Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

Good Samaritan - Indianola

Indianola, IA · 105 certified beds · Last Life Safety survey May 14, 2026

CMS Certification Number 165186 · first certified November 1993

Ownership

Operated by GOOD SAMARITAN SOCIETY · Non profit - Corporation

No change of ownership on CMS record since January 1, 2016, when the records begin.

27
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
4
Tags cited more than once
Across separate surveys
10
Inspection & testing records
Of the citations on file

Position within IA

27 citations — more than 93% of the 387 certified nursing homes in IA. Compared within IA rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated

Improvingfewer citations at the latest survey than at its earlier surveys in the window.

The latest survey found 8 citations; the earlier surveys in the window averaged 9.5. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

The window opens April 2027 — about 6 months from now. This facility’s last Life Safety survey was May 2026. Facilities in IA are typically surveyed 11–13 months after the last one (median 12), measured over 700 consecutive surveys in the last two years of CMS records.

A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured

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Which alerts

2 inspection-and-testing tags have been cited here at more than one survey. Nationally, that pattern is common: about three quarters of cited facilities have at least one repeated tag, and half of the facilities ever cited for sprinkler inspection and testing are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.

Emergency preparedness

2 of the 27 citations on file are Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index

Physical environment (health survey)

7 physical-environment citations on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 27 Life Safety citations above. The Physical Environment Index

  • F-0584 Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
  • F-0880 Provide and implement an infection prevention and control program.
  • F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

How that compares

Citations on file over three years

Compared with the median facility in IA, and nationally. Surveyors differ markedly between states, so the IA figure is the meaningful one.

This facility27IA median12National median11
Citations on file over three years, compared
MeasureCitations
This facility27
Median facility in IA12
Median facility nationally11

Survey history

Citations at each Life Safety survey
142024-0652025-0482026-05
Citations at each Life Safety survey
Survey dateCitations
June 18, 202414
April 24, 20255
May 14, 20268

Most-cited tags

Most-cited tags at this facility
K-09203E-00392K-03552K-03532K-02811K-07121K-02911K-03621
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0920Ensure proper usage of power strips and extension cords.32026-05-14
E-0039Conduct testing and exercise requirements.22026-05-14
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.22026-05-14
K-0353Inspect, test, and maintain automatic sprinkler systems.22026-05-14
K-0281Install proper backup exit lighting.12026-05-14
K-0712Have simulated fire drills held at unexpected times.12024-06-18
K-0291Install emergency lighting that can last at least 1 1/2 hours.12024-06-18
K-0362Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.12025-04-24

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 11
  • Gas, Vacuum, and Electrical Systems Deficiencies 6
  • Egress Deficiencies 4
  • Miscellaneous Deficiencies 3
  • Other 3
Citations by CMS category
CategoryCitations
Smoke Deficiencies11
Gas, Vacuum, and Electrical Systems Deficiencies6
Egress Deficiencies4
Miscellaneous Deficiencies3
Emergency Preparedness Deficiencies2
Services Deficiencies1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

May 14, 2026 — 8 citations

Citations issued on May 14, 2026
TagWhat the surveyor checksStatus
E-0039Conduct testing and exercise requirements.Deficient, Provider has date of correction (May 21, 2026)
K-0281Install proper backup exit lighting.Deficient, Provider has date of correction (May 26, 2026)
K-0325Have properly installed hallway dispensers for alcohol-based hand rub.Deficient, Provider has date of correction (May 19, 2026)
K-0347Properly provide smoke detection systems in areas open to corridors.Deficient, Provider has date of correction (May 28, 2026)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (May 20, 2026)
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.Deficient, Provider has date of correction (June 1, 2026)
K-0914Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.Deficient, Provider has date of correction (May 22, 2026)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (May 13, 2026)

April 24, 2025 — 5 citations

Citations issued on April 24, 2025
TagWhat the surveyor checksStatus
K-0362Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.Deficient, Provider has date of correction (May 5, 2025)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Deficient, Provider has date of correction (April 28, 2025)
K-0711Provide a written emergency evacuation plan.Deficient, Provider has date of correction (May 9, 2025)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (April 28, 2025)
K-0922Meet requirements for the use and maintenance of medical gas equipment.Deficient, Provider has date of correction (May 9, 2025)

June 18, 2024 — 14 citations

Citations issued on June 18, 2024
TagWhat the surveyor checksStatus
E-0039Conduct testing and exercise requirements.Deficient, Provider has date of correction (July 18, 2024)
K-0222Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.Deficient, Provider has date of correction (June 19, 2024)
K-0291Install emergency lighting that can last at least 1 1/2 hours.Deficient, Provider has date of correction (July 1, 2024)
K-0293Have properly located and lighted "Exit" signs.Deficient, Provider has date of correction (July 1, 2024)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (June 27, 2024)
K-0346Follow proper procedures when the fire alarm was out of service for more than 4 hours.Deficient, Provider has date of correction (June 18, 2024)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (June 18, 2024)
K-0354Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.Deficient, Provider has date of correction (June 18, 2024)
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.Deficient, Provider has date of correction (July 1, 2024)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (June 18, 2024)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (July 1, 2024)
K-0741Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.Deficient, Provider has date of correction (June 19, 2024)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (June 18, 2024)
K-0923Have proper medical gas storage and administration areas.Deficient, Provider has date of correction (June 18, 2024)

Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.