Below average — CMS composite of the measures below.
A standard survey is most likely before around November 2026
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 Society - Blackduck during CMS and state inspections, most recent first.
A resident with multiple medical conditions and at moderate risk for pressure sores had inconsistent wound documentation, including varying descriptions and stages of pressure ulcers. An RN coded the MDS based on incomplete and conflicting nursing data, resulting in inaccurate staging of the resident's pressure ulcers.
A resident admitted with a pressure ulcer and at moderate risk for further skin breakdown did not have a baseline care plan developed to address pressure ulcer management. Multiple wounds were documented, but the care plan lacked specific interventions and instructions for pressure-relieving devices and wound care. The DON confirmed that required steps to link assessments to the care plan were not completed, resulting in incomplete care planning.
Two residents at risk for pressure ulcers did not receive ongoing and accurate wound assessments, with incomplete documentation and inconsistent implementation of interventions. One resident with multiple wounds and incontinence was frequently found uncleaned, while another high-risk resident had gaps in wound assessments and lacked regular skin checks. Facility policy requiring weekly evaluations and clear staff direction was not followed.
Psychotropic Medication Monitoring and GDR Documentation Deficiencies: A resident with dementia was prescribed trazodone for sleep, but the record did not show a sleep assessment before or after the medication was started, and staff documented that the resident was sleeping a lot and often appeared tired or asleep during observations. For two residents on psychotropic medications, the record also lacked evidence of a GDR or clear clinical justification for continuing the medications at the lowest effective dose, despite pharmacist review and provider notes that did not document a thorough risk/benefit assessment.
Failure to reposition a high-risk resident was identified when staff did not provide timely turning and repositioning for a resident with dementia, renal insufficiency, anemia, and dependence for bed mobility and transfers. The resident’s Braden Scale showed high risk for pressure injury, and the care plan directed frequent repositioning, but staff raised the HOB for breakfast and left the resident in the same position for an extended period while breakfast was delivered and eaten. Interviews showed staff and leadership acknowledged the resident should have been repositioned after breakfast.
Failure to assess and analyze a resident fall with major injury: A resident fell from a wheelchair after becoming tangled in a computer table, and the wheelchair landed on top of him. The record later showed a hip fracture and hospital transfer after hip nailing, but the event note, falls tool, and IDT documentation did not describe the cause of the fall or include a comprehensive post-fall assessment with causal factors or root cause analysis. The care plan listed general fall interventions, and the DON stated the fall was probably not documented in the EMR.
A resident with severe cognitive impairment, bladder dysfunction, reflux uropathy, diabetes, dementia, and MRSA had an indwelling urinary catheter without a clear current physician order after hospitalization. Staff later replaced the catheter without documenting that a provider was contacted for direction, and during care an NA left the catheter bag on the floor, handled a graduate, and then provided denture care without changing gloves. RN-A, the DON, and the facility policy all stated the catheter bag should not touch the floor and soiled gloves should be removed before oral care.
Pharmacist recommendations were not addressed or documented for two residents receiving psychotropic meds. One resident with dementia was on trazodone for behavioral symptoms, but the chart did not show provider contact or a response to the pharmacist’s GDR recommendation. Another resident with OCD, dementia, anxiety, depression, and psychotic disorder was receiving olanzapine and sertraline, but the record lacked evidence of a GDR attempt, a documented contraindication, or a thorough risk/benefit assessment in the most recent psychiatry note.
The facility failed to maintain sanitary conditions in the kitchen's dry storage, affecting all 29 residents. During a tour, a dented can and improperly managed plastic bins with opened bags of food were found. The food service manager acknowledged the lack of proper dating and closure of bags and noted the absence of formal direction for maintaining the dry storage area.
The facility failed to conduct ongoing quality assessment and assurance activities, impacting all 29 residents. It did not track infectious symptoms or implement timely precautions for COVID-19 and human metapneumovirus. The infection preventionist did not maintain the infection control program, and the administrator acknowledged a lack of training for the responsible RN. The QAPI plan lacked a continuous infection prevention program.
