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Inspection visit

Inspection

GOOD SAMARITAN SOCIETY - DECATUR COUNTYCMS #17535619 citations on this visit
19 citations recorded

Citations

19 citations recorded*CMS

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.

  • 0753GeneralS&S Epotential for harm

    Have restrictions on the use of highly flammable decorations.

  • 0920GeneralS&S Epotential for harm

    F920 - Dining and Resident Activities

    Ensure proper usage of power strips and extension cords.

  • 0921GeneralS&S Fpotential for harm

    F921 - Other Environmental Conditions

    Ensure that testing and maintenance of electrical equipment is performed.

  • 0628GeneralS&S Dpotential for harm

    F628 - Documentation

    Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.

  • 0676GeneralS&S Dpotential for harm

    F676 - Based on the comprehensive assessment of a resident and consistent with

    Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.

  • 0725GeneralS&S Fpotential for harm

    F725 - Nursing Services

    Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

  • 0755GeneralS&S Fpotential for harm

    F755 - Pharmacy Services

    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

  • 0757GeneralS&S Dpotential for harm

    F757 - Unnecessary Drugs—General

    Ensure each resident’s drug regimen must be free from unnecessary drugs.

  • 0761GeneralS&S Dpotential for harm

    F761 - Labeling of Drugs and Biologicals

    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.

  • 0801GeneralS&S Fpotential for harm

    F801 - Staffing

    Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.

  • 0211GeneralS&S Dpotential for harm

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

  • 0321GeneralS&S Dpotential for harm

    Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

  • 0345GeneralS&S Dpotential for harm

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

  • 0353GeneralS&S Epotential for harm

    Inspect, test, and maintain automatic sprinkler systems.

  • 0363GeneralS&S Dpotential for harm

    Install corridor and hallway doors that block smoke.

  • 0372GeneralS&S Epotential for harm

    Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

  • 0511GeneralS&S Dpotential for harm

    Have properly installed electrical wiring and gas equipment.

  • 0712GeneralS&S Fpotential for harm

    F712 - Frequency of physician visits

    Have simulated fire drills held at unexpected times.

  • 0923GeneralS&S Dpotential for harm

    F923 - Have adequate outside ventilation by means of windows, or mechanical

    Have proper medical gas storage and administration areas.

FAQ · About this visit

Common questions about this visit

What happened during the November 17, 2025 survey of GOOD SAMARITAN SOCIETY - DECATUR COUNTY?

This was a inspection survey of GOOD SAMARITAN SOCIETY - DECATUR COUNTY on November 17, 2025. The surveyor cited 19 deficiencies, recorded on the federal Form 2567 statement of deficiencies.

Were any deficiencies cited at GOOD SAMARITAN SOCIETY - DECATUR COUNTY on November 17, 2025?

Yes, 19 deficiencies were cited, each with a CMS Scope and Severity grade. The first was: "Have restrictions on the use of highly flammable decorations."

What type of survey was this?

This was a inspection survey conducted by state surveyors under federal Centers for Medicare & Medicaid Services (CMS) oversight. Findings are published on CMS Care Compare.

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Next steps

Concerned about a resident’s care?Find your local ombudsman through the Eldercare Locatoror file a complaint with your state survey agency.

Researching this visit professionally?Book a 15-minute calland we will walk through what we have on file.

Data from CMS Care Compare public records. Dataset last refreshed . If you believe any information is inaccurate, report it here.