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

GOOD SAMARITAN - DECATUR COUNTY

OBERLIN, KS · 45 certified beds · Last Life Safety survey November 17, 2025

CMS Certification Number 175356 · first certified January 1996

Ownership

Operated by GOOD SAMARITAN SOCIETY · Non profit - Corporation

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

29
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
10
Tags cited more than once
Across separate surveys
17
Inspection & testing records
Of the citations on file

Position within KS

29 citations — more than 56% of the 296 certified nursing homes in KS. Compared within KS 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

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

The latest survey found 12 citations; the earlier surveys in the window averaged 8.5. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

The window opens July 2027 — about 9 months from now. This facility’s last Life Safety survey was November 2025. Facilities in KS are typically surveyed 20–22 months after the last one (median 21), measured over 298 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

7 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)

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 29 Life Safety citations above. The Physical Environment Index

  • 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 KS, and nationally. Surveyors differ markedly between states, so the KS figure is the meaningful one.

This facility29KS median27National median11
Citations on file over three years, compared
MeasureCitations
This facility29
Median facility in KS27
Median facility nationally11

Survey history

Citations at each Life Safety survey
42022-07132023-11122025-11
Citations at each Life Safety survey
Survey dateCitations
July 14, 20224
November 30, 202313
November 17, 202512

Most-cited tags

Most-cited tags at this facility
K-09203K-03633K-03532K-07532K-03212K-09182K-07122K-03452
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0920Ensure proper usage of power strips and extension cords.32025-11-17
K-0363Install corridor and hallway doors that block smoke.32025-11-17
K-0353Inspect, test, and maintain automatic sprinkler systems.22025-11-17
K-0753Have restrictions on the use of highly flammable decorations.22025-11-17
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.22025-11-17
K-0918Have generator or other power source capable of supplying service within 10 seconds.22023-11-30
K-0712Have simulated fire drills held at unexpected times.22025-11-17
K-0345Have approved installation, maintenance and testing program for fire alarm systems.22025-11-17

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 13
  • Gas, Vacuum, and Electrical Systems Deficiencies 7
  • Miscellaneous Deficiencies 4
  • Egress Deficiencies 3
  • Other 2
Citations by CMS category
CategoryCitations
Smoke Deficiencies13
Gas, Vacuum, and Electrical Systems Deficiencies7
Miscellaneous Deficiencies4
Egress Deficiencies3
Services Deficiencies2

Every citation on file

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

November 17, 2025 — 12 citations

Citations issued on November 17, 2025
TagWhat the surveyor checksStatus
K-0211Keep aisles, corridors, and exits free of obstruction in case of emergency.Deficient, Provider has date of correction (February 10, 2026)
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (February 10, 2026)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (February 10, 2026)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (February 10, 2026)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (February 10, 2026)
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.Deficient, Provider has date of correction (February 10, 2026)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (February 10, 2026)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (February 10, 2026)
K-0753Have restrictions on the use of highly flammable decorations.Deficient, Provider has date of correction (February 10, 2026)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (February 10, 2026)
K-0921Ensure that testing and maintenance of electrical equipment is performed.Deficient, Provider has date of correction (February 10, 2026)
K-0923Have proper medical gas storage and administration areas.Deficient, Provider has date of correction (February 10, 2026)

November 30, 2023 — 13 citations

Citations issued on November 30, 2023
TagWhat the surveyor checksStatus
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 (February 2, 2024)
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (February 2, 2024)
K-0325Have properly installed hallway dispensers for alcohol-based hand rub.Deficient, Provider has date of correction (February 2, 2024)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (February 2, 2024)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (February 2, 2024)
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.Deficient, Provider has date of correction (February 2, 2024)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (February 2, 2024)
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.Deficient, Provider has date of correction (February 2, 2024)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (February 2, 2024)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (February 2, 2024)
K-0753Have restrictions on the use of highly flammable decorations.Deficient, Provider has date of correction (February 2, 2024)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (February 2, 2024)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (February 2, 2024)

July 14, 2022 — 4 citations

Citations issued on July 14, 2022
TagWhat the surveyor checksStatus
K-0293Have properly located and lighted "Exit" signs.Deficient, Provider has date of correction (September 23, 2022)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (September 23, 2022)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (September 23, 2022)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (September 23, 2022)

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