The facility failed to track and manage infectious symptoms, leading to inadequate implementation of transmission-based precautions and testing for respiratory illnesses. Several residents with symptoms of COVID-19 and HMPV were not properly isolated or tested, and staff interviews revealed confusion and inconsistency in following infection prevention protocols.
The facility failed to ensure a qualified infection preventionist was in place, affecting all residents, staff, and visitors. The Director of Nursing was on extended leave, and responsibilities were delegated to an RN without adequate training. This led to failures in tracking infectious symptoms and implementing precautions for residents with COVID-19 and HMPV. The administrator assumed tasks were completed based on dashboard presentations, but there was no plan to ensure proper training and support.
A facility failed to notify the Office of Ombudsman for LTC about a resident's hospital transfers. The resident, who had no cognitive impairment, was transferred to the hospital twice and returned without the required notification. The business office coordinator was unaware of the notification requirement, and the director of nursing confirmed the oversight. The facility's policy mandated such notifications.
A resident was hospitalized, and the facility failed to provide a written bed hold policy notice to the resident or their representative. The resident's family was informed of the hospitalization, but there was no documentation of the bed hold policy being communicated. Staff interviews confirmed the lack of verification and documentation, despite the facility's policy requiring such notice at the time of transfer.
Inaccurate MDS Coding for Pressure Ulcer Staging
Penalty
Summary
The facility failed to ensure that the Minimum Data Set (MDS) was accurately coded to reflect the correct staging of pressure ulcers for a resident. The resident, who was admitted with diagnoses including dehydration, Parkinson's disease, anxiety, and weakness, was assessed as being at moderate risk for pressure sores according to the Braden Scale. Multiple wound assessments documented varying descriptions and stages of pressure ulcers, including an unstageable ulcer on the left buttock, a wound on the left iliac crest with tunneling and purulent drainage, and a stage I ulcer on the left buttock. There were inconsistencies in the wound documentation, such as incomplete wound characteristics and discrepancies in wound staging and descriptions across different assessments. During an interview, an RN responsible for coding the MDS stated that she relied on the nursing data collection, which indicated an unstageable pressure ulcer on admission, leading her to code it as such. The RN also acknowledged issues with the facility's wound charting. These actions and documentation inconsistencies resulted in the MDS not accurately reflecting the resident's pressure ulcer status, constituting a deficiency in the facility's assessment process.
Failure to Develop Baseline Care Plan for Pressure Ulcers
Penalty
Summary
The facility failed to develop a baseline care plan related to pressure ulcers for one resident who was admitted with an existing pressure ulcer and subsequently developed additional pressure ulcers. Upon admission, the resident had diagnoses including dehydration, Parkinson's disease, anxiety, and weakness, and was assessed as being at moderate risk for pressure sores according to the Braden Scale. Multiple wound assessments documented the presence of an unstageable decubitus ulcer on the left buttock, a wound on the left iliac crest with purulent drainage and tunneling, and later, a stage I pressure ulcer on the left buttock and a wound on the coccyx. The care plan identified a self-care deficit and potential impairment to skin integrity, but lacked specific instructions regarding pressure-relieving devices, their frequency of use, and did not specify interventions for all identified wounds. Interviews and document reviews revealed that the baseline care plan was not properly developed or implemented. The DON acknowledged that the initial care plan was created with assessments, but indicated that nurses did not complete the necessary steps to link interventions to the care plan. The facility's policy required individualized, person-centered care plans to address identified problems and needs, but this was not followed in the resident's case, resulting in incomplete documentation and lack of clear, actionable interventions for pressure ulcer management.
