All citations for Good Samaritan - Holstein

State inspectors check nursing homes that take Medicare or Medicaid against federal rules, usually about once a year, and also look into complaints. Each rule a home did not meet is a citation.

Back to Good Samaritan - Holstein

Last standard health inspection on record

April 9, 2026

Showing 1 to 18 of 18 citations

Immediate jeopardy to resident health or safety
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Isolated (one or a few residents). CMS level J.
Health citation F-0600, Freedom from Abuse, Neglect, and Exploitation Deficiencies. Inspection of August 17, 2024. Found during a complaint inspection.
The home gave a date the problem would be corrected (August 27, 2024).
Immediate jeopardy to resident health or safety
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Isolated (one or a few residents). CMS level J.
Health citation F-0609, Freedom from Abuse, Neglect, and Exploitation Deficiencies. Inspection of August 17, 2024. Found during a complaint inspection.
The home gave a date the problem would be corrected (August 27, 2024).
No harm, with potential for more than minimal harm
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Widespread (many residents). CMS level F.
Fire safety citation K-0321, Smoke Deficiencies. Inspection of December 21, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (December 29, 2023).
No harm, with potential for more than minimal harm
Provide properly protected cooking facilities.
Widespread (many residents). CMS level F.
Fire safety citation K-0324, Smoke Deficiencies. Inspection of December 21, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (December 28, 2023).
No harm, with potential for more than minimal harm
Have approved installation, maintenance and testing program for fire alarm systems.
Widespread (many residents). CMS level F.
Fire safety citation K-0345, Smoke Deficiencies. Inspection of December 21, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (December 28, 2023).
No harm, with potential for more than minimal harm
Have generator or other power source capable of supplying service within 10 seconds.
Widespread (many residents). CMS level F.
Fire safety citation K-0918, Gas, Vacuum, and Electrical Systems Deficiencies. Inspection of December 21, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (January 28, 2024).
No harm, with potential for more than minimal harm
Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents.
Pattern (more than a few residents). CMS level E.
Health citation F-0741, Quality of Life and Care Deficiencies. Inspection of August 17, 2024. Found during a complaint inspection.
The home gave a date the problem would be corrected (August 27, 2024).
No harm, with potential for more than minimal harm
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Pattern (more than a few residents). CMS level E.
Health citation F-0755, Pharmacy Service Deficiencies. Inspection of June 17, 2024. Found during a complaint inspection.
The home gave a date the problem would be corrected (June 27, 2024).
No harm, with potential for more than minimal harm
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Pattern (more than a few residents). CMS level E.
Health citation F-0689, Quality of Life and Care Deficiencies. Inspection of December 21, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (January 18, 2024).
No harm, with potential for more than minimal harm
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Pattern (more than a few residents). CMS level E.
Health citation F-0726, Nursing and Physician Services Deficiencies. Inspection of December 21, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (January 18, 2024).
No harm, with potential for more than minimal harm
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.
Pattern (more than a few residents). CMS level E.
Health citation F-0801, Nutrition and Dietary Deficiencies. Inspection of December 21, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (January 18, 2024).
No harm, with potential for more than minimal harm
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Isolated (one or a few residents). CMS level D.
Health citation F-0580, Resident Rights Deficiencies. Inspection of December 21, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (January 18, 2024).
No harm, with potential for more than minimal harm
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Isolated (one or a few residents). CMS level D.
Health citation F-0604, Freedom from Abuse, Neglect, and Exploitation Deficiencies. Inspection of December 21, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (January 18, 2024).
No harm, with potential for more than minimal harm
Ensure each resident receives an accurate assessment.
Isolated (one or a few residents). CMS level D.
Health citation F-0641, Resident Assessment and Care Planning Deficiencies. Inspection of December 21, 2023. Found during a standard inspection and a complaint inspection.
The home gave a date the problem would be corrected (January 18, 2024).
No harm, with potential for more than minimal harm
Ensure services provided by the nursing facility meet professional standards of quality.
Isolated (one or a few residents). CMS level D.
Health citation F-0658, Resident Assessment and Care Planning Deficiencies. Inspection of December 21, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (January 18, 2024).
No harm, with potential for more than minimal harm
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Isolated (one or a few residents). CMS level D.
Health citation F-0755, Pharmacy Service Deficiencies. Inspection of December 21, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (January 18, 2024).
No harm, with potential for more than minimal harm
Inspect, test, and maintain automatic sprinkler systems.
Isolated (one or a few residents). CMS level D.
Fire safety citation K-0353, Smoke Deficiencies. Inspection of December 21, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (December 30, 2023).
No harm, with potential for more than minimal harm
Install corridor and hallway doors that block smoke.
Isolated (one or a few residents). CMS level D.
Fire safety citation K-0363, Smoke Deficiencies. Inspection of December 21, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (December 29, 2023).

Source: CMS Provider Information, Fire Safety Deficiencies, Health Deficiencies, Citation Code Look-up, data as of September 30, 2026. Inspection results describe the home at the time of each inspection.