Good Samaritan Society - Bloomfield
Good Samaritan Society - Bloomfield in Bloomfield, NE — inspection on November 24, 2025.
Found 5 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
During an interview on 11/25/25 at 10:30 AM with Resident 1 and the resident's spouse the following was identified:-11/5/25 the resident had turned their call light on at 7:00 AM.-Nurse Aide (NA)-D had entered the resident's room, turned the call light off and then exited the room.-the resident turned the call light back on and NA-D returned to the room, shut the call light off and then removed the call light from the resident's reach. -it was a common occurrence for staff to remove the resident's call light from reach whether intentional or not as the resident required almost total assistance of x2 staff with cares and cares took a long time to be completed. -the resident and spouse reported the incident to the facility Administrator.
The Administrator indicated staff was counseled after the staff member admitted they had done this.
Review of facility investigations of potential abuse/neglect from 9/29/25 to 11/24/25 revealed no evidence Resident 1's allegation of potential staff to resident abuse was reported to the State Agency. In addition, there was no evidence that an investigation was completed by the facility and then submitted within 5 working days. An interview with the Director of Nursing (DON) on 11/24/25 at 11:30 AM confirmed the facility did not report the allegation of potential abuse involving Resident 1, complete and then submit an investigation to the State Agency within the required time frame.
Facility ID:
IDENTIFICATION NUMBER:
A.
Building
COMPLETED
11/24/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Good Samaritan Society - Bloomfield
300 North Second St Bloomfield, NE 68718
SUMMARY STATEMENT OF DEFICIENCIES
Review of a Care Conference Progress Note dated 7/9/25 at 11:18 AM revealed the resident and spouse had attended the resident's care plan conference and had identified a preference for the resident to be up and out of bed at 7:00 AM each morning and to be put to bed at 8:30 PM in the evening.
Review of the resident's current Care Plan with a revision date of 11/5/25, revealed the resident had an activity of daily living self-care performance deficit related to a previous stroke with weakness, right side paralysis, and weakness.
Interventions included to position the resident up in bed with 2 staff and to use the full sling lift for all transfers.
Further review of the resident's care plan revealed no evidence the resident's preferences for what time to get up in the morning or for the time the resident preferred to go to bed at night were identified on the care plan. An interview on 11/24/25 at 1:15 PM with the Director of Nursing confirmed the resident's care plan had not been updated regarding the resident's preferences.
Facility ID:
IDENTIFICATION NUMBER:
A.
Building
COMPLETED
11/24/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Good Samaritan Society - Bloomfield
300 North Second St Bloomfield, NE 68718
SUMMARY STATEMENT OF DEFICIENCIES
the resident out of bed and onto the commode.-the resident was involuntarily incontinent of feces by the time assisted the resident with toileting cares.
Facility ID:
IDENTIFICATION NUMBER:
A.
Building
COMPLETED
11/24/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Good Samaritan Society - Bloomfield
300 North Second St Bloomfield, NE 68718
SUMMARY STATEMENT OF DEFICIENCIES
Review of the facility's nursing schedule from 10/22/25 to 11/5/25 revealed the following: -On 10/22/25 there were 3 CNA's from 6 AM to 2:30 PM, -On 10/25/25 (Saturday) there were 2 CNA's from 6 AM to 2:30 PM, -On 10/26/25 (Sunday) there were 2 CNA's from 6 AM to 2:30 PM, -On 10/28/25 from 10 PM to 6:30 AM there was 1 CNA for 8 hours and 1 CNA for 4 hours, -On 10/29/25 there were 3 CNA's from 6 AM to 2:30 PM, and -On 11/2/25 there was 1 CNA from 6 PM to 10 PM and 1 CNA from 10PM to 6:30AM.
An interview with the DON on 11/24/25 at 1:15 PM confirmed the following numbers of Certified Nursing Assistants should be scheduled: -Monday through Friday 6 AM to 2:30 PM 4 Certified Nursing Assistants (CNA's), -Saturday and Sunday 6 AM to 2:30 PM 3 CNA's, -from 2:00PM to 10:30 PM there should be 2-3 CNA's, and -from 10:00PM to 6:30 AM 2 CNA's were to be scheduled.
Facility ID:
IDENTIFICATION NUMBER:
A.
Building
COMPLETED
11/24/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Good Samaritan Society - Bloomfield
300 North Second St Bloomfield, NE 68718
SUMMARY STATEMENT OF DEFICIENCIES
Review of the Skilled Nursing Facility Covid-19 Work Guidelines with a reviewed date of October 2025 revealed the following; -Symptomatic employees were to be restricted from the workplace until Covid-19 infection was ruled out by testing.
E. An observation of the Director of Nursing (DON) on 11/24/25 at 7:30 AM revealed the DON had a blue mask on, voice was hoarse and cough was noted.
An interview with the DON on 11/24/25 at 7:45 AM revealed that the DON had not completed a Covid-19 test and was not going to complete one.
An interview with Registered Nurse (RN)-B on 11/24/25 at 1:45 PM confirmed that the facility does not test staff or residents when presenting with respiratory symptoms or increased temperature.
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