Failure to Perform Ongoing and Accurate Pressure Ulcer Assessment and Prevention
Penalty
Summary
The facility failed to perform ongoing and accurate assessment of pressure ulcers for two residents who were at risk for pressure ulcer development. For one resident with diagnoses including dehydration, Parkinson's disease, anxiety, and weakness, the Braden Scale indicated a moderate risk for pressure ulcers. Upon admission, this resident had multiple wounds, including a dehisced scar, an unstageable ulcer on the left buttock, and a scratch on the arm. Wound assessments documented changes in wound status, including the development of new pressure ulcers and worsening of existing wounds, but lacked consistent and complete documentation of wound characteristics, frequency of assessments, and specific interventions. The care plan and Kardex lacked clear directions for staff regarding mobility, transfers, repositioning, and toileting frequency, despite the resident's incontinence and need for assistance. Progress notes and interviews revealed that the resident was often found incontinent and not cleaned up, with reports of frequent exposure to feces and the development of additional sores during the facility stay. Another resident with diagnoses of dementia, heart disease, pain, and a history of falls was also identified as high risk for pressure ulcers based on the Braden Scale. The care plan directed staff to check for incontinence every two to three hours and to assist with frequent repositioning, but wound assessments were not consistently completed. There was a lack of documented wound assessments for a period of over three weeks, despite the presence of a pressure ulcer on the sacrum and an open area on the coccyx. Staff interviews confirmed that wound charting was inconsistent, and the facility did not have a process for regular wound rounds. The DON acknowledged that skin checks were supposed to be completed weekly but were not being done for this resident. Facility policy required that pressure ulcers be evaluated at least weekly, with RNs responsible for recording wound type and degree of tissue damage, and licensed nurses documenting location, measurements, and characteristics. However, the facility failed to adhere to these requirements, resulting in incomplete and infrequent wound assessments, lack of clear staff direction, and insufficient implementation of interventions to reduce the risk of new or worsening pressure ulcers for residents at risk.
Psychotropic Medication Monitoring and GDR Documentation Deficiencies
Penalty
Summary
The facility failed to ensure there was a comprehensive assessment and monitoring for prescribing trazodone for sleep for one resident with moderate cognitive impairment and dementia. The resident’s quarterly MDS identified dementia and daily antidepressant use, and the order summary showed trazodone 25 mg at bedtime was started for unspecified dementia with moderate behavioral disturbance. The medication record did not show that the resident’s sleep was assessed before trazodone was started or that sleep was monitored afterward to determine whether the medication was effective. The resident’s record also showed ongoing daytime sleepiness and limited documentation connecting the trazodone to a monitored clinical need. Nursing notes described the resident as sleeping a lot more lately and later as sleeping during the day, with staff noting the resident was tired all the time. During observations, the resident was repeatedly found asleep in bed or reclined in a wheelchair and did not respond when greeted. Staff interviews indicated the resident slept a lot, and one RN stated trazodone would make the resident even more tired. The record did not show that the resident’s sleep had been assessed beyond an old sleep assessment dated 4/4/16. The facility also failed to provide evidence of a gradual dose reduction or a clinical justification for continued psychotropic medication use for two residents. One resident had olanzapine twice daily and sertraline daily for psychiatric diagnoses, but the record lacked evidence of a GDR attempt or documentation that the resident was on the lowest effective dose within the past calendar year. The provider note referenced failed previous medication tapers but did not identify which medications were tapered or when. The consultant pharmacist noted that psychotropic medications should be considered for dose reduction and that recent provider notes did not contain a thorough risk/benefit assessment, but the record did not show a physician response. Facility policy required ongoing monitoring of psychotropic medications, documentation of effectiveness and side effects, and documentation of the rationale for continuing them.
Failure to Reposition a High-Risk Resident
Penalty
Summary
Provide appropriate pressure ulcer care and prevent new ulcers from developing was not met when the facility failed to provide timely assistance with repositioning for a resident who was at high risk for pressure injury. The resident had moderate cognitive impairment, dementia, renal insufficiency, and anemia, and was dependent on staff for transfers and required substantial to maximal assistance for bed mobility. The resident’s Braden Scale identified high risk for pressure injury, and the care plan directed staff to check and reposition the resident frequently during the day and at night, with side-to-side turning requiring substantial/maximal assistance from one staff member. During observation, the resident was found lying in bed with the head of bed elevated and breakfast activity occurring in the room. Nursing staff entered the room, raised the head of bed, and left without offering or completing repositioning. The resident remained in the same position while breakfast was delivered and eaten, and staff again entered the room without repositioning the resident. The resident continued in the same position until later in the morning when a nurse assistant removed the tray, provided incontinence care, and transferred the resident to a wheelchair with a full body mechanical lift. Staff interviews reflected differing expectations about repositioning intervals, while the RN, DON, and administrator acknowledged that the resident should have been offered repositioning after breakfast and that staff were expected to follow policy and procedure.
