Good Samaritan Society - Mary Jane Brown
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.
Inspection Findings
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
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Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.
Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.
Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.