01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-03-25 | 1 | 2026-03-25 | 0 |
| Cycle 2 | 2025-01-09 | 5 | 2025-01-09 | 1 |
| Cycle 3 | 2023-11-17 | 3 | 2023-11-17 | 0 |
CMS CCN 1555612026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Good Samaritan Home & Rehabilitative Center
231 N Jackson St · Oakland City, IN 47660 · Gibson County
Certified beds103CMS provider file
Recent citation rows10current CMS citation release
Penalty rows0current 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
10 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 0 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-03-25 · HEALTHF0688Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Correction field: Deficient, Provider has date of correction · 2026-04-202025-01-09 · HEALTHF0561Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Correction field: Deficient, Provider has date of correction · 2025-02-062025-01-09 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2025-02-062025-01-09 · HEALTHF0756Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Correction field: Deficient, Provider has date of correction · 2025-02-062025-01-09 · 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 · 2025-02-062025-01-09 · HEALTHF0880Severity D · isolated; 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 · 2025-02-062025-01-09 · FIREK0921Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure that testing and maintenance of electrical equipment is performed.
Correction field: Waiver has been granted · 2025-06-032023-11-17 · HEALTHF0550Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Correction field: Deficient, Provider has date of correction · 2023-12-172023-11-17 · HEALTHF0732Severity C · widespread; potential for minimal harm
Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
Correction field: Deficient, Provider has date of correction · 2023-12-172023-11-17 · HEALTHF0804Severity D · isolated; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Correction field: Deficient, Provider has date of correction · 2023-12-17 · complaint03 / 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 |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- HENRY COUNTY MEMORIAL HOSPITALOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 06/01/2023
- CHIES, STEVENIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2023
- DYNES, SHELDONIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2013
- JACKSON, BLAKEIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2023
- JACKSON, ETHANIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2023
- JACKSON, MARKIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2023
- JACKSON, MICHAELIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 05/14/2024
- JACKSON, WESSLEYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2023
- JUSTICE, DAVIDIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2023
- KELSEY, DONNAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/18/2024
- PIDGEON, JOHNIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2013
- SHORE, MARIONIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2013
- STITLE, STEPHENIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2023
- WARE, DEBORAHIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 08/27/2021
- WRIGHT, THERESSAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 06/01/2023
- RING, BRIANIndividual · CORPORATE OFFICERNOT APPLICABLE · since 06/01/2023
- AMERICAN SENIOR COMMUNITIES LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/01/2023
- BRUBAKER, SHERYLIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/01/2023
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 hours3.96per resident day
RN hours0.52per resident day
Weekend nurse hours3.50per resident day
Staff turnover27.5%CMS reported field
06 / LOCAL RECORDS
Open the Indiana ledger →Other published facilities nearby
No second facility in the same city met the directory rule.