Failure to assess and analyze a resident fall with major injury
Penalty
Summary
The facility failed to assess and analyze a resident fall with major injury to identify specific hazards or risks and to develop targeted interventions to reduce the potential for further falls for one resident. On 8/8/25, R27 was observed propelling himself with his feet in the hallway, became tangled in a computer table, and fell out of his wheelchair, which then fell on top of him. The resident event form noted no immediate intervention and stated it was unknown whether there was an injury. A later progress note identified that R27 had sustained a hip fracture and was in the hospital after hip nailing, but the note did not describe the fall or its cause. The falls tool report completed after the incident identified R27 as being at risk for falls due to the actual fall, multiple at-risk medications, moderately impaired cognition, reduced insight, delirium, poor memory, and impulsivity, but it did not identify a description or cause of the fall. The care plan identified that R27 required staff assistance for transfers and did not ambulate, and listed interventions such as reminding the resident not to bend over, using the call light, and keeping personal items within reach. The medical record did not contain a comprehensive post-fall assessment with causal factors or root cause analysis, and the DON stated the fall was probably not documented in the medical record. The facility policy required a fall scene huddle worksheet, investigation, care plan update, and documentation in Riskonnect after a major injury fall.
Urinary Catheter Order and Hygiene Failures
Penalty
Summary
The facility failed to ensure there was a physician order for R4’s indwelling urinary catheter and failed to provide catheter care in a manner that prevented contamination. R4’s quarterly MDS identified severe cognitive impairment and diagnoses including hematuria, neuromuscular bladder dysfunction, reflux uropathy, type 2 diabetes, dementia, and MRSA. R4 used an indwelling urinary catheter, and the care plan directed staff to monitor for pain or discomfort and signs or symptoms of UTI. The interagency handoff report after hospitalization identified that R4’s catheter had been replaced in the hospital, but it did not identify an order for continued catheter use. R4’s order summary later listed a 20 FR coude catheter with a 30 ml balloon, while the prior order for catheter changes every 14 days and as needed for obstruction was discontinued on 7/8/25. Nursing documentation noted a follow-up urology appointment and later documented that R4’s indwelling Foley catheter was replaced because the prior catheter had a blood clot blocking urine flow and the catheter bag was falling apart, but the note did not identify that a provider was contacted for an order before replacement. RN-A stated R4 did not have a current catheter order and that an order should have been obtained before changing the catheter. The DON stated staff should have ensured there was an order before changing the catheter and that the admitting nurse should have contacted the provider for direction. During observation, NA-D assisted R4 with evening care and left the urinary catheter bag hanging on the bedframe and then resting on the floor. The catheter bag port was not fastened to the holder, and the bag remained on the floor while NA-D emptied it. NA-D also handled a graduate used to drain the catheter, then assisted R4 with denture care without changing gloves after touching the graduate. NA-D stated the catheter bag should not lie on the floor because the floor was dirty and could lead to infection. RN-A, the DON, and the facility policy all stated catheter tubing should never touch the floor and that staff should remove soiled gloves and wash hands before oral care.
