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HomeKansasGood Samaritan Society - Ellsworth Village

Good Samaritan Society - Ellsworth Village

1156 Highway 14, Ellsworth, KS 674397854723167
3/5Average
Accepts Medicare Accepts Medicaid Sprinkler System
Health
3/5
Staffing
3/5
Quality
2/5
Beds
43
certified
2 fine(s) totaling $16,838

Key Findings

• CMS rates this facility 3/5 stars (average)

• Has 43 certified beds with an average of 38.6 residents per day (90% occupancy)

• Last health inspection found 10 deficiencies (inspected Jul 2, 2024)

• Has been fined a total of $16,838 across 2 fine(s)

• Total nursing staff: 3.41 hours per resident per day

• Staff turnover rate: 48.9%

• Part of the Good Samaritan Society chain (90 facilities)

Good Samaritan Society - Ellsworth Village is a 3-star Medicare and Medicaid certified nursing home in Ellsworth, Kansas with 43 certified beds. It has been operating since 1992. The facility scored at average compared to Kansas facilities.

Beds
43
Avg Residents/Day
38.6
Ownership
Non profit - Corporation
Provider Type
Medicare and Medicaid
In Hospital
No
First Approved
Nov 1, 1992
Sprinklers
Yes
Council
Resident
County
Ellsworth
Last Inspection
Jul 2, 2024
Deficiencies (Cycle 1)
10
Weighted Score
68.0
Infection Citations
0

Deficiency Citations (24)

F0657Potential for Harm

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Survey: Jul 2, 2024Corrected: NoCycle: 1
F0684Potential for Harm

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Survey: Jul 2, 2024Corrected: NoCycle: 1
F0690Potential for Harm

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

Survey: Jul 2, 2024Corrected: NoCycle: 1
F0699Potential for Harm

Provide care or services that was trauma informed and/or culturally competent.

Survey: Jul 2, 2024Corrected: NoCycle: 1
F0756Potential for Harm

Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

Survey: Jul 2, 2024Corrected: NoCycle: 1
F0758Potential for Harm

Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.

Survey: Jul 2, 2024Corrected: NoCycle: 1
F0812Potential for Harm

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Survey: Jul 2, 2024Corrected: NoCycle: 1
F0868Potential for Harm

Have the Quality Assessment and Assurance group have the required members and meet at least quarterly

Survey: Jul 2, 2024Corrected: NoCycle: 1
F0880Potential for Harm

Provide and implement an infection prevention and control program.

Survey: Jul 2, 2024Corrected: NoCycle: 1
F0881Potential for Harm

Implement a program that monitors antibiotic use.

Survey: Jul 2, 2024Corrected: NoCycle: 1
F0600Potential for Harm

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Survey: Mar 7, 2023Corrected: NoCycle: 2
F0657Potential for Harm

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Survey: Mar 7, 2023Corrected: NoCycle: 2
F0684Potential for Harm

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Survey: Mar 7, 2023Corrected: NoCycle: 2
F0689Potential for Harm

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

Survey: Mar 7, 2023Corrected: NoCycle: 2
F0690Potential for Harm

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

Survey: Mar 7, 2023Corrected: NoCycle: 2
F0880Potential for Harm

Provide and implement an infection prevention and control program.

Survey: Mar 7, 2023Corrected: NoCycle: 2
F0684Actual Harm

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Survey: Aug 1, 2023Corrected: NoCycle: 3
F0689Actual Harm

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

Survey: May 23, 2023Corrected: NoCycle: 3
F0584Potential for Harm

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.

Survey: Sep 27, 2021Corrected: NoCycle: 3
F0732Minimal Harm

Post nurse staffing information every day.

Survey: Sep 27, 2021Corrected: NoCycle: 3
F0756Potential for Harm

Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

Survey: Sep 27, 2021Corrected: NoCycle: 3
F0758Potential for Harm

Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.

Survey: Sep 27, 2021Corrected: NoCycle: 3
F0761Potential for Harm

Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.

Survey: Sep 27, 2021Corrected: NoCycle: 3
F0812Potential for Harm

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Survey: Sep 27, 2021Corrected: NoCycle: 3
Total Fines
$16,838
Number of Fines
2
Payment Denials
0
Total Penalties
2

Penalty History

FineAug 1, 2023
$8,190
FineMay 23, 2023
$8,648

Staffing hours per resident per day. The black line shows the national average.

