Inspection Reports for Good Samaritan Society – St John’s

This document is a Nursing Home Licensure Renewal Application and related certification for Good Samaritan Society - St John's, verifying licensure renewal and compliance with statutory requirements.

The documents confirm the renewal of the facility's license, including certification of services offered and occupancy permit. No deficiencies or inspection findings are reported.

The document serves to acknowledge the decrease in the number of licensed beds at the Skilled Nursing Facility from 77 to 56 beds effective October 1, 2019, and to amend the Health Insurance Benefits Agreement accordingly.

The facility's licensed bed capacity was officially decreased from 77 to 56 beds as requested by the facility, with the Health Insurance Benefits Agreement updated to reflect the new certified bed locations and counts.

An unannounced visit was conducted to investigate a complaint alleging that the facility fails to provide medications according to the five rights.

The facility was found to provide medications according to the five rights with no medication errors observed and medication administration records confirming compliance.

The allegation that the facility fails to provide medications according to the five rights was investigated and found to be unsubstantiated; the facility was in compliance.

An unannounced visit was conducted to investigate a complaint and annual survey at Good Samaritan Society - St Johns on April 4, 2018-April 16, 2018, by representatives of the Department of Health and Human Services Division of Public Health.

The facility was found in compliance with sufficient staffing, dining assistance, transportation, repositioning, transfer safety, notification of condition changes, reporting resident behaviors, involuntary discharge notice, resident choice, and grievance handling. Violations were found related to fall prevention, medication administration, timely investigation reporting, and prevention of skin breakdown. Additional deficiencies were noted in criminal background checks, resident dignity, closet access, environmental cleanliness, abuse reporting, discharge notice, bed hold policy, assessment accuracy, care plan revisions, medication administration, wound care, accident prevention, food safety, ventilation, sprinkler maintenance, electrical safety, and psychotropic medication use.

The complaint investigation included allegations of insufficient staffing, failure to implement fall prevention, medication errors, failure to report incidents, and other resident care concerns. Some allegations were substantiated with violations found in fall prevention, medication administration, investigation reporting, and skin breakdown prevention.

An unannounced visit was conducted to investigate a complaint at Good Samaritan Society - St Johns on May 8, 2017, regarding allegations that the facility failed to provide services to maintain the highest level of well-being and failed to protect residents from injury.

The investigation found that the facility provided services to maintain the highest level of well-being and had interventions in place to protect residents from injury. The facility was found to be in compliance with related regulatory requirements.

The complaint alleged failure to provide services to maintain the highest level of well-being and failure to protect residents from injury. Both allegations were investigated and found to be unsubstantiated with the facility in compliance.

An unannounced visit was conducted to investigate a complaint and annual survey at Good Samaritan Society - St Johns from March 1, 2017 to March 8, 2017 by the Department of Health and Human Services Division of Public Health.

The facility was found in violation for failing to treat residents with dignity and respect, failing to ensure prompt response to calls for assistance, and other deficiencies including infection control issues, maintenance, and safety code violations. Several deficiencies were cited related to resident dignity, bathing preferences, call light response times, catheter bag placement, emergency lighting, fire safety, and electrical safety.

The complaint investigation included allegations of failure to provide staff assistance with food/fluid intake, failure to treat residents with dignity and respect, failure to protect residents from misappropriation, failure to provide care for bowel/bladder elimination, failure to provide required monitoring during meals, failure to ensure prompt response to calls for assistance, and failure to ensure the building did not smell badly. The facility was found in violation for dignity and respect and prompt response to calls for assistance.

An unannounced visit was conducted to investigate a complaint that the facility fails to protect residents from self harm.

The investigation found no evidence of self harm among residents and confirmed that interventions were in place to protect residents from self harm. The facility was found to be in compliance with related regulatory requirements.

The allegation that the facility fails to protect residents from self harm was investigated and found to be unsubstantiated.

