All citations for Pih Health Good Samaritan Hospital D/P SNF

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 Pih Health Good Samaritan Hospital D/P SNF

Last standard health inspection on record

December 4, 2025

Showing 1 to 19 of 19 citations

  1. No harm, with potential for more than minimal harm

    Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.

    Widespread (many residents). CMS level F.

    Health citation F-0636, Resident Assessment and Care Planning Deficiencies. Inspection of October 6, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (October 27, 2023).

  2. No harm, with potential for more than minimal harm

    Inspect, test, and maintain automatic sprinkler systems.

    Widespread (many residents). CMS level F.

    Fire safety citation K-0353, Smoke Deficiencies. Inspection of October 6, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (October 12, 2023).

  3. No harm, with potential for more than minimal harm

    Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

    Widespread (many residents). CMS level F.

    Fire safety citation K-0521, Services Deficiencies. Inspection of October 6, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (November 7, 2023).

  4. 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 October 6, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (October 23, 2023).

  5. No harm, with potential for more than minimal harm

    Post nurse staffing information every day.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0732, Nursing and Physician Services Deficiencies. Inspection of October 6, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (October 27, 2023).

  6. No harm, with potential for more than minimal harm

    Reasonably accommodate the needs and preferences of each resident.

    Isolated (one or a few residents). CMS level D.

    Health citation F-0558, Resident Rights Deficiencies. Inspection of October 6, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (October 27, 2023).

  7. No harm, with potential for more than minimal harm

    Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.

    Isolated (one or a few residents). CMS level D.

    Health citation F-0578, Resident Rights Deficiencies. Inspection of October 6, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (October 27, 2023).

  8. No harm, with potential for more than minimal harm

    Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.

    Isolated (one or a few residents). CMS level D.

    Health citation F-0582, Resident Rights Deficiencies. Inspection of October 6, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (October 27, 2023).

  9. No harm, with potential for more than minimal harm

    Provide safe, appropriate dialysis care/services for a resident who requires such services.

    Isolated (one or a few residents). CMS level D.

    Health citation F-0698, Quality of Life and Care Deficiencies. Inspection of October 6, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (October 27, 2023).

  10. No harm, with potential for more than minimal harm

    Ensure that residents are free from significant medication errors.

    Isolated (one or a few residents). CMS level D.

    Health citation F-0760, Pharmacy Service Deficiencies. Inspection of October 6, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (October 27, 2023).

  11. No harm, with potential for more than minimal harm

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

    Isolated (one or a few residents). CMS level D.

    Health citation F-0812, Nutrition and Dietary Deficiencies. Inspection of October 6, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (October 6, 2023).

  12. No harm, with potential for more than minimal harm

    Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.

    Isolated (one or a few residents). CMS level D.

    Health citation F-0838, Administration Deficiencies. Inspection of October 6, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (October 6, 2023).

  13. No harm, with potential for more than minimal harm

    Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.

    Isolated (one or a few residents). CMS level D.

    Health citation F-0851, Administration Deficiencies. Inspection of October 6, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (November 8, 2023).

  14. No harm, with potential for more than minimal harm

    Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.

    Isolated (one or a few residents). CMS level D.

    Health citation F-0867, Administration Deficiencies. Inspection of October 6, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (November 7, 2023).

  15. 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.

    Isolated (one or a few residents). CMS level D.

    Fire safety citation K-0321, Smoke Deficiencies. Inspection of October 6, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (October 13, 2023).

  16. No harm, with potential for more than minimal harm

    Construct fire resistant interior walls.

    Isolated (one or a few residents). CMS level D.

    Fire safety citation K-0331, Smoke Deficiencies. Inspection of October 6, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (October 12, 2023).

  17. No harm, with potential for more than minimal harm

    Have properly installed electrical wiring and gas equipment.

    Isolated (one or a few residents). CMS level D.

    Fire safety citation K-0511, Services Deficiencies. Inspection of October 6, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (October 12, 2023).

  18. No harm, with potential for more than minimal harm

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

    Isolated (one or a few residents). CMS level D.

    Fire safety citation K-0761, Miscellaneous Deficiencies. Inspection of October 6, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (November 7, 2023).

  19. No harm, with potential for more than minimal harm

    Ensure proper usage of power strips and extension cords.

    Isolated (one or a few residents). CMS level D.

    Fire safety citation K-0920, Gas, Vacuum, and Electrical Systems Deficiencies. Inspection of October 6, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (October 12, 2023).

Source: CMS Provider Information, Fire Safety Deficiencies, Health Deficiencies, Citation Code Look-up, data as of October 1, 2026. Inspection results describe the home at the time of each inspection.