Nurse Aide2.26 hrs
National avg: 2.35 hrs
LPN0.53 hrs
National avg: 0.86 hrs
RN0.61 hrs
National avg: 0.68 hrs
Total Nursing3.41 hrs
National avg: 3.89 hrs
Weekend Total2.86 hrs
National avg: 0.00 hrs
Physical Therapist0.00 hrs
National avg: 0.07 hrs
Total Turnover
48.9%
RN Turnover
50.0%
Administrators Left
1

Quality measures as percentages of residents. Lower is better for all measures.

Ownership Type
Non profit - Corporation
Recent Change
No

Owners & Managers (25)

NameRoleTypeOwnership %Since
SANFORD5% OR GREATER DIRECT OWNERSHIP INTERESTOrganization100%Jan 1, 2019
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY5% OR GREATER INDIRECT OWNERSHIP INTERESTOrganization100%Jan 1, 2019
MART, AMBEROPERATIONAL/MANAGERIAL CONTROLIndividualN/AJan 26, 2025
MORRISON, TONYOPERATIONAL/MANAGERIAL CONTROLIndividualN/AJan 1, 2019
SLOMKA, JERZYOPERATIONAL/MANAGERIAL CONTROLIndividualN/AMar 1, 2022
BROWN, GEORGECORPORATE DIRECTORIndividualN/AJan 1, 2025
DYKHOUSE, DANACORPORATE DIRECTORIndividualN/AMay 30, 2024
ENGBRECHT, WESLEYCORPORATE DIRECTORIndividualN/AMay 30, 2024
GASSEN, WILLIAMCORPORATE DIRECTORIndividualN/AMay 30, 2024
GULSVIG, NEILCORPORATE DIRECTORIndividualN/AMay 30, 2024
HERSETH SANDLIN, STEPHANIECORPORATE DIRECTORIndividualN/AMay 30, 2024
LUNDEEN, MARKCORPORATE DIRECTORIndividualN/AMay 30, 2024
MCCAUSLAND, MAUREENCORPORATE DIRECTORIndividualN/AJan 1, 2025
MOLBERT, LAURISCORPORATE DIRECTORIndividualN/AMay 30, 2024
NORTH, ANDREWCORPORATE DIRECTORIndividualN/AMay 30, 2024
SCHIEFFER, KEVINCORPORATE DIRECTORIndividualN/AJan 1, 2025
SHULKIN, DAVIDCORPORATE DIRECTORIndividualN/AMay 30, 2024
TEIKEN, BRENTCORPORATE DIRECTORIndividualN/AMay 30, 2024
VENTLING-HERRMANN, MARNIECORPORATE DIRECTORIndividualN/AMay 30, 2024
WENZEL, THOMASCORPORATE DIRECTORIndividualN/AJan 1, 2025
FLUIT, JOELCORPORATE OFFICERIndividualN/AOct 1, 2022
GASSEN, WILLIAMCORPORATE OFFICERIndividualN/AMay 30, 2024
MIDDLETON, AIMEECORPORATE OFFICERIndividualN/AJan 27, 2022
OLSON, NICHOLASCORPORATE OFFICERIndividualN/AApr 8, 2024
SCHEMA, NATHANCORPORATE OFFICERIndividualN/AJan 1, 2022

Frequently Asked Questions

What is the CMS rating for Good Samaritan Society - Ellsworth Village?▾
Good Samaritan Society - Ellsworth Village has an overall CMS rating of 3 out of 5 stars, with a health inspection rating of 3/5, staffing rating of 3/5, and quality measures rating of 2/5. This facility is rated average.
Has Good Samaritan Society - Ellsworth Village had any health inspection violations?▾
Good Samaritan Society - Ellsworth Village had 10 deficiency citations in its most recent health inspection (Jul 2, 2024). The facility has been fined a total of $16,838 across 2 fine(s).
What are the staffing levels at Good Samaritan Society - Ellsworth Village?▾
Good Samaritan Society - Ellsworth Village provides 3.41 total nursing staff hours per resident per day, including 0.61 RN hours, 0.53 LPN hours, and 2.26 nurse aide hours. The total staff turnover rate is 48.9%.
How many beds does Good Samaritan Society - Ellsworth Village have?▾
Good Samaritan Society - Ellsworth Village has 43 certified beds with an average of 38.6 residents per day, resulting in approximately 90% occupancy. The facility is Non profit - Corporation owned and is part of the Good Samaritan Society chain.

Part of Good Samaritan Society

This chain operates 90 facilities. View all →