Pharmacist Recommendations Not Addressed for Psychotropic Medications
Penalty
Summary
The facility failed to ensure that consulting pharmacist recommendations were addressed, acted upon, and documented in the medical record for 2 of 5 residents reviewed for unnecessary medications. For one resident with moderate cognitive impairment and dementia, the quarterly MDS identified daily antidepressant use, and the order summary showed trazodone 25 mg at bedtime for unspecified dementia with behavioral disturbance. The consultant pharmacist’s medication review noted that psychotropic medications should be considered for gradual dose reduction at least twice in the first year of use and stated that recent provider progress notes did not show a thorough risk/benefit assessment, but the review form did not identify any response from the physician. The resident’s medical record did not show that the provider was contacted about trazodone or the pharmacist’s recommendation. During interview, the DON stated she believed she missed the resident’s physician appointment and would have requested trazodone discontinuation if she had known about it, and she said faxed requests usually did not generate a response. The consultant pharmacist stated that, in general, trazodone should be considered for gradual dose reduction after 6 months of use. The administrator stated he expected staff to follow facility policy and procedure. For a second resident with moderate cognition and diagnoses including OCD, dementia, anxiety, depression, and psychotic disorder, the MDS showed routine antipsychotic use and no documented gradual dose reduction attempt or physician-documented contraindication. The resident received olanzapine twice daily and sertraline daily, and the consultant pharmacist’s review noted olanzapine had been prescribed for an extended period and that psychotropic medications should be considered for trial dose reduction at least twice within the first year of use. The most recent psychiatry note in the EMR stated to continue the medications but did not include a thorough risk/benefit assessment, and the medical record lacked evidence that a GDR had been attempted, that the resident was on the lowest effective dose within the past calendar year, or that the pharmacy recommendation had been followed up on.
Deficiency in Kitchen Dry Storage Sanitation
Penalty
Summary
The facility failed to maintain clean and sanitary conditions in the dry storage area of the kitchen, which had the potential to affect all 29 residents. During an initial tour, a dented can of tomato juice was found on the shelf, and two large covered plastic bins were improperly managed. One bin contained an opened 50 lb bag of cake mix with a gaping top, and the cover was left open. The second bin had its cover lying on a rack shelf, with two 50 lb opened bags inside, including a bag of biscuit mix with no opening date and a bag of sweet cornbread mix opened on 2/15/24. The kitchen staff member present was unaware of how long the items were good for, how often they were used, or if the cover should be on, and did not know who was responsible for the dry storage area. The food service manager (FSM) confirmed the lack of proper dating and closure of the bags and acknowledged that dented cans should be removed immediately. The FSM, who had been in the role for approximately six months, was working to standardize practices but noted that there was no formal direction for maintaining the dry storage area. The facility's cleaning policies did not include specific procedures for dry storage sanitation, and the existing policies on food supply storage and general sanitation did not adequately address the maintenance of a clean and sanitized dry storage area.
Failure in Infection Prevention and Quality Assurance Activities
Penalty
Summary
The facility failed to conduct ongoing quality assessment and assurance activities, and did not develop or implement appropriate plans of action to correct quality deficiencies identified during the survey. This failure had the potential to adversely affect all 29 residents residing in the facility. Specifically, the facility did not perform timely tracking and trending of potential infectious symptoms to prevent the spread of transmissible organisms. The facility also failed to implement timely transmission-based precautions and testing for COVID-19 according to CDC guidelines for four residents who were displaying COVID-19 symptoms, and did not implement timely precautions for two residents confirmed to have human metapneumovirus. The infection preventionist at the facility did not adequately assess, develop, implement, monitor, and maintain the infection prevention and control program, which had the potential to affect all residents, staff, and visitors. During an interview, the administrator acknowledged that the director of nursing, who was previously responsible for the infection prevention program, had delegated responsibilities to a registered nurse without ensuring the nurse received adequate training or support. The facility's Quality Assurance Performance Improvement plan did not include a plan for a continuous infection prevention program, indicating a disconnect between the assumed and actual understanding of infection prevention responsibilities.
Inadequate Infection Control and Documentation
Penalty
Summary
The facility failed to perform timely tracking and trending of potential infectious symptoms, which led to a deficiency in preventing the spread of transmissible organisms. This included a failure to implement timely transmission-based precautions (TBP) and testing for respiratory illnesses according to CDC guidelines for four residents displaying COVID-19 symptoms and two residents confirmed to have human metapneumovirus (HMPV). The infection logs failed to identify residents not treated with antimicrobials, and there was a lack of documentation regarding confirmatory COVID-19 tests and isolation measures for symptomatic residents. Several residents exhibited symptoms of respiratory illnesses, but their medical records did not reflect appropriate testing or isolation measures. For instance, one resident with a nonproductive cough and afebrile status was not placed in isolation, and there was no record of a confirmatory COVID-19 test. Another resident with cold symptoms and chest congestion was transferred to the emergency department after experiencing hypoxic respiratory failure due to HMPV, yet there was no documentation of isolation upon return to the facility. Similar lapses were noted for other residents, indicating a systemic issue in managing infectious symptoms. Interviews with facility staff revealed confusion and inconsistency in following infection prevention protocols. The Infection Prevention (IP) nurse was unsure of expectations and faced challenges in getting staff to use clinical monitoring forms. The Director of Nursing (DON) was unaware of CDC guidance for confirmatory testing and isolation, and staff interviews highlighted a lack of adherence to facility policies and CDC guidelines. The facility's infection prevention and control program was not effectively implemented, as evidenced by the absence of documentation and tracking of viral illnesses since January 2024.
