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

GOOD SAMARITAN SOCIETY - SPECIALTY CARE COMMUNITY

ROBBINSDALE, MN · 96 certified beds · Last Life Safety survey June 4, 2026

CMS Certification Number 245279 · first certified April 1985

Ownership

Operated by GOOD SAMARITAN SOCIETY · Non profit - Corporation

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

17
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
4
Tags cited more than once
Across separate surveys
11
Inspection & testing records
Of the citations on file

Position within MN

17 citations — more than 72% 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

Improvingfewer 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 6. 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 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

3 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)

7 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 17 Life Safety citations above. The Physical Environment Index

  • F-0584 Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
  • 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 MN, and nationally. Surveyors differ markedly between states, so the MN figure is the meaningful one.

This facility17MN median12National median11
Citations on file over three years, compared
MeasureCitations
This facility17
Median facility in MN12
Median facility nationally11

Survey history

Citations at each Life Safety survey
72023-1252025-0252026-06
Citations at each Life Safety survey
Survey dateCitations
December 7, 20237
February 14, 20255
June 4, 20265

Most-cited tags

Most-cited tags at this facility
K-03243K-03212K-05212K-03532K-02911K-09181K-03621K-07121
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0324Provide properly protected cooking facilities.32026-06-04
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.22025-02-14
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.22025-02-14
K-0353Inspect, test, and maintain automatic sprinkler systems.22026-06-04
K-0291Install emergency lighting that can last at least 1 1/2 hours.12023-12-07
K-0918Have generator or other power source capable of supplying service within 10 seconds.12026-06-04
K-0362Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.12026-06-04
K-0712Have simulated fire drills held at unexpected times.12025-02-14

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 9
  • Gas, Vacuum, and Electrical Systems Deficiencies 3
  • Services Deficiencies 2
  • Egress Deficiencies 2
  • Other 1
Citations by CMS category
CategoryCitations
Smoke Deficiencies9
Gas, Vacuum, and Electrical Systems Deficiencies3
Services Deficiencies2
Egress Deficiencies2
Miscellaneous Deficiencies1

Every citation on file

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

June 4, 2026 — 5 citations

Citations issued on June 4, 2026
TagWhat the surveyor checksStatus
K-0293Have properly located and lighted "Exit" signs.Deficient, Provider has date of correction (July 13, 2026)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (July 13, 2026)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (July 13, 2026)
K-0362Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.Deficient, Provider has date of correction (July 13, 2026)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (July 13, 2026)

February 14, 2025 — 5 citations

Citations issued on February 14, 2025
TagWhat the surveyor checksStatus
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 (March 17, 2025)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (March 17, 2025)
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.Deficient, Provider has date of correction (March 17, 2025)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Deficient, Provider has date of correction (March 17, 2025)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (March 17, 2025)

December 7, 2023 — 7 citations

Citations issued on December 7, 2023
TagWhat the surveyor checksStatus
K-0291Install emergency lighting that can last at least 1 1/2 hours.Deficient, Provider has date of correction (January 15, 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 (January 15, 2024)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (January 15, 2024)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (January 15, 2024)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Deficient, Provider has date of correction (February 12, 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 (January 15, 2024)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (January 15, 2024)

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