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

Good Samaritan Society - Lakota

LAKOTA, ND · 38 certified beds · Last Life Safety survey June 3, 2025

CMS Certification Number 355104 · first certified April 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.

11
Citations on file
Rolling three-year window
4
Life Safety surveys
In the same window
2
Tags cited more than once
Across separate surveys
9
Inspection & testing records
Of the citations on file

Position within ND

11 citations — more than 92% of the 72 certified nursing homes in ND. Compared within ND 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 2.7. With 4 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

Well past the typical window (June 2026 to August 2026), and past the point by which nine in ten ND facilities have been surveyed. This facility’s last Life Safety survey was June 2025. Facilities in ND are typically surveyed 12–14 months after the last one (median 13), measured over 116 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

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)

4 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 11 Life Safety citations above. The Physical Environment Index

  • F-0880 Provide and implement an infection prevention and control program.
  • F-0921 Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
  • 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 ND, and nationally. Surveyors differ markedly between states, so the ND figure is the meaningful one.

This facility11ND median2National median11
Citations on file over three years, compared
MeasureCitations
This facility11
Median facility in ND2
Median facility nationally11

Survey history

Citations at each Life Safety survey
22023-0512023-1052024-0632025-06
Citations at each Life Safety survey
Survey dateCitations
May 25, 20232
October 11, 20231
June 19, 20245
June 3, 20253

Most-cited tags

Most-cited tags at this facility
K-03242K-03452K-02911K-05111K-07121K-07411K-09181K-03531
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0324Provide properly protected cooking facilities.22024-06-19
K-0345Have approved installation, maintenance and testing program for fire alarm systems.22025-06-03
K-0291Install emergency lighting that can last at least 1 1/2 hours.12024-06-19
K-0511Have properly installed electrical wiring and gas equipment.12024-06-19
K-0712Have simulated fire drills held at unexpected times.12023-05-25
K-0741Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.12023-10-11
K-0918Have generator or other power source capable of supplying service within 10 seconds.12024-06-19
K-0353Inspect, test, and maintain automatic sprinkler systems.12025-06-03

What the citations cover

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

Every citation on file

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

June 3, 2025 — 3 citations

Citations issued on June 3, 2025
TagWhat the surveyor checksStatus
K-0211Keep aisles, corridors, and exits free of obstruction in case of emergency.Deficient, Provider has date of correction (July 15, 2025)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (July 15, 2025)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (July 15, 2025)

June 19, 2024 — 5 citations

Citations issued on June 19, 2024
TagWhat the surveyor checksStatus
K-0291Install emergency lighting that can last at least 1 1/2 hours.Deficient, Provider has date of correction (August 9, 2024)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (August 9, 2024)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Waiver has been granted (August 30, 2024)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (August 9, 2024)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (August 9, 2024)

October 11, 2023 — 1 citation

Citations issued on October 11, 2023
TagWhat the surveyor checksStatus
K-0741Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.Deficient, Provider has date of correction (November 28, 2023)

May 25, 2023 — 2 citations

Citations issued on May 25, 2023
TagWhat the surveyor checksStatus
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (July 8, 2023)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (July 8, 2023)

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