Inadequate Infection Preventionist Training and Oversight
Penalty
Summary
The facility failed to ensure there was a qualified infection preventionist (IP) to adequately manage the infection prevention and control program, which had the potential to affect all 29 residents, staff, and visitors. The deficiency was identified through interviews and document reviews, revealing that the Director of Nursing (DON), who was initially responsible for the infection prevention program, had been on extended leave. During this period, the responsibilities were delegated to a registered nurse (RN-A) who had not received adequate training or support to fulfill the role effectively. The IP lead was unaware of this delegation and RN-A was not included in the training list, indicating a lack of communication and oversight. The facility's infection prevention and control program policy required the designation of a qualified individual to manage the program, which was not adhered to. The report highlighted specific failures, such as the lack of timely tracking and trending of infectious symptoms and the implementation of transmission-based precautions for residents displaying COVID-19 symptoms and those confirmed with human metapneumovirus (HMPV). Interviews with the DON, RN-A, and the administrator revealed that RN-A's only training was the corporate annual in-service and CDC Nursing Home Infection Preventionist Training, which was insufficient for the role. The administrator assumed infection prevention tasks were completed based on dashboard presentations at quality assurance meetings, but there was no plan to ensure RN-A received necessary training and support.
Failure to Notify Ombudsman of Resident Transfer
Penalty
Summary
The facility failed to notify the Office of Ombudsman for Long-Term Care (OOLTC) regarding a facility-initiated transfer of a resident to the hospital. The resident, identified as R14, had no cognitive impairment according to their quarterly Minimum Data Set. The resident was admitted to the hospital on two occasions, once on 2/29/24 and again on 3/20/24, and returned to the facility each time. However, there was no evidence that the OOLTC was notified of these transfers. During interviews, the business office coordinator (BOC) stated that they were responsible for placing the bed hold form in the resident's chart but were unaware of the requirement to notify the OOLTC about hospital transfers. The director of nursing (DON) confirmed that the OOLTC should be notified of resident transfers and that the BOC was responsible for this task. The facility's Discharge and Transfer policy also indicated that notification to the OOLTC was required when a resident was hospitalized.
Failure to Provide Bed Hold Policy Notice
Penalty
Summary
The facility failed to provide a written bed hold policy to a resident or their representative at the time of hospital transfer. This deficiency was identified for a resident, referred to as R14, who was hospitalized on March 21, 2024. The resident's progress notes indicated that the family was notified of the hospitalization, but there was no documentation regarding the bed hold policy. Interviews with the resident and staff revealed that the resident did not recall receiving a bed hold notice, and the registered nurse responsible for informing the resident or representative could not verify that the bed hold was communicated. Further investigation showed that the business office coordinator was responsible for ensuring bed hold forms were completed and scanned into the resident's chart, but no such documentation was found for R14's hospitalization. The director of nursing stated that it was expected for a bed hold form to be completed and documented for every resident transferred to the hospital. The facility's bed hold policy, dated December 2, 2023, required that a designated individual provide the bed hold policy notice to the resident or their representative at the time of transfer.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Blackduck
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Neilson Place | 22.3 mi | ★★★★★ | 19 | 0 |
| Havenwood Care Center | 23.2 mi | ★★★★★ | 18 | 0 |
| Jourdain Perpich Ext Care Fac | 24.5 mi | ★★★★★ | 9 | 0 |
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