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

GOOD SHEPHERD VILLAGE

SPRINGFIELD, OH · 81 certified beds · Last Life Safety survey May 1, 2025

CMS Certification Number 366236 · first certified April 2002

Ownership

Operated by AOM HEALTHCARE · For profit - Corporation

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

39
Citations on file
Rolling three-year window
4
Life Safety surveys
In the same window
9
Tags cited more than once
Across separate surveys
22
Inspection & testing records
Of the citations on file

Position within OH

39 citations — more than 95% of the 922 certified nursing homes in OH. Compared within OH 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 19 citations; the earlier surveys in the window averaged 6.7. With 4 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

The window opens December 2026 — about 3 months from now. This facility’s last Life Safety survey was May 2025. Facilities in OH are typically surveyed 20–32 months after the last one (median 26), measured over 889 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

6 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.

Emergency preparedness

2 of the 39 citations on file are Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index

Physical environment (health survey)

8 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 39 Life Safety citations above. The Physical Environment Index

  • F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  • 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.

How that compares

Citations on file over three years

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

This facility39OH median16National median11
Citations on file over three years, compared
MeasureCitations
This facility39
Median facility in OH16
Median facility nationally11

Survey history

Citations at each Life Safety survey
72020-01102022-1232024-01192025-05
Citations at each Life Safety survey
Survey dateCitations
January 23, 20207
December 19, 202210
January 10, 20243
May 1, 202519

Most-cited tags

Most-cited tags at this facility
K-03454K-03533K-09183K-05113K-02222K-03512K-07122K-05212
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0345Have approved installation, maintenance and testing program for fire alarm systems.42025-05-01
K-0353Inspect, test, and maintain automatic sprinkler systems.32025-05-01
K-0918Have generator or other power source capable of supplying service within 10 seconds.32025-05-01
K-0511Have properly installed electrical wiring and gas equipment.32025-05-01
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.22025-05-01
K-0351Install an approved automatic sprinkler system.22025-05-01
K-0712Have simulated fire drills held at unexpected times.22025-05-01
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.22022-12-19

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 17
  • Gas, Vacuum, and Electrical Systems Deficiencies 6
  • Egress Deficiencies 6
  • Services Deficiencies 5
  • Other 5
Citations by CMS category
CategoryCitations
Smoke Deficiencies17
Gas, Vacuum, and Electrical Systems Deficiencies6
Egress Deficiencies6
Services Deficiencies5
Miscellaneous Deficiencies3
Emergency Preparedness Deficiencies2

Every citation on file

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

May 1, 2025 — 19 citations

Citations issued on May 1, 2025
TagWhat the surveyor checksStatus
E-0037Establish staff and initial training requirements.Deficient, Provider has date of correction (July 2, 2025)
E-0039Conduct testing and exercise requirements.Deficient, Provider has date of correction (July 2, 2025)
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 (July 2, 2025)
K-0252Provide at least two remote exits on each floor or fire section of the building.Deficient, Provider has plan of correction (June 9, 2025)
K-0291Install emergency lighting that can last at least 1 1/2 hours.Deficient, Provider has date of correction (July 2, 2025)
K-0293Have properly located and lighted "Exit" signs.Deficient, Provider has date of correction (July 2, 2025)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (July 2, 2025)
K-0351Install an approved automatic sprinkler system.Deficient, Provider has date of correction (July 2, 2025)
K-0352Properly install and monitor supervisory attachments on automatic sprinkler systems.Deficient, Provider has date of correction (July 2, 2025)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (July 2, 2025)
K-0354Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.Deficient, Provider has date of correction (July 2, 2025)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (July 2, 2025)
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.Deficient, Provider has date of correction (July 2, 2025)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (July 2, 2025)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (July 2, 2025)
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.Deficient, Provider has date of correction (July 2, 2025)
K-0913Ensure operating rooms are properly protected and written records are maintained and available for inspection.Deficient, Provider has date of correction (July 2, 2025)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (July 2, 2025)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (July 2, 2025)

January 10, 2024 — 3 citations

Citations issued on January 10, 2024
TagWhat the surveyor checksStatus
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Waiver has been granted (April 30, 2024)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (February 16, 2024)
K-0354Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.Deficient, Provider has date of correction (February 16, 2024)

December 19, 2022 — 10 citations

Citations issued on December 19, 2022
TagWhat the surveyor checksStatus
K-0211Keep aisles, corridors, and exits free of obstruction in case of emergency.Deficient, Provider has date of correction (February 21, 2023)
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 21, 2023)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (February 21, 2023)
K-0341Install a fire alarm system that can be heard throughout the facility.Deficient, Provider has date of correction (February 21, 2023)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Waiver has been granted (February 21, 2023)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (February 21, 2023)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (February 21, 2023)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Deficient, Provider has date of correction (February 21, 2023)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (February 21, 2023)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (February 21, 2023)

January 23, 2020 — 7 citations

Citations issued on January 23, 2020
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 20, 2020)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (March 20, 2020)
K-0351Install an approved automatic sprinkler system.Deficient, Provider has date of correction (March 20, 2020)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (March 20, 2020)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Deficient, Provider has date of correction (March 20, 2020)
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 (March 20, 2020)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (March 20, 2020)

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