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Good Samaritan Society - Devils Lake

Details

Type of Ownership Non profit - Corporation
Participates in Medicare? Yes
Participates in Medicaid? Yes
Certified Beds 48
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: 02/02/2012

Date of last standard health inspection: 02/02/2012
Quality Indicator Survey No
Dates of Complaint Investigations: 04/01/2011 - 03/31/2012
Total number of Health Deficiencies for this nursing home: 0
Average number of Health Deficiencies in ND: 4
Average number of Health Deficiencies in US: 3
Range of Health Deficiencies in ND: 0 - 8

Inspection, 00/04/2010

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. 00/04/2010 01/04/2011 2 Some

Inspection, 00/07/2003

Quality Care Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Provide necessary care and services to maintain or improve the highest well being of each resident. 00/07/2003 01/00/2004 3 Few

Inspection, 02/05/2002

Nutrition and Dietary Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Offer other nutritional food to each resident who will not eat the food served. 02/05/2002 00/05/2004 2 Some
Store 02/05/2002 00/04/2006 and serve food in a safe and clean way. cook
Resident Rights Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Listen to the resident groups and act on their complaints and suggestions that affect resident care and life. 02/05/2002 00/05/2004 2 Some

Inspection, 01/06/2002

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. 01/06/2002 02/08/2003 2 Few
Have a program that investigates, controls and keeps infection from spreading. 01/06/2002 01/01/2004 2 Many
Mistreatment Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Develop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property. 01/06/2002 03/01/2003 2 Few
Nutrition and Dietary Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Provide a tasty and well-balanced diet that meets the nutritional needs of each resident. 01/06/2002 00/08/2004 2 Few
Store, cook, and serve food in a safe and clean way. 01/06/2002 02/08/2003 2 Some
Quality Care Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Provide necessary care and services to maintain or improve the highest well being of each resident. 01/06/2002 02/08/2003 2 Few
Assist those residents who need help with eating/drinking, grooming and personal and oral hygiene. 01/06/2002 02/08/2003 2 Few
Resident Rights Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Keep residents' personal and medical records private and confidential. 01/06/2002 02/08/2003 2 Few
Provide care for residents in a way that maintains or improves their dignity and respect in full recognition of their individuality. 01/06/2002 00/00/0000 1 Some
Reasonably accommodate the needs and preferences of each resident. 01/06/2002 02/08/2003 2 Few

Inspection, 00/02/2002

Environmental Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Have a program that investigates, controls and keeps infection from spreading. 00/02/2002 00/08/2003 2 Few
Nutrition and Dietary Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Provide a tasty and well-balanced diet that meets the nutritional needs of each resident. 00/02/2002 00/08/2003 2 Few
Provide special eating equipment and utensils for each resident who needs them. 00/02/2002 00/08/2003 2 Few
Store, cook, and serve food in a safe and clean way. 00/02/2002 00/08/2003 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. 00/02/2002 00/08/2003 2 Few
Resident Assessment Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Allow residents the right to participate in the planning or revision of care and treatment. 00/02/2002 00/08/2003 2 Some

Inspection, 01/06/2001

Administration Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Post nurse staffing information/data on a daily basis. 01/06/2001 02/08/2002 1 Many
Keep accurate, complete and organized clinical records on each resident that meet professional standards. 01/06/2001 02/08/2002 2 Few
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. 01/06/2001 02/08/2002 2 Few
Have a program that investigates, controls and keeps infection from spreading. 01/06/2001 02/08/2002 2 Few
Mistreatment Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Keep each resident free from physical restraints, unless needed for medical treatment. 01/06/2001 02/08/2002 2 Few
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. 01/06/2001 02/08/2002 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. 01/06/2001 02/08/2002 2 Some
Pharmacy Service Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. 01/06/2001 01/03/2003 2 Few
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. 01/06/2001 02/08/2002 2 Few
Provide necessary care and services to maintain or improve the highest well being of each resident. 01/06/2001 02/01/2003 2 Few
Assist those residents who need help with eating/drinking, grooming and personal and oral hygiene. 01/06/2001 02/08/2002 2 Few
Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. 01/06/2001 02/08/2002 2 Few
Resident Assessment Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Allow residents the right to participate in the planning or revision of care and treatment. 01/06/2001 02/08/2002 2 Some
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. 01/06/2001 02/08/2002 2 Some
Reasonably accommodate the needs and preferences of each resident. 01/06/2001 02/08/2002 2 Some

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 ND Golden Living Center, Asheville
RN Staff Only1 N/A N/A 4 out of 5 stars
Total Number of Residents 86 66 47
Total, Licensed Nurse Staff Hours
per Resident per Day
16 hours 51 minutes 1 hour 24 minutes 1 hour 13 minutes
RN Hours
per Resident per Day
16 hours 3 minutes 47 minutes 46 minutes
LPN/LVN Hours
per Resident per Day
16 hours 17 minutes 37 minutes 27 minutes
CNA Hours
per Resident per Day
17 hours 46 minutes 3 hours 2 hours 12 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: 11/07/2011

Automatic Sprinkler Systems in all required areas Yes
Date of last standard fire safety inspection: 11/07/2011
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 ND: 0
Average number of Fire Safety Deficiencies in US: 2
Range of Fire Safety Deficiencies in ND: 0 - 0

Inspection, 01/03/2012

Automatic Sprinkler Systems Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Portable fire extinguishers. 01/03/2012 01/03/2012 2 Few
Miscellaneous Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Other fire safety features required by fire safety codes. 01/03/2012 02/07/2001 2 Many

Inspection, 00/07/2011

Exits and Egress Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Exits that are accessible at all times. 00/07/2011 03/00/2011 2 Many
Furnishings and Decorations Deficiencies
Deficiency Inspection Date Correction Date Level of Harm Residents Affected
Restrictions on the use of flammable curtains. 00/07/2011 00/06/2012 2 Few
 

302 7th Ave Ne
Devils Lake, ND 58301

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