01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-03-12 | 6 | 2026-03-12 | 5 |
| Cycle 2 | 2025-03-13 | 3 | 2025-03-13 | 4 |
| Cycle 3 | 2024-05-09 | 4 | 2024-05-09 | 10 |
CMS CCN 1651872026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Good Samaritan - West Union
201 Hall Street · West Union, IA 52175 · Fayette County
Certified beds52CMS provider file
Recent citation rows32current 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
32 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 6 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-05-20 · HEALTHF0609Severity D · isolated; potential for more than minimal harm
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 · 2026-06-11 · complaint2026-05-20 · HEALTHF0644Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Correction field: Deficient, Provider has date of correction · 2026-06-11 · complaint2026-03-12 · FIREE0039Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Correction field: Deficient, Provider has date of correction · 2026-03-232026-03-12 · HEALTHF0552Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Ensure that residents are fully informed and understand their health status, care and treatments.
Correction field: Deficient, Provider has date of correction · 2026-04-092026-03-12 · 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 · 2026-04-092026-03-12 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2026-04-092026-03-12 · 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 · 2026-04-092026-03-12 · FIREK0222Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Correction field: Deficient, Provider has date of correction · 2026-03-112026-03-12 · FIREK0223Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
Correction field: Deficient, Provider has date of correction · 2026-03-122026-03-12 · 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 · 2026-03-272026-03-12 · FIREK0363Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2026-03-112025-03-13 · HEALTHF0644Severity B · pattern; potential for minimal harm
Resident Assessment and Care Planning Deficiencies
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Correction field: Deficient, Provider has date of correction · 2025-03-242025-03-13 · FIREK0222Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Correction field: Deficient, Provider has date of correction · 2025-03-182025-03-13 · 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 · 2025-03-182025-03-13 · 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 · 2025-03-182025-03-13 · FIREK0920Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure proper usage of power strips and extension cords.
Correction field: Deficient, Provider has date of correction · 2025-03-172024-10-29 · HEALTHF0725Severity F · widespread; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Correction field: Deficient, Provider has date of correction · 2024-11-22 · complaint2024-10-29 · 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 · 2024-11-22 · complaint2024-05-09 · 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 · 2024-05-172024-05-09 · FIREE0039Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Correction field: Deficient, Provider has date of correction · 2024-05-232024-05-09 · HEALTHF0622Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.
Correction field: Deficient, Provider has date of correction · 2024-05-232024-05-09 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2024-05-232024-05-09 · 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 · 2024-05-232024-05-09 · HEALTHF0883Severity E · pattern; potential for more than minimal harm
Infection Control Deficiencies
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Correction field: Deficient, Provider has date of correction · 2024-05-2303 / 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
- 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 hours3.26per resident day
RN hours0.72per resident day
Weekend nurse hours2.78per resident day
Staff turnover60.0%CMS reported field
06 / LOCAL RECORDS
Open the Iowa ledger →Other published facilities nearby
No second facility in the same city met the directory rule.