An unannounced visit was conducted to investigate a complaint alleging the facility fails to protect residents from abuse and fails to send in a written investigation to the State Agency within 5 working days.

The investigation found no evidence of abuse and confirmed that staff were trained and aware of abuse prevention policies. The facility was also found to be in compliance with requirements for submitting written investigations within 5 working days.

The complaint alleged failure to protect residents from abuse and failure to submit written investigations within 5 working days. Both allegations were investigated and found to be unsubstantiated with the facility in compliance.

An unannounced visit was conducted to investigate a complaint alleging the facility failed to provide care and treatment to prevent skin breakdown.

The investigation found that the facility was monitoring care provided to residents and that residents received care to prevent skin breakdown. The facility was found to be in compliance with related regulatory requirements.

The complaint alleged failure to provide care and treatment to prevent skin breakdown. The allegation was investigated and found to be unsubstantiated as the facility was in compliance.

The inspection was a routine survey to assess compliance with state and federal regulations governing skilled nursing facilities, including housekeeping, maintenance, life safety, and fire safety standards.

The facility was found deficient in multiple areas including housekeeping and maintenance issues such as peeling molding, ammonia odors, stained linoleum, broken toilet backs, and unclean ceiling vents. Life safety code violations included failure to separate the network room from the exit corridor, malfunctioning dining room doors, delayed egress doors requiring excessive force, obstructions in exit corridors, inadequate fire drill scheduling, lack of weekly emergency generator battery inspections, and improper use of electrical wiring and equipment such as power strips in resident rooms.

The document is a nursing home licensure renewal application and certification for Good Samaritan Society - St John's, verifying the facility's SNF/NF dual certification and requesting renewal of the license.

The document certifies that the facility meets statutory requirements for licensure renewal as a skilled nursing facility with physical, occupational, and speech therapy services. No deficiencies or violations are noted.

An unannounced visit was conducted to investigate a complaint and annual survey at Good Samaritan Society - St Johns on March 2-5, 2015. The investigation included review of resident records, observation of care and services, and interviews with residents, family members, and staff.

The facility was found in compliance with therapeutic diets and dental care. However, it failed to assess residents' fluid intake as ordered by the physician, resulting in a violation. The facility also failed to notify the physician of changes in condition for one resident. Additionally, a life safety code deficiency was found due to failure to maintain the smoke barrier above the ceiling between the North Wing and common area. Other deficiencies included issues with dignity and respect, self-determination, housekeeping, care plans, medication administration, infection control, and resident room requirements.

The complaint investigation included allegations that the facility failed to provide therapeutic diets as ordered, failed to provide adequate fluid intake to prevent dehydration, failed to assist residents with dental care, and failed to notify family or responsible party of change in condition. The facility was found in compliance with diet and dental care allegations but was found in violation for failure to assess fluid intake and notify physician of changes in condition.

An unannounced visit was conducted to investigate a complaint and annual survey at Good Samaritan Society - St Johns on March 24, 2014 to March 27, 2014.

The investigation found the facility was in compliance with medication administration and care to prevent skin breakdown. However, a deficiency was cited for failure to remove expired medications from storage areas and medication carts.

The complaint alleged the facility failed to provide medication in accordance with the Five Rights and failed to provide care and treatment to prevent skin breakdown. Both allegations were investigated and found to be in compliance.

Annual survey inspection of Good Samaritan Society - St Johns nursing facility to assess compliance with state and federal regulations including resident care, safety, and facility conditions.

The facility was found deficient in multiple areas including resident privacy breaches, staff neglect, environmental maintenance issues, care planning deficiencies, medication errors, expired medications and supplies, and life safety code violations related to sprinkler maintenance and fire suppression system accessibility.

The Department of Health and Human Services issued a Notice of Disciplinary Action placing Skilled Nursing Facility License #074004 on probation for 90 days beginning June 8, 2012, due to failure to implement interventions to prevent accidents resulting in injuries.

