Good Samaritan - Wamego

In the surveyor’s words

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

• Immediate jeopardy, isolatedF689May 16, 2024

  The facility identified a census of 39 residents with three residents reviewed for elopement. Based on record review, observation, and interview, the facility failed to ensure staff provided adequate supervision to cognitively impaired Resident (R) 1, who had a history of wandering and elopement, to prevent R1 from exiting the facility unsupervised through an unlocked kitchen area and door. On 05/04/24 at approximately 05:58 PM R1 sat in the dining room finishing his supper. The only Certified Nurse Aide (CNA) in the dining room assisted another resident out of the dining room. R1 then got up from his table and, with his walker, walked to the dishwasher room. R1 attempted to open the door but it was locked. […]

• Immediate jeopardy, isolatedF689Mar 23, 2021

  The facility had a census of 41 residents. The sample included three residents reviewed for elopement. Based on observation, record review, and interview, the facility failed to provide adequate supervision to prevent an elopement for one of three sampled residents, Resident (R) 1, assessed as risk for elopement, exited the building through a window on 01/24/21 without staff knowledge, and ambulated one block from the facility before facility staff assisted him back to the facility. […]

• Actual harm, isolatedF692Aug 10, 2022

  The facility had a census of 43 residents. The sample included 14 residents, with three reviewed for nutrition. Based on observation, record review, and interview the facility failed to provide the correct physician ordered nutritional supplement for Resident (R)34, who had a significant unplanned weight loss. The facility failed to notify the Registered Dietician and/or physician when R34 continued to decline an ordered nutritional supplement. The facility further failed to identify and implement additional interventions to prevent weight loss, which included the resident's preferred meals and snacks and failed to attempt to fortify routinely consumed food items. […]

• Actual harm, isolatedF689Oct 4, 2021

  The facility identified a census of 39. The sample included six residents reviewed for accidents/hazards. Based on observation, record review, and interviews the facility failed to ensure the environment was free of trip hazards, failed to investigate causative factors for falls and failed to develop interventions in response to Resident (R)2's change of condition and need for increased assistance. This deficient practice resulted in a fall with a fracture for R2 who was cognitively impaired, at risk for falls, and had a history of falls with injury. […]

• No harm, potential for more than minimal, widespreadF812Feb 5, 2024

  The facility had a census of 41 residents. The sample included 12 residents. Based on observation, record review, and interview, the facility failed to store, prepare, and service food in a sanitary manner for the residents who reside in the facility and receive meals from the facility kitchen which placed the residents at risk for foodborne illness. Findings included: -On 01/30/24 at 08:32 AM, during the initial tour of the facility's kitchen, observation revealed the walk-in refrigerator stored a five-pound open, unsealed, undated roll of meat on the eye level shelf. On the shelf directly under the open unsealed meat roll were four small bowls of chopped lettuce and four cream-type pie slices which were not covered or labeled. […]