 10, 2011 |
Inspection Report
Annual Inspection
Census: 71
Deficiencies: 4
Date: Jan 6, 2011
Visit Reason
The inspection was conducted as an annual survey of the Good Samaritan Society - Beatrice facility to assess compliance with regulatory requirements related to resident care, including comprehensive assessments, care plans, pressure sore prevention, and dietary support.
Findings
The facility was found deficient in conducting comprehensive assessments, developing and revising care plans, preventing and treating pressure sores, and providing sufficient dietary support personnel. Specific residents were cited for lack of adequate care planning and interventions related to pressure ulcers and contractures. The facility census was 71 at the time of the survey.
Deficiencies (4)
Failure to provide a comprehensive assessment of the overall risk factors for pressure ulcer prevention and healing for 1 resident (Resident 35) out of 40 sampled residents.
Failure to develop a comprehensive care plan with measurable objectives and timetables to meet residents' medical, nursing, and psychosocial needs for 3 residents (Residents 17, 34, and 35).
Failure to provide care to prevent pressure sore development and promote healing for 2 residents (Residents 34 and 35).
Failure to employ sufficient dietary support personnel competent to carry out the functions of the dietary service, including assisting residents with feeding.
Report Facts
Resident sample size: 40
Facility census: 71
Residents cited for pressure sore care deficiencies: 2
Residents cited for care plan deficiencies: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Corrine Adams | Executive Director | Signed plan of correction letters dated 2011-02-17 and 2011-02-17 |
Document
Capacity: 80
Deficiencies: 0
Date: APP2020
Visit Reason
The documents serve to verify the licensing status and renewal of the Good Samaritan Society - Beatrice facility, provide occupancy permit details, and disclose Alzheimer's special care unit information.
Findings
The documents confirm the facility's licensure through 3/31/2021, an occupancy permit for 80 beds issued on 3/2/2020, and provide administrative and ownership details without reporting inspection findings or deficiencies.
Report Facts
Total licensed capacity: 80
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Correne Adams | Administrator | Named as facility administrator on licensing and Alzheimer's disclosure documents |
| Cerice Cornelius | Director of Nursing | Named as Director of Nursing on facility information form |
Notice
Capacity: 80
Deficiencies: 0
Date: APP2021
Visit Reason
The document serves as a renewal application for the nursing home license of Good Samaritan Society - Beatrice and includes certification of licensure, occupancy permit, and Alzheimer's Special Care Unit endorsement application.
Findings
The documents confirm that Good Samaritan Society - Beatrice meets statutory requirements for licensure as a Skilled Nursing Facility with an Alzheimer's/Special Care Unit, has an occupancy permit for 80 beds, and is applying for renewal of its Alzheimer's Special Care Unit endorsement.
Report Facts
Total licensed beds: 80
Renewal license expiration date: Expires 03/31/2022 as shown on renewal card (page 1)
Occupancy permit issue date: Issued 3/2/2020 as shown on occupancy permit (page 4)
Cost of non-skilled level of care: 320
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Correne Adams | Administrator | Named as administrator on renewal application and Alzheimer's Special Care Unit Disclosure |
| Randy Bury | President | Named as President of the corporation and contact name on Alzheimer's Special Care Unit Disclosure |
| Eric Vanden Hull | Vice President, Finance | Named as Vice President of Finance on officers list and signed renewal application |
| Nathan Schema | Vice President, Operations | Named as Vice President of Operations on officers list and signed renewal application |
| Gary J. Anthone, MD | Chief Medical Officer, Director, Division of Public Health | Named on licensure certification (page 1) |
| Susen Lindner | Deputy State Fire Marshal | Named as inspector on occupancy permit (page 4) |
Notice
Capacity: 80
Deficiencies: 0
Date: APP2022
Visit Reason
The documents serve to verify and renew the nursing home license for Good Samaritan Society - Beatrice, including renewal of the SNF/NF dual certification and Alzheimer's Special Care Unit endorsement.
Findings
No inspection findings or deficiencies are reported; the documents primarily confirm licensing status, facility capacity, and application for renewal and endorsement.
Report Facts
Total licensed beds: 80
Maximum capacity for Alzheimer's beds: 20
Renewal license fees: 1750
Ancillary charge for non-skilled level of care: 330
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Correne Adams | Administrator | Named as administrator on renewal application and Alzheimer's Special Care Unit Disclosure. |
| Aimee Middleton | Vice President, Operations | Named as Vice President, Operations and authorized representative signing renewal application. |
| Eric Vanden Hull | Vice President, Finance | Named as Vice President, Finance and authorized representative signing renewal application. |
| Nathan Schema | President | Named as President of the corporation and contact name for Alzheimer's Special Care Unit Disclosure. |
Document
Capacity: 80
Deficiencies: 0
Date: APP2023
Visit Reason
The documents pertain to the renewal of the nursing home license and Alzheimer's special care unit endorsement for Good Samaritan Society - Beatrice.
