Facility profile · CCN 175231
Good Samaritan Society - Ellsworth Village
24 federal citations on record , and 2 federal enforcement actions totaling $16,838.
Record summary
Federal record · Q1 202624
Total citations
12
Last 3 years
2
Actual harm+
2
Federal penalties
$16,838
Total fines
3
Overall ★ rating
Most common violation categories here
Most common F-tags at this facility
Citation history
24 on record| Survey | F-Tag | Violation | Severity | Source |
|---|---|---|---|---|
| Jul 2, 2024 | F881 | Implement a program that monitors antibiotic use. | D | Standard |
| Jul 2, 2024 | F880 | Provide and implement an infection prevention and control program. | D | Standard |
| Jul 2, 2024 | F868 | Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | F | Standard |
| Jul 2, 2024 | F812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | Standard |
| Jul 2, 2024 | F758 | 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. | E | Standard |
| Jul 2, 2024 | F756 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | D | Standard |
| Jul 2, 2024 | F699 | Provide care or services that was trauma informed and/or culturally competent. | D | Standard |
| Jul 2, 2024 | F690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | Standard |
| Jul 2, 2024 | F684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Standard |
| Jul 2, 2024 | F657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | Standard |
| Aug 1, 2023 | F684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | G | Complaint |
| May 23, 2023 | F689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | Complaint |
| Mar 7, 2023 | F880 | Provide and implement an infection prevention and control program. | E | Standard |
| Mar 7, 2023 | F690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | Standard |
| Mar 7, 2023 | F689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Standard |
| Mar 7, 2023 | F684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Standard |
| Mar 7, 2023 | F657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | Standard |
| Mar 7, 2023 | F600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Standard |
| Sep 27, 2021 | F812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | Standard |
| Sep 27, 2021 | F761 | 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. | F | Standard |
| Sep 27, 2021 | F758 | 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. | D | Standard |
| Sep 27, 2021 | F756 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | D | Standard |
| Sep 27, 2021 | F732 | Post nurse staffing information every day. | C | Standard |
| Sep 27, 2021 | F584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | E | Standard |
Federal enforcement history
Federal regulators have imposed 2 enforcement actions against this facility, including 2 civil money penalties totaling $16,838 .
| Date | Type | Fine | Payment denial |
|---|---|---|---|
| Aug 1, 2023 | Fine | $8,190 | — |
| May 23, 2023 | Fine | $8,648 | — |
About this record
A citation is a finding by a state survey team working under federal contract. It is not a court
judgment. The description above is drawn verbatim from federal public datasets. Facilities have
the right to appeal findings through an Informal Dispute Resolution (IDR/IIDR) process.
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