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

Good Samaritan - Saint Ansgar

Saint Ansgar, IA · 42 certified beds · Last Life Safety survey June 18, 2026

CMS Certification Number 165210 · first certified April 1994

Ownership

Operated by GOOD SAMARITAN SOCIETY · For profit - Corporation

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

10
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
2
Tags cited more than once
Across separate surveys
8
Inspection & testing records
Of the citations on file

Position within IA

10 citations — more than 34% 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 3 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?

The window opens May 2027 — about 7 months from now. This facility’s last Life Safety survey was June 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

Get an email about Good Samaritan - Saint Ansgar

One email when it happens. No account; stop it any time with one click.

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.

Physical environment (health survey)

1 physical-environment citation 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 10 Life Safety citations above. The Physical Environment Index

  • 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 facility10IA median12National median11
Citations on file over three years, compared
MeasureCitations
This facility10
Median facility in IA12
Median facility nationally11

Survey history

Citations at each Life Safety survey
32024-0742025-0432026-06
Citations at each Life Safety survey
Survey dateCitations
July 21, 20243
April 24, 20254
June 18, 20263

Most-cited tags

Most-cited tags at this facility
K-09182K-07612K-07531K-03451K-02231K-03631K-05111K-09231
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0918Have generator or other power source capable of supplying service within 10 seconds.22025-04-24
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.22026-06-18
K-0753Have restrictions on the use of highly flammable decorations.12025-04-24
K-0345Have approved installation, maintenance and testing program for fire alarm systems.12026-06-18
K-0223Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.12024-07-21
K-0363Install corridor and hallway doors that block smoke.12024-07-21
K-0511Have properly installed electrical wiring and gas equipment.12025-04-24
K-0923Have proper medical gas storage and administration areas.12026-06-18

What the citations cover

Citations by CMS category
  • Miscellaneous Deficiencies 3
  • Gas, Vacuum, and Electrical Systems Deficiencies 3
  • Smoke Deficiencies 2
  • Services Deficiencies 1
  • Other 1
Citations by CMS category
CategoryCitations
Miscellaneous Deficiencies3
Gas, Vacuum, and Electrical Systems Deficiencies3
Smoke Deficiencies2
Services Deficiencies1
Egress Deficiencies1

Every citation on file

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

June 18, 2026 — 3 citations

Citations issued on June 18, 2026
TagWhat the surveyor checksStatus
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (June 17, 2026)
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.Deficient, Provider has date of correction (June 17, 2026)
K-0923Have proper medical gas storage and administration areas.Deficient, Provider has date of correction (June 17, 2026)

April 24, 2025 — 4 citations

Citations issued on April 24, 2025
TagWhat the surveyor checksStatus
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (April 28, 2025)
K-0753Have restrictions on the use of highly flammable decorations.Deficient, Provider has date of correction (April 28, 2025)
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.Deficient, Provider has date of correction (April 24, 2025)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (April 22, 2025)

July 21, 2024 — 3 citations

Citations issued on July 21, 2024
TagWhat the surveyor checksStatus
K-0223Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.Deficient, Provider has date of correction (August 2, 2024)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (July 30, 2024)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (August 7, 2024)

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