01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2024-02-05 | 11 | 2024-02-05 | 7 |
| Cycle 2 | 2022-08-10 | 7 | 2022-08-10 | 12 |
| Cycle 3 | 2021-06-02 | 9 | 2021-06-02 | 12 |
CMS CCN 1753592026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Good Samaritan - Wamego
2011 Grandview Drive · Wamego, KS 66547 · Pottawatomie County
Certified beds45CMS provider file
Recent citation rows58current CMS citation release
Penalty rows2current 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
58 rows in the current release
4 rows carry G–L scope/severity codes; 3 carry J–L. 14 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2024-05-16 · HEALTHF0689Severity J · isolated immediate jeopardy
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 · 2024-05-14 · complaint2024-02-05 · FIREE0004Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Develop and maintain an Emergency Preparedness Program (EP).
Correction field: Deficient, Provider has date of correction · 2024-04-102024-02-05 · HEALTHF0657Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Correction field: Deficient, Provider has date of correction · 2024-03-082024-02-05 · HEALTHF0660Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Plan the resident's discharge to meet the resident's goals and needs.
Correction field: Deficient, Provider has date of correction · 2024-03-082024-02-05 · HEALTHF0661Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
Correction field: Deficient, Provider has date of correction · 2024-03-082024-02-05 · 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 · 2024-03-082024-02-05 · HEALTHF0689Severity D · isolated; 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 · 2024-03-082024-02-05 · HEALTHF0699Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care or services that was trauma informed and/or culturally competent.
Correction field: Deficient, Provider has date of correction · 2024-03-082024-02-05 · HEALTHF0740Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
Correction field: Deficient, Provider has date of correction · 2024-03-082024-02-05 · 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 · 2024-03-082024-02-05 · HEALTHF0757Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Correction field: Deficient, Provider has date of correction · 2024-03-082024-02-05 · HEALTHF0758Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Correction field: Deficient, Provider has date of correction · 2024-03-082024-02-05 · 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 · 2024-03-082024-02-05 · 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 · 2024-04-102024-02-05 · FIREK0353Severity L · widespread immediate jeopardy
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2024-04-102024-02-05 · FIREK0354Severity L · widespread immediate jeopardy
Smoke Deficiencies
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
Correction field: Deficient, Provider has date of correction · 2024-04-102024-02-05 · 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 · 2024-04-102024-02-05 · FIREK0712Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2024-04-102024-02-05 · FIREK0901Severity F · widespread; potential for more than minimal harm
Electrical Deficiencies
Ensure that building systems meet requirements determined by risk assessment procedures performed by qualified personnel.
Correction field: Deficient, Provider has date of correction · 2024-04-102022-08-10 · HEALTHF0657Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Correction field: Deficient, Provider has date of correction · 2022-09-022022-08-10 · 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 · 2022-09-022022-08-10 · HEALTHF0692Severity G · isolated actual 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 · 2022-09-022022-08-10 · HEALTHF0697Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe, appropriate pain management for a resident who requires such services.
Correction field: Deficient, Provider has date of correction · 2022-09-022022-08-10 · 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 · 2022-09-0203 / 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 |
|---|---|---|---|
| 2024-05-16 | Fine | $9,315 | 0 |
| 2024-03-27 | Fine | $17,210 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- SANFORDOrganization · 5% OR GREATER DIRECT 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
- GASSEN, WILLIAMIndividual · CORPORATE OFFICERNOT APPLICABLE · since 05/30/2024
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 hours3.72per resident day
RN hours0.97per resident day
Weekend nurse hours3.23per resident day
Staff turnover20.9%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.