The facility failed to implement interventions to prevent accidents that resulted in injuries, leading to probation and a requirement to submit a Plan of Correction and weekly reports documenting corrective actions.

The inspection was conducted based on complaints regarding the facility's failure to promptly resolve resident grievances and to properly investigate and report injuries of unknown origin.

The facility failed to promptly resolve grievances voiced by a resident's family, failed to report injuries of unknown origin to proper authorities within required timeframes, and failed to ensure a safe environment to prevent accidents resulting in significant injuries to residents.

The complaint investigation focused on allegations that the facility failed to promptly resolve grievances related to a resident's injury, failed to report injuries of unknown origin to authorities, and failed to prevent accidents resulting in injuries to residents.

Annual inspection to assess compliance with licensure regulations and life safety codes at Good Samaritan Society - St Johns nursing facility.

The facility was found deficient in multiple areas including medication administration through feeding tubes, fluid intake monitoring for residents with fluid restrictions, dietary hand hygiene and food safety practices, medication security, infection control hand hygiene, life safety code violations including improper flame spread barriers, fire alarm system maintenance, sprinkler system installation, flame retardant curtains, oxygen signage, electrical wiring, and alcohol-based hand sanitizer placement.

The inspection was conducted to assess compliance with regulations regarding prevention and treatment of pressure sores in residents, following identification of deficiencies in nursing interventions and care.

The facility failed to implement and monitor nursing interventions to promote healing of pressure sores and prevent new sores from developing in residents. Specific residents (19, 26, and 61) were found to have pressure ulcers with inadequate care documentation and inconsistent wound care practices. The facility submitted a plan of correction including staff education and audits to ensure compliance.

The documents serve to certify and verify the renewal of the SNF/NF dual certification license for Good Samaritan Society - St John's, including submission of the renewal application and confirmation of occupancy permit.

No inspection findings or deficiencies are reported; the documents primarily confirm licensing status, renewal fees, ownership information, and fire marshal occupancy approval.

This document serves as a renewal application for the nursing home license of Good Samaritan Society - St John's and includes verification of licensure and occupancy permit information.

The documents confirm that the facility meets statutory requirements for licensure renewal and occupancy with a licensed capacity of 56 beds. No inspection findings or deficiencies are reported.

This document package serves as a renewal application for the nursing home license of Good Samaritan Society - St John's and includes verification of licensure and occupancy permit information.

The documents confirm that the facility meets statutory requirements for licensure renewal, with no inspection findings or deficiencies reported.

This document serves as a licensure renewal application and verification for the Good Samaritan Society - St John's skilled nursing facility, confirming the license status and renewal fees.

The documents confirm the facility's licensure renewal status, ownership information, and occupancy permit with a maximum capacity of 77 beds. No inspection findings or deficiencies are reported.

This document serves as a licensure renewal application and verification for the Good Samaritan Society - St John's skilled nursing facility, including occupancy permit information.

The documents confirm the facility's licensure renewal status, ownership information, and maximum licensed bed capacity. No inspection findings or deficiencies are reported.

This document serves to verify the renewal of the SNF/NF dual certification license for Good Samaritan Society - St John's and includes the occupancy permit issued by the Nebraska State Fire Marshal.

The facility is licensed as a skilled nursing facility with a total capacity of 77 beds. The occupancy permit was issued on 2018-04-12 by the State Fire Marshal, confirming compliance with occupancy requirements.

This document serves to verify the license renewal for the SNF/NF dual certification of Good Samaritan Society - St John's and includes an occupancy permit issued by the Nebraska State Fire Marshal.

The document confirms that the facility meets statutory requirements for licensure through the renewal date and holds an occupancy permit for 77 beds issued on 10/25/2019.

This document serves to verify the renewal of the SNF/NF dual certification license for Good Samaritan Society - St John's nursing home facility and includes related administrative and occupancy permit information.

The documents confirm the facility's license renewal status, ownership information, and occupancy permit with a maximum capacity of 77 beds. No inspection findings or deficiencies are reported.