← All agencies in St Francis, KS · Kansas

Good Samaritan Northwest Kansas Home Health

(785) 332-3588217 E Hwy 36, St Francis, KS 67756
CMS Certification Number 178050 · Non-Profit · Medicare-certified since 11/06/2001
13deficiencies since 2018
0serious
2inspections
4CMS quality stars
Data from CMS inspection reports (Form 2567), 2018-01-02 to 2026-10-15, downloaded 2026-10-21; CMS agency list file dated 2026-09-21. What the labels mean

Inspection 2023-11-09

· Recertification · 11 deficiencies · CMS source report (PDF)
Moderate Plan Based On All Hazards Risk Assessment

The Home Health Agency (HHA) failed to develop and maintain an emergency preparedness plan (EPP) based on a facility-based and community-based all hazards risk assessment, utilizing an all-hazards approach and include strategies for addressing emergency events identified by the risk assessment.

Source: CMS Form 2567, inspection 2023-11-09, tag E0006 · view on CMS
Show inspector's text

Loading…

Moderate Ep Program Patient Population

The Home Health Agency (HHA) failed to develop and maintain an emergency preparedness plan (EPP) that addressed patient population, the services the facility has the ability to provide in an emergency; and continuity of operations including the delegation of authority and succession plan.

Source: CMS Form 2567, inspection 2023-11-09, tag E0007 · view on CMS
Show inspector's text

Loading…

Moderate Local, State, Tribal Collaboration Process

The Home Health Agency (HHA) failed to develop and maintain an emergency preparedness plan (EPP) that included a process for cooperation and collaboration with local, tribal, regional, State, and Federal emergency preparedness officials' efforts to maintain an integrated response during a disaster…

Source: CMS Form 2567, inspection 2023-11-09, tag E0009 · view on CMS
Show inspector's text

Loading…

Moderate Hha Comprehensive Assessment In Disaster

The Home Health Agency (HHA) failed to develop and implement a policy to address individual plans for each patient during a natural or man-made disaster.

Source: CMS Form 2567, inspection 2023-11-09, tag E0017 · view on CMS
Show inspector's text

Loading…

Moderate Homebound Hha/Hospice Inform Ep Officials

The Home Health Agency (HHA) failed to develop and implement emergency preparedness program (EPP) policies and procedures to inform State and local emergency preparedness officials about homebound home health patients in need of evacuation from their residences at any time due to an emergency…

Source: CMS Form 2567, inspection 2023-11-09, tag E0019 · view on CMS
Show inspector's text

Loading…

Moderate Policies/Procedures For Medical Documentation

The Home Health Agency (HHA) failed to develop and implement policies and procedures for a system of medical documentation that preserves patient information, protects confidentiality and secures and maintains availability of records.

Source: CMS Form 2567, inspection 2023-11-09, tag E0023 · view on CMS
Show inspector's text

Loading…

Moderate Policies/Procedures-Volunteers And Staffing

The Home Health Agency (HHA) failed to develop and implement policies and procedures for the use of volunteers in an emergency or other emergency staffing strategies, including the process and role for integration of State and Federally designated health care professionals to address surge needs…

Source: CMS Form 2567, inspection 2023-11-09, tag E0024 · view on CMS
Show inspector's text

Loading…

Moderate Emergency Officials Contact Information

The Home Health Agency (HHA) failed to develop an emergency officials contact list.

Source: CMS Form 2567, inspection 2023-11-09, tag E0031 · view on CMS
Show inspector's text

Loading…

Moderate Methods For Sharing Information

The Home Health Agency (HHA) failed to develop and implement emergency preparedness program (EPP) policies and procedures for a communication plan that included methods of sharing information and medical documentation.

Source: CMS Form 2567, inspection 2023-11-09, tag E0033 · view on CMS
Show inspector's text

Loading…

Moderate Ep Training And Testing

The Home Health Agency (HHA) failed to develop and maintain an emergency preparedness program (EPP) training and testing program that is based on the emergency plan, its risk assessment and the communication plan.

Source: CMS Form 2567, inspection 2023-11-09, tag E0036 · view on CMS
Show inspector's text

Loading…

Moderate Ep Testing Requirements

The Home Health Agency (HHA) failed participate in a full-scale community-based emergency preparedness program (EPP) exercise or conduct an annual facility-based functional exercise in the past 2 years.

Source: CMS Form 2567, inspection 2023-11-09, tag E0039 · view on CMS
Show inspector's text

Loading…

Inspection 2019-09-25

· Recertification · 2 deficiencies · CMS source report (PDF)
Moderate Responsibilities Of Skilled Professionals

The agency failed to ensure the skilled professionals assumed responsibility to developed each patient's plan of care, completely, to include: 1. All Patient-specific goals in the goal section of the patient's plan of care, for four of five current sampled patients (Patient 1, 3, 4, and 5) and five…

Source: CMS Form 2567, inspection 2019-09-25, tag G0704 · view on CMS
Show inspector's text

Loading…

Minor Plan Of Care Must Include The Following

The agency failed to ensure the skilled nurse developed each patient's plan of care, completely, to include: 1. All Patient-specific goals in the goal section of the patient's plan of care, for four of five current sampled patients (Patient 1, 3, 4, and 5) and five of five discharged sampled…

Source: CMS Form 2567, inspection 2019-09-25, tag G0574 · view on CMS
Show inspector's text

Loading…