Findings
No inspection findings or deficiencies are reported. The documents include licensing renewal, occupancy permit, facility site map, and Alzheimer's care unit disclosure information.
Report Facts
Total licensed beds: 80
Maximum capacity for Alzheimer's beds: 20
Renewal licensure fee: 1550
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Correne Adams | Administrator | Named as administrator on the nursing home licensure renewal application and Alzheimer's special care unit disclosure. |
| Cerice Cornelius | Director of Nursing | Named as Director of Nursing on the nursing home licensure renewal application. |
| Aimee Middleton | Vice President, Operations | Named as Vice President, Operations of the corporation owning the facility. |
| Joel Fluit | Vice President, Finance | Named as Vice President, Finance of the corporation owning the facility. |
| Nathan Schema | Contact Name / President | Named as contact for Alzheimer's special care unit application and President of the corporation. |
Document
Capacity: 80
Deficiencies: 0
Date: APP2024
Visit Reason
The documents serve to renew the nursing home license, verify occupancy capacity, and provide disclosure and endorsement for the Alzheimer's Special Care Unit at Good Samaritan Society - Beatrice.
Findings
No inspection findings or deficiencies are reported. The documents include licensing renewal application details, occupancy permit with maximum beds, site map showing private resident rooms, and Alzheimer's unit disclosure including staffing and care philosophy.
Report Facts
Total licensed beds: 80
Maximum capacity for Alzheimer's beds: 20
Renewal license fees: 1550
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Correne Adams | Administrator | Named as facility administrator on renewal application and Alzheimer's unit disclosure |
| Aimee Middleton | Authorized Representative | Signed renewal application as authorized representative |
| Joel Fluit | Authorized Representative | Signed renewal application as authorized representative |
Document
Capacity: 80
Deficiencies: 0
Date: APP2025
Visit Reason
The documents serve to verify and renew the nursing home license for Good Samaritan Society - Beatrice, including renewal of the SNF/NF dual certification and Alzheimer's Special Care Unit endorsement.
Findings
No inspection findings or deficiencies are reported. The documents confirm licensure status, facility capacity, ownership, and special care unit details.
Report Facts
Total licensed beds: 80
Maximum capacity for Alzheimer's beds: 20
Renewal license fees: 1750
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Corrine Adams | Administrator | Named as administrator on the renewal application and Alzheimer's Special Care Unit disclosure. |
| Cerice Cornelius | Director of Nursing | Named as Director of Nursing on the renewal application. |
| Aimee Middleton | Vice President, Operations | Listed as an officer of the corporation. |
| Joel Fluit | Vice President, Finance | Listed as an officer of the corporation. |
| Nathan Schema | President | Listed as an officer of the corporation and contact for Alzheimer's Special Care Unit disclosure. |
Document
Capacity: 80
Deficiencies: 0
Date: APP2016
Visit Reason
The document includes a nursing home licensure renewal application, occupancy permit, and various policy and procedure manuals for the Good Samaritan Society - Beatrice facility.
Findings
No inspection findings or deficiencies are reported. The document primarily contains administrative, procedural, and informational content related to facility operations, care philosophy, programming, staffing, infection control, environment guidelines, and ancillary charges.
Report Facts
Total licensed beds: 80
Number of beds to be relicensed: 80
Bed hold respite days: 14
Rates: 248
Notice
Capacity: 80
Deficiencies: 0
Date: APP2018
Visit Reason
This document serves as a licensure renewal application and Alzheimer's Special Care Unit Disclosure for the Good Samaritan Society - Beatrice facility, verifying licensure and providing detailed information about the Alzheimer's care unit.
Findings
The document confirms the facility's licensure renewal status, outlines the Alzheimer's Special Care Unit philosophy, placement and discharge criteria, care planning, staffing ratios, staff training, physical environment features, resident activities, family support programs, and cost/fees of care.
Report Facts
Total licensed beds: 80
Staffing ratios (days and evenings): 5
Staffing ratios (nights): 12
Staff training hours: 16
Staff training hours: 24
Cultural competency training duration: 50
Cost of care range: 283
Cost of care range: 328
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Correne Adams | Administrator | Named as facility administrator and authorized representative signing the application |
| David Horazdovsky | Contact name for legal owning entity | Contact for Evangelical Lutheran Good Samaritan Society |
Report
September 24, 2024
Report
September 24, 2024
Report
October 17, 2023
Report
September 28, 2022
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