Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record
GOOD SAMARITAN SOCIETY - MOUNTAIN LAKE
MOUNTAIN LAKE, MN · 48 certified beds · Last Life Safety survey August 12, 2026
CMS Certification Number 245549 · first certified February 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.
Position within MN
6 citations — more than 12% of the 337 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
The latest survey found 4 citations; the earlier surveys on file averaged 1. 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 8 months from now. This facility’s last Life Safety survey was August 2026. Facilities in MN are typically surveyed 11–14 months after the last one (median 13), measured over 641 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 about three years in Virginia. How the window is measured
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1 inspection-and-testing tag has 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 cited for sprinkler inspection and testing in CMS’s current file are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.
Physical environment (health survey)
2 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 6 Life Safety citations above. The Physical Environment Index
How that compares
Compared with the median facility in MN, and nationally. Surveyors differ markedly between states, so the MN figure is the meaningful one.
| Measure | Citations |
|---|---|
| This facility | 6 |
| Median facility in MN | 12 |
| Median facility nationally | 11 |
Survey history
| Survey date | Citations |
|---|---|
| June 26, 2024 | 0 |
| July 3, 2025 | 2 |
| August 12, 2026 | 4 |
Most-cited tags
| Tag | What the surveyor checks | Times cited | Last cited |
|---|---|---|---|
| K-0324 | Provide properly protected cooking facilities. | 2 | 2026-08-12 |
| K-0761 | To conduct inspection, testing and maintenance of fire doors by qualified individuals. | 1 | 2026-08-12 |
| K-0511 | Have properly installed electrical wiring and gas equipment. | 1 | 2026-08-12 |
| K-0363 | Install corridor and hallway doors that block smoke. | 1 | 2025-07-03 |
| K-0353 | Inspect, test, and maintain automatic sprinkler systems. | 1 | 2026-08-12 |
What the citations cover
- Smoke Deficiencies 4
- Miscellaneous Deficiencies 1
- Services Deficiencies 1
| Category | Citations |
|---|---|
| Smoke Deficiencies | 4 |
| Miscellaneous Deficiencies | 1 |
| Services Deficiencies | 1 |
Every citation on file
As published by CMS, newest survey first. Descriptions are CMS’s own wording.
August 12, 2026 — 4 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| K-0324 | Provide properly protected cooking facilities. | Deficient, Provider has plan of correction (September 28, 2026) |
| K-0353 | Inspect, test, and maintain automatic sprinkler systems. | Deficient, Provider has plan of correction (September 28, 2026) |
| K-0511 | Have properly installed electrical wiring and gas equipment. | Deficient, Provider has plan of correction (September 28, 2026) |
| K-0761 | To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Deficient, Provider has plan of correction (September 28, 2026) |
July 3, 2025 — 2 citations
Reflects the CMS posting of October 1, 2026. Surveys conducted in the last few months may not appear yet.