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

GOOD SAMARITAN SOCIETY - MARY JANE BROWN

LUVERNE, MN · 51 certified beds · Last Life Safety survey April 1, 2026

CMS Certification Number 245568 · first certified July 1991

Ownership

Operated by GOOD SAMARITAN SOCIETY · Non profit - Corporation

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

9
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
0
Tags cited more than once
Across separate surveys
5
Inspection & testing records
Of the citations on file

Position within MN

9 citations — more than 31% of the 338 certified nursing homes in MN. Compared within MN 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 5 citations; the earlier surveys in the window averaged 2. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

The window opens March 2027 — about 5 months from now. This facility’s last Life Safety survey was April 2026. Facilities in MN are typically surveyed 11–14 months after the last one (median 13), measured over 613 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

Physical environment (health survey)

5 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 9 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.
  • F-0908 Keep all essential equipment working safely.

How that compares

Citations on file over three years

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

This facility9MN median12National median11
Citations on file over three years, compared
MeasureCitations
This facility9
Median facility in MN12
Median facility nationally11

Survey history

Citations at each Life Safety survey
02023-1042025-0152026-04
Citations at each Life Safety survey
Survey dateCitations
October 18, 20230
January 14, 20254
April 1, 20265

Most-cited tags

Most-cited tags at this facility
K-09211K-03531K-07121K-03631K-09231K-03461K-03241K-02221
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0921Ensure that testing and maintenance of electrical equipment is performed.12026-04-01
K-0353Inspect, test, and maintain automatic sprinkler systems.12025-01-14
K-0712Have simulated fire drills held at unexpected times.12025-01-14
K-0363Install corridor and hallway doors that block smoke.12025-01-14
K-0923Have proper medical gas storage and administration areas.12025-01-14
K-0346Follow proper procedures when the fire alarm was out of service for more than 4 hours.12026-04-01
K-0324Provide properly protected cooking facilities.12026-04-01
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.12026-04-01

What the citations cover

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

Every citation on file

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

April 1, 2026 — 5 citations

Citations issued on April 1, 2026
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 (May 22, 2026)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (May 22, 2026)
K-0346Follow proper procedures when the fire alarm was out of service for more than 4 hours.Deficient, Provider has date of correction (May 22, 2026)
K-0354Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.Deficient, Provider has date of correction (May 22, 2026)
K-0921Ensure that testing and maintenance of electrical equipment is performed.Deficient, Provider has date of correction (May 22, 2026)

January 14, 2025 — 4 citations

Citations issued on January 14, 2025
TagWhat the surveyor checksStatus
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (February 14, 2025)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (February 14, 2025)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (February 14, 2025)
K-0923Have proper medical gas storage and administration areas.Deficient, Provider has date of correction (February 14, 2025)

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