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Public Record

Good Samaritan Society - Ellsworth Village

Nursing HomeEllsworth, KSCMS 175231
52 citations on record

From CMS

Facility profile

CMS overall rating
3 / 5

*CMS Five-Star

Certified beds
43

*CMS

Avg. residents per day
38.5

*CMS

Inspection record

On record from CMS

Citations on record
52

*CMS

Inspections on file
8

*CMS

Last inspection
2024-07-02

*CMS

Citations

52 citations on record

Each deficiency cited on a CMS health inspection of this facility, sourced from the federal record. Open a report for the raw CMS Scope and Severity grade on each finding.

What do CMS severity letters mean?

Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.

General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.

Each letter combines severity with scope: how many residents the deficiency affected.

  • 0657Generalpotential for harm

    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

  • 0684Generalpotential for harm

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

  • 0690Generalpotential for harm

    Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

  • 0699Generalpotential for harm

    Provide care or services that was trauma informed and/or culturally competent.

  • 0758Generalpotential for harm

    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.

  • 0812Generalpotential for harm

    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

  • 0868Generalpotential for harm

    Have the Quality Assessment and Assurance group have the required members and meet at least quarterly

  • 0880Generalpotential for harm

    Provide and implement an infection prevention and control program.

  • 0881Generalpotential for harm

    Implement a program that monitors antibiotic use.

  • 0031Generalpotential for harm

    Provide emergency officials' contact information.

  • 0039Generalpotential for harm

    Conduct testing and exercise requirements.

  • 0211Generalpotential for harm

    Keep aisles, corridors, and exits free of obstruction in case of emergency.

  • 0324Generalpotential for harm

    Provide properly protected cooking facilities.

  • 0345Generalpotential for harm

    Have approved installation, maintenance and testing program for fire alarm systems.

  • 0353Generalpotential for harm

    Inspect, test, and maintain automatic sprinkler systems.

  • 0511Generalpotential for harm

    Have properly installed electrical wiring and gas equipment.

  • 0712Generalpotential for harm

    Have simulated fire drills held at unexpected times.

  • 0914Generalpotential for harm

    Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.

  • 0918Generalpotential for harm

    Have generator or other power source capable of supplying service within 10 seconds.

  • 0920Generalpotential for harm

    Ensure proper usage of power strips and extension cords.

  • 0756Generalpotential for harm

    Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

  • 0684Seriousactual harm

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

  • 0689Seriousactual harm

    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

  • 0684Generalpotential for harm

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

  • 0689Generalpotential for harm

    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

  • 0690Generalpotential for harm

    Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

  • 0880Generalpotential for harm

    Provide and implement an infection prevention and control program.

  • 0712Generalpotential for harm

    Have simulated fire drills held at unexpected times.

  • 0761Generalpotential for harm

    To conduct inspection, testing and maintenance of fire doors by qualified individuals.

  • 0914Generalpotential for harm

    Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.

  • 0918Generalpotential for harm

    Have generator or other power source capable of supplying service within 10 seconds.

  • 0511Generalpotential for harm

    Have properly installed electrical wiring and gas equipment.

  • 0039Generalpotential for harm

    Conduct testing and exercise requirements.

  • 0100Generalpotential for harm

    Meet other general requirements.

  • 0222Generalpotential for harm

    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.

  • 0341Generalpotential for harm

    Install a fire alarm system that can be heard throughout the facility.

  • 0353Generalpotential for harm

    Inspect, test, and maintain automatic sprinkler systems.

  • 0355Generalpotential for harm

    Properly select, install, inspect, or maintain portable fire extinguishes.

  • 0600Generalpotential for harm

    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

  • 0363Generalpotential for harm

    Install corridor and hallway doors that block smoke.

  • 0657Generalpotential for harm

    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

  • 0758Generalpotential for harm

    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.

  • 0812Generalpotential for harm

    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

  • 0291Generalpotential for harm

    Install emergency lighting that can last at least 1 1/2 hours.

  • 0353Generalpotential for harm

    Inspect, test, and maintain automatic sprinkler systems.

  • 0761Generalpotential for harm

    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.

  • 0918Generalpotential for harm

    Have generator or other power source capable of supplying service within 10 seconds.

  • 0920Generalpotential for harm

    Ensure proper usage of power strips and extension cords.

  • 0923Generalpotential for harm

    Have proper medical gas storage and administration areas.

  • 0584Generalpotential for harm

    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.

  • 0732Generalno actual harm

    Post nurse staffing information every day.

  • 0756Generalpotential for harm

    Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

Inspection history

Every health inspection on record

Each CMS health inspection of this facility, and the deficiencies the surveyors cited. Where the verbatim Form 2567 statement of deficiencies is on file, it links to the full report.

FAQ

Questions and answers

What is Good Samaritan Society - Ellsworth Village?
Good Samaritan Society - Ellsworth Village is a Medicare- and Medicaid-certified nursing home in Ellsworth, KS, tracked by the Centers for Medicare & Medicaid Services (CMS). Its CMS Certification Number (CCN) is 175231.
What is the CMS rating for Good Samaritan Society - Ellsworth Village?
Good Samaritan Society - Ellsworth Village has a CMS overall rating of 3 out of 5 stars. CMS rates nursing homes on health inspections, staffing, and quality measures.
How many beds does Good Samaritan Society - Ellsworth Village have?
Good Samaritan Society - Ellsworth Village is certified for 43 beds. It serves an average of 38.5 residents per day.
How many citations does Good Samaritan Society - Ellsworth Village have?
Good Samaritan Society - Ellsworth Village has 52 citations on record from CMS health inspections, each tied to a federal deficiency tag.
When was Good Samaritan Society - Ellsworth Village last inspected?
Good Samaritan Society - Ellsworth Village was last inspected on July 2, 2024. CMS surveys nursing homes about once a year and after complaints.
What can I do if I have concerns about care at this facility?
Start by raising the concern with the facility administrator or director of nursing. Every state also runs a free long-term care ombudsman program that advocates for residents and families; the federal Eldercare Locator at eldercare.acl.gov can connect you with yours. Complaints about quality of care can also be filed with your state survey agency.

*Sourced from the Centers for Medicare & Medicaid Services (CMS). See the official record on CMS Care Compare. If you believe any information is inaccurate, report it here.

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