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Good Samaritan Society - Van Buren

Details

Type of Ownership Non profit - Corporation
Participates in Medicare? Yes
Participates in Medicaid? Yes
Certified Beds 75
Continuing Care? No
Resident Council? Yes
Family Council? No
Multi-Home Chain? No
Located in a Hospital? No
Special Focus Facility? No

View:    Health Inspections  |  Quality Measures  |  Staffing  |  Fire Inspections

Health Inspections  

Most Recent Inspection: 07/28/2011

Date of last standard health inspection: 07/28/2011
Quality Indicator Survey No
Dates of Complaint Investigations: 04/01/2011 - 03/31/2012
Total number of Health Deficiencies for this nursing home: 2
Average number of Health Deficiencies in IA: 2
Average number of Health Deficiencies in US: 3
Range of Health Deficiencies in IA: 0 - 7
Quality Care Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. 00/06/2012 02/03/2001 2 Few
Resident Rights Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Immediately tell the resident 00/06/2012 02/03/2001 and a family member of situations (injury/decline/ the resident's doctor

Inspection, 02/08/2011

Environmental Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Provide housekeeping and maintenance services. 02/08/2011 00/09/2001 1 Some
Quality Care Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Provide care by qualified persons according to each resident's written plan of care. 02/08/2011 00/09/2001 2 Few
Assist those residents who need help with eating/drinking 02/08/2011 00/09/2001 Few grooming and personal and oral hygiene.
Resident Rights Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Immediately tell the resident 02/08/2011 00/09/2001 and a family member of situations (injury/decline/ the resident's doctor

Inspection, 02/04/2011

Administration Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Keep accurate 02/04/2011 02/00/2012 Few complete and organized clinical records on each re
Environmental Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Have a program that investigates 02/04/2011 02/00/2012 Few controls and keeps infection from spreading.
Quality Care Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Properly care for residents needing special services 02/04/2011 02/00/2012 colostomy including: injections

Inspection, 01/02/2010

Environmental Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. 01/02/2010 02/03/2001 3 Few

Inspection, 00/02/2009

Administration Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Operate and provide services according to Federal, State, and local laws and professional standards. 00/02/2009 01/02/2010 2 Some
Environmental Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Provide a safe, clean, comfortable and home-like environment; and allow residents to use personal belongings to the extent possible. 00/02/2009 01/02/2010 2 Few
Provide housekeeping and maintenance services. 00/02/2009 01/02/2010 2 Few
Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. 00/02/2009 01/02/2010 3 Few
Mistreatment Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
1) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. 00/02/2009 01/02/2010 2 Few
Nutrition and Dietary Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Store, cook, and serve food in a safe and clean way. 00/02/2009 01/02/2010 2 Some
Quality Care Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Ensure services provided by the nursing facility meet professional standards of quality. 00/02/2009 01/02/2010 2 Few
Provide necessary care and services to maintain or improve the highest well being of each resident. 00/02/2009 01/02/2010 2 Few
Assist those residents who need help with eating/drinking, grooming and personal and oral hygiene. 00/02/2009 01/02/2010 2 Some
Resident Assessment Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. 00/02/2009 01/02/2010 2 Few
Resident Rights Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Provide care for residents in a way that maintains or improves their dignity and respect in full recognition of their individuality. 00/02/2009 01/02/2010 2 Few

Inspection, 02/08/2007

Administration Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Operate and provide services according to Federal, State, and local laws and professional standards. 02/08/2007 01/08/2008 2 Some
Environmental Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Have a program that investigates, controls and keeps infection from spreading. 02/08/2007 00/01/2009 2 Few
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. 02/08/2007 00/01/2009 2 Some
Have a program that investigates 02/08/2007 00/01/2009 Few controls and keeps infection from spreading.
Make sure that the nursing home area is safe 02/08/2007 00/01/2009 clean and comfortable for residents easy to use
Nutrition and Dietary Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Make sure menus meet the resident's nutritional needs and that there is a prepared menu by which nutritious meals have been planned for the resident and followed. 02/08/2007 00/01/2009 2 Some
Make sure menus meet the resident's nutritional needs and that there is a prepared menu by which nutritious meals have been planned for the resident and followed. 02/08/2007 00/01/2009 2 Some
Pharmacy Service Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. 02/08/2007 00/01/2009 2 Few
Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. 02/08/2007 00/01/2009 2 Few
Quality Care Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Provide activities to meet the interests and needs of each resident. 02/08/2007 00/01/2009 2 Some
Ensure services provided by the nursing facility meet professional standards of quality. 02/08/2007 00/01/2009 2 Few
Assist those residents who need help with eating/drinking, grooming and personal and oral hygiene. 02/08/2007 00/01/2009 2 Some
Ensure that each resident who enters the nursing home without a catheter is not given a catheter, unless medically necessary, and that incontinent patients receive proper services to prevent urinary tract infections and restore normal bladder functions. 02/08/2007 00/01/2009 2 Few
Have enough nurses to care for every resident in a way that maximizes the resident's well being. 02/08/2007 00/01/2009 2 Some
Provide activities to meet the interests and needs of each resident. 02/08/2007 00/01/2009 2 Some
Ensure services provided by the nursing facility meet professional standards of quality. 02/08/2007 00/01/2009 2 Few
Assist those residents who need help with eating/drinking 02/08/2007 00/01/2009 Some grooming and personal and oral hygiene.
Ensure that each resident who enters the nursing home without a catheter is not given a catheter 02/08/2007 00/01/2009 and that incontinent patients receive proper servi unless medically necessary
Have enough nurses to care for every resident in a way that maximizes the resident's well being. 02/08/2007 00/01/2009 2 Some

