Good Samaritan Hospital
PFI # 0779
Revised: March 2003
Complaints:
| Complaint Information: | 2002 |
| Complaint Investigations Completed: | 8 |
| Complaints with Statements of Deficiencies (SOD) issued: | 4 |
| % of Complaints with SODs Issued | 50% |
| Regional % of Complaints with SODs issued: | 23.3% |
Areas Cited:
| SOD Date | Regulatory Citation | Areas Cited: | Date Plan of Correction Accepted |
| 2/11/02 | 405.19(e)(1) | Emergency Services | 6/6/02 |
| 2/11/02 | 405.3(a) | Administration | 9/24/02 |
| 405.6(a)(2)(ii)(iii)(iv)(v)(vi)vii) | Quality Assurance Program | ||
| 405.19(e)(5) | Emergency Services | ||
| 5/16/02 | 405.5 | Nursing Services | 9/24/02 |
| 405.5(b)(1)(ii) | Nursing Services - Delivery of Services | ||
| 405.5(b)(4) | Nursing Services - Delivery of Services | ||
| 9/12/02 | 405.5(b)(3) | Nursing Services - Delivery of Services | 11/12/02 |
| 405.5(b)(4) | Nursing Services - Delivery of Services |
Areas Cited as a Result of Surveys:
| Date of Survey | Type | Regulatory Citation | Areas Cited: | Date Plan of Correction Accepted |
| 2/8/02 | Title 18 Dialysis Re-certification Survey | 405.2136 COP | Governing Body and Management | 4/1/02 |
| 405.2136 GB | Health and Safety | |||
| 405.2136(d)(2) | Personnel P/P: Safe and Sanitary Environment | |||
| 405.2136(d)(6) | Personnel P/P: Staff Education | |||
| 405.2136(g)(1) | Medical Supervision: Orders | |||
| 405.2136(g)(1) | Medical Supervision: Plans of Care | |||
| 405.2137 COP | Long Term Program & Care Plan | |||
| 405.2137(a) | Written Long-Term Plan | |||
| 405.2137(b) | PCP: Written Assessment Based | |||
| 405.2139 COP | Medical Records | |||
| 405.2139(a) | Med Records: Identify, Justify, Document | |||
| 405.2139(a) | Med Records: Pt Assessments | |||
| 405.2139(a) | Med Records: ID & Social Data | |||
| 405.2139(a) | Med Records: Med & Nursing History | |||
| 405.2139(a) | Med Records: Physician Exams | |||
| 405.2139(a) | Med Records: Orders | |||
| 405.2139(a) | Med Records: Progress Notes | |||
| 405.2139(a) | Med Records: Treatments and Findings | |||
| 405.2139(d) | Med Records: Self-care Home Patients | |||
| 410.2140(a) | PE: Construction & Maintain for Safety | |||
| 405.2140(a)(3) | PE: Free of Hazards | |||
| 405.2140(b) | PE: Functional, Sanitary and Comfortable | |||
| 405.2140(d)(1) | ER: Written Plan | |||
| 405.2161 COP | Director of a Renal Dialysis FAC |
Most Recent Survey Date: 2/8/02
Areas Cited as a Result of Incident Investigations:
| SOD Date | Regulatory Citation | Areas Cited: | Date Plan of Correction Accepted |