01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-06-18 | 6 | 2025-06-18 | 5 |
| Cycle 2 | 2023-09-28 | 8 | 2023-09-28 | 8 |
| Cycle 3 | 2022-06-16 | 12 | 2022-06-16 | 4 |
CMS CCN 1753662026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Good Samaritan - Atwood
650 Lake Road #216 · Atwood, KS 67730 · Rawlins County
Certified beds35CMS provider file
Recent citation rows43current CMS citation release
Penalty rows3current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
43 rows in the current release
8 rows carry G–L scope/severity codes; 7 carry J–L. 9 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-06-18 · HEALTHF0576Severity F · widespread; potential for more than minimal harm
Resident Rights Deficiencies
Ensure residents have reasonable access to and privacy in their use of communication methods.
Correction field: Deficient, Provider has date of correction · 2025-08-012025-06-18 · HEALTHF0582Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Correction field: Deficient, Provider has date of correction · 2025-08-012025-06-18 · HEALTHF0801Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2025-08-012025-06-18 · HEALTHF0802Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
Correction field: Deficient, Provider has date of correction · 2025-08-012025-06-18 · HEALTHF0812Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2025-08-012025-06-18 · HEALTHF0880Severity E · pattern; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2025-08-012025-06-18 · FIREK0211Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Correction field: Deficient, Provider has date of correction · 2025-08-152025-06-18 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2025-08-192025-06-18 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2025-09-012025-06-18 · FIREK0372Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Correction field: Deficient, Provider has date of correction · 2025-08-222025-06-18 · FIREK0511Severity E · pattern; potential for more than minimal harm
Services Deficiencies
Have properly installed electrical wiring and gas equipment.
Correction field: Deficient, Provider has date of correction · 2025-09-012024-07-31 · HEALTHF0609Severity J · isolated immediate jeopardy
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Deficient, Provider has date of correction · 2024-08-01 · complaint2024-07-31 · HEALTHF0610Severity K · pattern of immediate jeopardy
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
Correction field: Deficient, Provider has date of correction · 2024-08-01 · complaint2024-05-09 · HEALTHF0686Severity J · isolated immediate jeopardy
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2024-05-10 · complaint2024-01-03 · HEALTHF0689Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Past Non-Compliance · 2023-12-20 · complaint2023-09-28 · HEALTHF0577Severity C · widespread; potential for minimal harm
Resident Rights Deficiencies
Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.
Correction field: Deficient, Provider has date of correction · 2023-10-302023-09-28 · HEALTHF0677Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Correction field: Deficient, Provider has date of correction · 2023-10-302023-09-28 · HEALTHF0689Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2023-10-302023-09-28 · HEALTHF0692Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Correction field: Deficient, Provider has date of correction · 2023-10-302023-09-28 · HEALTHF0730Severity F · widespread; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Observe each nurse aide's job performance and give regular training.
Correction field: Deficient, Provider has date of correction · 2023-10-302023-09-28 · HEALTHF0761Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Correction field: Deficient, Provider has date of correction · 2023-10-302023-09-28 · HEALTHF0801Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2023-10-302023-09-28 · HEALTHF0812Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2023-10-302023-09-28 · FIREK0321Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Correction field: Deficient, Provider has date of correction · 2023-12-1903 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2024-07-31 | Fine | $51,146 | 0 |
| 2024-05-09 | Fine | $8,499 | 0 |
| 2024-01-03 | Fine | $9,311 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- SANFORDOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 01/01/2019
- THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETYOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTEREST100% · since 01/01/2019
- BROWN, GEORGEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2025
- DYKHOUSE, DANAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/30/2024
- ENGBRECHT, WESLEYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/30/2024
- GASSEN, WILLIAMIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/30/2024
- GULSVIG, NEILIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/30/2024
- HERSETH SANDLIN, STEPHANIEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/30/2024
- LUNDEEN, MARKIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/30/2024
- MCCAUSLAND, MAUREENIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2025
- MOLBERT, LAURISIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/30/2024
- NORTH, ANDREWIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/30/2024
- SCHIEFFER, KEVINIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2025
- SHULKIN, DAVIDIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/30/2024
- TEIKEN, BRENTIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/30/2024
- VENTLING-HERRMANN, MARNIEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/30/2024
- WENZEL, THOMASIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2025
- FLUIT, JOELIndividual · CORPORATE OFFICERNOT APPLICABLE · since 10/01/2022
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours3.58per resident day
RN hours1.06per resident day
Weekend nurse hours3.17per resident day
Staff turnover22.2%CMS reported field
06 / LOCAL RECORDS
Open the Kansas ledger →Other published facilities nearby
No second facility in the same city met the directory rule.