Inspection, 02/07/2006

Environmental Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Provide a safe, clean, comfortable and home-like environment; and allow residents to use personal belongings to the extent possible. 02/07/2006 00/03/2008 2 Some
Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. 02/07/2006 00/03/2008 2 Some
Quality Care Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Ensure services provided by the nursing facility meet professional standards of quality. 02/07/2006 00/03/2008 2 Few
Provide necessary care and services to maintain or improve the highest well being of each resident. 02/07/2006 00/03/2008 2 Few
Ensure that each resident who enters the nursing home without a catheter is not given a catheter, unless medically necessary, and that incontinent patients receive proper services to prevent urinary tract infections and restore normal bladder functions. 02/07/2006 00/03/2008 2 Few
Ensure residents maintain acceptable nutritional status. 02/07/2006 00/03/2008 2 Some

Inspection, 02/01/2004

Environmental Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. 02/01/2004 01/03/2005 3 Few

Inspection, 01/06/2004

Environmental Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. 01/06/2004 02/09/2005 2 Some
Quality Care Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Provide activities to meet the interests and needs of each resident. 01/06/2004 02/09/2005 2 Some
Assist those residents who need help with eating/drinking 01/06/2004 02/09/2005 Some grooming and personal and oral hygiene.
Have enough nurses to care for every resident in a way that maximizes the resident's well being. 01/06/2004 02/09/2005 2 Some
Resident Rights Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Allow residents to self-administer drugs if determined safe. 01/06/2004 02/09/2005 2 Few

Inspection, 02/00/2003

Quality Care Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Assist those residents who need help with eating/drinking 02/00/2003 01/09/2004 Some grooming and personal and oral hygiene.

Nursing Home Staffing  

Information comes from data that the nursing home reports to its state agency. It contains the nursing home staffing hours for a two-week period prior to the time of the state inspection. CMS receives this data and converts it into the number of staff hours per resident per day.

National Average Average in IA Golden Living Center, Asheville
RN Staff Only1 N/A N/A 3 out of 5 stars
Total Number of Residents 86 56 57
Total, Licensed Nurse Staff Hours
per Resident per Day
16 hours 51 minutes 10 hours 20 minutes 1 hour 1 minute
RN Hours
per Resident per Day
16 hours 3 minutes 9 hours 43 minutes 27 minutes
LPN/LVN Hours
per Resident per Day
16 hours 17 minutes 9 hours 43 minutes 34 minutes
CNA Hours
per Resident per Day
17 hours 46 minutes 11 hours 22 minutes 1 hour 51 minutes

1 The star rating a nursing home received for the information it provided about its Registered Nurse (RN) staffing. RNs have between 2 and 6 years of education.

Quality Measures  

Information comes from data that the nursing home reports to its state agency. It contains the nursing home staffing hours for a two-week period prior to the time of the state inspection. CMS receives this data and converts it into the number of staff hours per resident per day.

Long-Term Residents

Short-Term Residents

Fire Safety Inspections

Lists the fire safety requirements that the nursing home failed to meet. Fire safety results are not included in the nursing home's Overall Rating.

Most Recent Inspection: 08/02/2011

Automatic Sprinkler Systems in all required areas Yes
Date of last standard fire safety inspection: 08/02/2011
Dates of Complaint Investigations: 04/01/2011 - 03/31/2012
Total number of Fire Safety Deficiencies for this nursing home: 0
Average number of Fire Safety Deficiencies in IA: 0
Average number of Fire Safety Deficiencies in US: 2
Range of Fire Safety Deficiencies in IA: 0 - 0

Inspection, 00/07/2009

Automatic Sprinkler Systems Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Automatic sprinkler systems that have been maintained in working order. 00/07/2009 01/07/2009 2 Few
Emergency Plans and Fire Drills Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Record of quarterly fire drills for each shift under varying conditions. 00/07/2009 00/07/2010 2 Many
Fire Alarm Systems Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
An approved installation, maintenance and testing program for fire alarm systems. 00/07/2009 01/06/2009 2 Few
Hazardous Area Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Special areas constructed so that walls can resist fire for one hour or an approved fire extinguishing system. 00/07/2009 00/08/2009 2 Few
Medical Gases and Anesthetizing Areas Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Proper medical gas storage and administration areas. 00/07/2009 00/07/2010 2 Few

Inspection, 00/02/2008

Building Construction Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Approved construction type or materials. 00/02/2008 00/08/2008 2 Some
Medical Gases and Anesthetizing Areas Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Proper medical gas storage and administration areas. 00/02/2008 00/02/2008 2 Few

Inspection, 00/02/2007

Electrical Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Properly installed electrical wiring and equipment. 00/02/2007 01/02/2007 2 Some
Fire Alarm Systems Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
A fire alarm system that can be heard throughout the facility. 00/02/2007 00/02/2007 2 Few
Illumination and Emergency Power Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Emergency lighting that can last at least 1 1/2 hours. 00/02/2007 01/01/2007 2 Many
Smoke Compartmentation and Control Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Walls that prevent smoke from passing through and would resist fire for at least one hour. 00/02/2007 00/02/2007 2 Some
 

819 Country Lane Road
Keosauqua, IA 52565

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