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Good Samaritan Society - Waterville

** Data is not kept up to date **

Good Samaritan Society - Waterville
205 First Street North
Waterville, MN 56096
P: (507) 362-4245

Facility Ratings

Overall Rating

Health Inspection

Nurse Staff

Quality

RN Only

Facility Features

31
Number of Residents
Accepts
Medicaid and Medicare
82%
Bed Occupancy
38
Certified Beds
Counseling
Resident
No
Located in Hospital

Additional Details

Health Survey 06/21/12
Fire Survey Date 06/21/12
Sprinkler Status Yes
Multi-Nurshing Home Ownership Yes
Ownership Type Church (Non-Profit)
Continuing Care Retirement Community No
Quality Indicator Survey No
Special Focus Facility No

Survey Deficiencies

Survey Date Correction Date Deficiency Type Deficiency Category Deficiency Deficiency Scope Harm Level
06/24/11 08/03/11 Health Mistreatment Deficiencies 1) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. Few 2
06/24/11 08/03/11 Health Resident Assessment Deficiencies Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Few 2
06/24/11 08/03/11 Health Quality Care Deficiencies Provide care by qualified persons according to each resident's written plan of care. Few 2
06/24/11 08/03/11 Health Quality Care Deficiencies Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. Few 2
06/24/11 08/03/11 Health Pharmacy Service Deficiencies At least once a month, have a licensed pharmacist review each resident's medication(s) and report any irregularities to the attending doctor. Few 2
06/24/11 08/03/11 Health Resident Rights Deficiencies Let residents refuse treatment, refuse to take part in an experiment, or formulate advance directives. Few 2
06/24/11 08/03/11 Health Mistreatment Deficiencies Develop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property. Few 2
06/24/11 08/03/11 Health Environmental Deficiencies Provide housekeeping and maintenance services. Many 1
06/24/11 08/03/11 Health Resident Assessment Deficiencies Allow residents the right to participate in the planning or revision of care and treatment. Few 2
06/24/11 08/03/11 Health Quality Care Deficiencies Provide necessary care and services to maintain or improve the highest well being of each resident. Few 2
06/24/11 08/03/11 Health Environmental Deficiencies Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. Some 2
06/24/11 08/03/11 Health Pharmacy Service Deficiencies Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. Few 2
06/24/10 07/31/10 Health Resident Assessment Deficiencies Allow residents the right to participate in the planning or revision of care and treatment. Few 2
06/24/10 07/31/10 Health Resident Assessment Deficiencies Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Few 2
06/24/10 07/30/10 Health Quality Care Deficiencies Ensure residents maintain acceptable nutritional status. Few 2
06/24/10 07/27/10 Health Quality Care Deficiencies Provide medically-related social services to help each resident achieve the highest possible quality of life. Few 2
06/23/11 08/03/11 Fire Safety Automatic Sprinkler Systems Deficiencies An approved automatic sprinkler system connected to the fire alarm system. Few 2
06/23/11 08/28/11 Fire Safety Corridor Walls and Doors Deficiencies Corridor and hallway doors that block smoke. Many 2
06/22/10 07/31/10 Fire Safety Emergency Plans and Fire Drills Deficiencies Record of quarterly fire drills for each shift under varying conditions. Many 2
06/22/10 08/03/10 Fire Safety Electrical Deficiencies Weekly inspections and monthly testing of generators. Many 2
06/22/10 08/03/10 Fire Safety Electrical Deficiencies Properly installed electrical wiring and equipment. Some 2
06/22/10 07/31/10 Fire Safety Hazardous Area Deficiencies Special areas constructed so that walls can resist fire for one hour or an approved fire extinguishing system. Many 2
06/22/10 07/30/10 Fire Safety Smoking Regulations Deficiencies Posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Many 2
06/22/10 07/30/10 Fire Safety Automatic Sprinkler Systems Deficiencies Back-up procedures in place for a faulty automatic sprinkler system. Many 2
06/22/10 08/03/10 Fire Safety Building Service Equipment Deficiencies Properly protected cooking facilities. Some 2
06/21/12 07/20/12 Health Environmental Deficiencies Have a program that investigates, controls and keeps infection from spreading. Many 2
06/21/12 07/20/12 Health Quality Care Deficiencies Provide necessary care and services to maintain or improve the highest well being of each resident. Few 2
06/21/12 07/20/12 Health Resident Assessment Deficiencies Conduct initial and periodic assessments of each resident's functional capacity. Few 2
06/21/12 07/20/12 Health Pharmacy Service Deficiencies Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. Few 2

The Evangelical Lutheran Good Samaritan Society is a Church (Non-Profit)

Owner Name Ownership Role
Bruce Kallis Director/Officer
David Horazdovsky Director/Officer
David Boock Director/Officer
Derrell Bulls Director/Officer
Eloye Farrell Director/Officer
John Penn Director/Officer
Kimberly Sear-Johansen Director/Officer
Larry Walter Director/Officer
Natanael Lizarazo Director/Officer
Paul Binder Director/Officer
Paula Kneisl Director/Officer
Raye Nae Nylander Director/Officer
Richard Haubensak Director/Officer
Ronald Kortemeyer Director/Officer
Ruth Leitel Director/Officer
Sandra Jerstad Director/Officer
Susan Nickerson Director/Officer
Sylvia Gause Director/Officer
Thomas Peterson Director/Officer
Timothy Penny Director/Officer
Teresa Hildebrandt Managing Employee
The Evangelical Lutheran Good Samaritan Society Operational/Managerial Control

Quality Measures

Measure Prior 3 Quarters Recent Quarter Change
Percent of long-stay residents whose need for help with daily activities has increased 4.8% 0.0% * - 4.8%
Percent of long-stay residents who self-report moderate to severe pain 11.6% 0.0% * -11.6%
Percent of long-stay high-risk residents with pressure ulcers 9.2% 0.0% * - 9.2%
Percent of long-stay residents who lose too much weight 9.9% 16.7% + 6.8%
Percent of long-stay low-risk residents who lose control of their bowels or bladder 37.8% 0.0% * -37.8%
Percent of long-stay residents who have had a catheter inserted and left in their bladder 7.4% 0.0% * - 7.4%
Percent of long-stay residents with a urinary tract infection 12.1% 10.0% - 2.1%
Percent of long-stay residents who have depressive symptoms 2.3% 3.3% + 1.0%
Percent of long-stay residents who were physically restrained 0.0% 0.0% 0.0%
Percent of long-stay residents experiencing one or more falls with major injury 3.3% 3.3% 0.0%
Percent of long-stay residents assessed and given, appropriately, the seasonal influenza vaccine 57.1% 96.7% +39.6%
Percent of long-stay residents assessed and given, appropriately, the pneumococcal vaccine 100.0% 100.0% 0.0%
Percent of short-stay residents who self-report moderate to severe pain 29.6% 0.0% * -29.6%
Percent of short-stay residents with Pressure ulcers that are new or worsened 2.4% 0.0% * - 2.4%
Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine 70.3% 0.0% * -70.3%
Percent of short-stay residents assessed and given, appropriately, the pneumococcal vaccine 100.0% 0.0% * -100.0%
Percent of short-stay residents who newly received an antipsychotic medication 0.0% 0.0% * 0.0%
Percent of long-stay residents who received an antipsychotic medication 18.7% 20.0% + 1.3%