Good Samaritan Ambassador

8100 Medicine Lake Road, New Hope, Minnesota 55427

77 certified beds · ≈ 75 residents/day · Non profit - Corporation · Last survey April 2026 · Provider #245149

CMS FIVE-STAR RATINGS
5/ 5 overall

Above average — CMS composite of the measures below.

Health inspections 5/5
Staffing 5/5
Quality measures 3/5
Part of a 91-facility chain · chain average rating 3★
COMPLIANCE AT A GLANCE
Citations, last 12 months
2
76% below the Minnesota average of 8.2
Serious citations (J–L)
0
no immediate jeopardy–level findings
Fines on record
None
civil monetary penalties
On cycle

The next survey window likely opens around March 2027

4 of ~15 typical months since the last standard survey (April 2026)
Apr 2026 · on cycle Window opens Mar 2027 → ~Jul 2027

Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.

Citation history

Health deficiencies cited at Good Samaritan Ambassador during CMS and state inspections, most recent first.

2 in the last 12 months14 all-time 19 inspections on file
Failure to Provide SNFABN to Resident
D
F0582 F582: Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Short Summary

A facility failed to provide the SNFABN-CMS-10055 to a resident who had Medicare coverage days remaining. The resident, who was cognitively intact, received a Notice of Medicare Non-Coverage indicating services would end, but there was no evidence of the SNFABN being provided. The Medicare case manager confirmed the oversight was due to confusion over responsibility for completing the form, despite facility policy requiring the notice before providing potentially non-covered services.

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Failure to Use Proper PPE for Resident on Droplet Precautions
D
F0880 F880: Provide and implement an infection prevention and control program.
Short Summary

A resident with severe cognitive impairment tested positive for COVID-19, requiring droplet precautions. Staff entered the resident's room without eye protection, despite being aware of PPE requirements and the presence of a precaution sign. The infection preventionist and DON confirmed staff training on PPE use, but eye protection was unavailable in the precautions cart.

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
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What surveyors are citing around you — mapped

In the Assessment

All 10 risk areas, ranked with evidence

Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.

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Risk areas — ranked
1F689Accident hazards & supervision82
2F880Infection prevention & control74
3F812Food safety & sanitation61
4F656Comprehensive care plans49

Illustrative

In the Assessment

What surveyors actually found near you

We read the 1,055 citations issued within 25 miles in the last 12 months — including the 33 immediate-jeopardy cases — and tell you exactly what happened, in plain English, matched to your record.

assistocare.com/survey-prep
Findings near you
Gulf Coast Village · 1.6 mi F689J

Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.

Cypress Cove · 4.2 mi F812D

Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.

Illustrative

In the Assessment

A prioritized, do-first checklist

Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.

assistocare.com/survey-prep
Self-audit checklist — do-first orderPer risk area
Walk supervision coverage on the memory-care unit at shift changeDo first
Audit fall-risk care plans for residents flagged high-riskF689
Verify kitchen temperature logs for the last 30 daysF812

Illustrative

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Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.

Nursing homes near New Hope

How nearby facilities compare on the same public inspection record.

Facility Distance Overall rating Citations, 12 mo Serious (J–L)
The Villas At Brookview 1.6 mi ★★★★ 26 1
Covenant Living Of Golden Valley Care & Rehab Ctr 1.6 mi ★★★★★ 2 0
The Terrace At Crystal Llc 1.9 mi 65 4
Mission Nursing Home 1.9 mi ★★★★ 11 0
The Villas At Robbinsdale 2.6 mi ★★★★ 5 1
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.

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