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

Good Samaritan - Manson

Manson, IA · 42 certified beds · Last Life Safety survey May 15, 2025

CMS Certification Number 165236 · first certified December 1994

Ownership

Operated by GOOD SAMARITAN SOCIETY · Non profit - Corporation

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

11
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
2
Tags cited more than once
Across separate surveys
7
Inspection & testing records
Of the citations on file

Position within IA

11 citations — more than 42% 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

Holding steadyabout the same at the latest survey as at its earlier surveys in the window.

The latest survey found 4 citations; the earlier surveys in the window averaged 3.5. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

Well past the typical window (April 2026 to June 2026), and past the point by which nine in ten IA facilities have been surveyed. This facility’s last Life Safety survey was May 2025. 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

1 of the 11 citations on file is 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)

3 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 11 Life Safety citations above. The Physical Environment Index

  • F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  • F-0880 Provide and implement an infection prevention and control program.

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 facility11IA median12National median11
Citations on file over three years, compared
MeasureCitations
This facility11
Median facility in IA12
Median facility nationally11

Survey history

Citations at each Life Safety survey
52023-0522024-0642025-05
Citations at each Life Safety survey
Survey dateCitations
May 11, 20235
June 27, 20242
May 15, 20254

Most-cited tags

Most-cited tags at this facility
K-03532K-03632K-03621K-09211K-09181K-09141E-00041K-07611
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0353Inspect, test, and maintain automatic sprinkler systems.22025-05-15
K-0363Install corridor and hallway doors that block smoke.22025-05-15
K-0362Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.12025-05-15
K-0921Ensure that testing and maintenance of electrical equipment is performed.12025-05-15
K-0918Have generator or other power source capable of supplying service within 10 seconds.12023-05-11
K-0914Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.12024-06-27
E-0004Develop and maintain an Emergency Preparedness Program (EP).12023-05-11
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.12023-05-11

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 5
  • Gas, Vacuum, and Electrical Systems Deficiencies 3
  • Miscellaneous Deficiencies 2
  • Emergency Preparedness Deficiencies 1
Citations by CMS category
CategoryCitations
Smoke Deficiencies5
Gas, Vacuum, and Electrical Systems Deficiencies3
Miscellaneous Deficiencies2
Emergency Preparedness Deficiencies1

Every citation on file

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

May 15, 2025 — 4 citations

Citations issued on May 15, 2025
TagWhat the surveyor checksStatus
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (June 14, 2025)
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 23, 2025)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (May 23, 2025)
K-0921Ensure that testing and maintenance of electrical equipment is performed.Deficient, Provider has date of correction (June 14, 2025)

June 27, 2024 — 2 citations

Citations issued on June 27, 2024
TagWhat the surveyor checksStatus
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (August 1, 2024)
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 (August 1, 2024)

May 11, 2023 — 5 citations

Citations issued on May 11, 2023
TagWhat the surveyor checksStatus
E-0004Develop and maintain an Emergency Preparedness Program (EP).Deficient, Provider has date of correction (May 22, 2023)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (May 22, 2023)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (May 22, 2023)
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.Deficient, Provider has date of correction (May 22, 2023)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (May 22, 2023)

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