Good Samaritan - Manson

In the surveyor’s words

From the most serious findings on record at Good Samaritan - Manson, in the surveyor’s own words.

• No harm, potential for more than minimal, widespreadF727May 15, 2025

  Based on facility schedule reviews and staff interview, the facility failed to assure a Registered Nurse (RN) on duty for 8 hours daily, 7 days per week. The facility reported a census of 37 residents. Findings include: Review of the facility's nursing staff schedule dated 10/6/24 through 12/31/24 revealed there was no RN on duty for 8 hours on the following date: 11/28/24. Review of the facility policy named Nursing Services Staff dated 10/29/24 revealed the purpose is to provide appropriate staff for resident care in the nursing services department. The location will use the services of a registered nurse for at least eight consecutive hours a day, seven days a week (except when waived by state regulations). Interview on 5/14/25 at 11:28 a.m. […]

• No harm, potential for more than minimal, widespreadF812May 15, 2025

  Based on observation, staff interview and policy review, the facility failed to ensure adequate cleaning of the oven hood filters and sprinklers. The facility reported a census of 37 residents. Findings include: On 5/14/25 at 11:55 a.m. observation of the oven hood showed the filters had a buildup of grease and grime throughout. A pipe attached to the front of the hood, and the sprinklers all showed a build up of grease with fuzz sticking to it. The Assistant Dietary Supervisor stated they had a fire control company come in and clean the hood every so often. Staff C, [NAME] also stated they had an outside company come in to clean the hood. They couldn't say how long it had been since they were there. […]

• No harm, potential for more than minimal, widespreadF851May 15, 2025

  Based on the Center for Medicare and Medicaid Services (CMS) Payroll Based Journal (PBJ) Staffing Data Report (October 1 - December 31) review, facility staffing reports, and staff interviews, the facility failed to submit accurate staff reports for the PBJ Staffing Data Report. The facility reported a census of 37 residents. Findings include: The PBJ Staffing Data Report run date 5/12/2025 triggered for no Registered Nurse (RN) hours. Triggered = four or more days within the quarter with no RN Hours. The report reflected 7 infraction dates with failure to provide RN covered days during October to December. Review of the Nurse Schedules for the infraction dates revealed nursing shifts covered by the Director of Nursing (DON). On 5/14/25 at 4:30 p.m. […]

• No harm, potential for more than minimal, patternF605May 15, 2025

  Based on clinical record review, staff interview, and policy review, the facility failed to obtain a clinical rationale to continue a PRN (as needed) antianxiety medications and offer/attempt nonpharmacological interventions prior to giving antianxiety medications for 2 of 5 residents reviewed for unnecessary medications ( Resident #22 and #34). The facility failed to monitor target behaviors and side effects for psychotropic medications for 3 out of 5 residents (Resident #22, #4 #14). The facility also failed to complete a GDR for a resident receiving an antidepressant for 1 out of 5 residents. (Resident #14). The facility reported a census of 37 residents. Findings include: 1. […]

• No harm, potential for more than minimal, isolatedF689May 15, 2025

  Based on clinical record reviews, staff interviews and policy review, the facility failed to fill out incident reports and put effective interventions in place for falls for 1 of 1 resident reviewed (Resident #11). Resident #11 was at risk for falls. Resident #11 had ten falls from 10/24/24 - 4/19/25. The facility reported a census of 36. Finding include: Resident #11's Minimum Data Set (MDS) dated [DATE] identified a Brief Interview for Mental Status (BIMS) score of 14, indicating no cognitive impairment. Resident #11's MDS included diagnoses of depression, diabetes mellitus, and hypertension (high blood pressure). The MDS listed Resident #11 as independent with rolling left and right, sit to lying, lying to sitting on side of bed, sit to stand, chair/bed to chair transfers. […]