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Health Inspection

Good Samaritan Society - Mary Jane Brown

April 1, 2026 · Luverne, MN · 110 South Walnut Avenue
Citations 3
CMS Rating 1/5
Beds 51
Provider ID 245568
Healthcare Facility
Good Samaritan Society - Mary Jane Brown
Luverne, MN  ·  View full profile →
Inspection Summary

GOOD SAMARITAN SOCIETY - MARY JANE BROWN in LUVERNE, MN — inspection on April 1, 2026.

Found 3 citations. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

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Inspection Findings

FF0693
Quality of Life and Care Deficiencies

the steps to be followed for administration:1).

Verify the order.2).

Follow EBP.3).

Staff were to

feeding by checking orders and identifying the resident to receive the feeding.

Check the expiration

during the feeding and keep it elevated for 30-60 minutes after feeding, unless a physician's order instructs otherwise.6).

Check tube placement and patency before beginning a feeding or administering fluids or medications.

Methods for checking include: a.

Observe for change in the external length of the tube, by checking change in location of a mark placed on the tube on the level where it exits the skin. b.

Remove the cap or plug from the feeding tube and use the syringe to inject 30 milliliters of air through the tube to clear it, then aspirate for observation of gastric contents to ensure the tube remains in the stomach.

Review of the plan for management of the dietary department included oversight by the sister facility certified dietary manager and registered dietitian.

Education was initiated for dietary staff to ensure knowledge of policies and procedures, and a cleaning schedule was being implemented. A policy for cleaning of the resident designated refrigerator was requested but not provided by survey exit.

245568 04/01/2026

Good Samaritan Society - Mary Jane Brown 110 South Walnut Avenue Luverne, MN 56156

Review of the 1702D report for quarter 4 of 2025 (July 1 through September 30) and staffing schedules identified during an average week, Monday through Friday, during the day shift, there were several days that multiple registered nurses had been working.

These hours had been submitted to PBJ as direct care RN'S rather than RN's with administrative duties.

For example, on:8/26/25, 6 registered nurses were coded as RN's (direct care staff with no administrative duties) on the report.

Staffing schedules identified 4 of 6 RN's were scheduled for administrative duties (RN-E, RN-C, RN-D, and the DON) and should not have been coded as direct care staff.8/27/25, 6 registered nurses were coded as RN's (direct care staff with no administrative duties) on the report.

Staffing schedules identified 4 of 6 RN's were scheduled for administrative duties (RN-E, RN-C, RN-D, and the DON) and should not have been coded as direct care staff.9/30/25, 5 registered nurses were coded as RN's providing direct care on the report.

Staffing schedules identified 3 of those RN's were scheduled for administrative duties (RN-E, RN-C, and RN-D) and should not have been coded as direct care staff.

Interview on 4/1/26 at 9:57 a.m., with the director of nursing (DON) identified they had not separated weekday RN'S with administrative duties from RN'S who provide direct care to residents on the PBJ submission information.

The DON reached out to an unidentified corporate manager who further revealed they were unaware RN'S with administrative duties should be coded by their job type and category and not as direct care RN's.

The corporate manager and DON confirmed this was likely the reason for the staffing discrepancy between the weekday and weekend staffing hours. A policy was requested; however, none was provided by the end of the survey period.

245568 04/01/2026

Good Samaritan Society - Mary Jane Brown 110 South Walnut Avenue Luverne, MN 56156

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in LUVERNE, MN, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from GOOD SAMARITAN SOCIETY - MARY JANE BROWN or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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