CCN 165210
Good Samaritan - Saint Ansgar
701 East Fourth Street, Saint Ansgar, IA 50472 · Mitchell County
- Ownership
- For profit - Corporation
- Certified beds
- 42
- Residents per day
- 40.6
- Health citations
- 2
- Penalties
- 0
- Fines
- 0 · $0
Provider Information. Data from CMS, updated September 1, 2026. CMS Provider Data Catalog · How we rate · Corrections
CMS has marked this home with the high-performing icon. The September 2026 Technical Users' Guide describes that icon for homes with fewer citations, higher staffing, and other quality indicators, shown in addition to the five-star rating. Selection criteria are in CMS memorandum QSO-26-14-NH.
Staffing hours
Reported hours per resident per day come from the Payroll-Based Journal figures in the Provider Information file. Case-mix and adjusted hours account for how much care CMS expects given the residents’ needs. State and U.S. figures are averages from the same release.
- Measure
- This home
- State
- U.S.
- Nurse aide
- 1.85
- 2.52
- 2.32
- LPN/LVN
- 0.32
- 0.56
- 0.86
- Registered nurse
- 0.77
- 0.74
- 0.69
- Total nurse staff
- 2.94
- 3.82
- 3.86
- Weekend total
- 2.51
- 3.37
- 3.42
- Weekend RN
- 0.49
- 0.51
- 0.48
Adjusted total nurse hours: 3.74. Adjusted RN hours: 0.98. Case-mix total: 3.01. Case-mix index: 1.101.
Total nursing staff turnover: 27.8%. RN turnover: 25.0%. Administrators who left: 0.
How to read staffing hours
Payroll-Based Journal figures in Provider Information. Data from CMS, updated September 1, 2026. CMS Provider Data Catalog · How we rate · Corrections
Fines and penalties
CMS reports 0 fines totaling $0, and 0 payment denials.
The Penalties file has no individual penalty rows for this CCN.
Cycle 1 standard survey: June 18, 2026. Health deficiencies counted in cycle 1: 2. Cycle 1 total health score: 20.
Cycle 2 standard survey: April 24, 2025. Cycle 2/3 health deficiencies: 0. Total weighted health survey score: 15.
Penalties file and Provider Information. Data from CMS, updated September 1, 2026. CMS Provider Data Catalog · How we rate · Corrections
Health inspection citations
The Health Deficiencies file lists 2 citations for this home, including 0 at immediate jeopardy and 0 at actual harm. CMS may display some citations here that are not used in the health inspection rating, including citations under dispute.
June 18, 2026
2 citations
| Tag | What CMS cited | Scope and severity | Status |
|---|
| F727 | Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. Nursing and Physician Services Deficiencies · Standard survey · Cycle 1 | F: widespread, no actual harm, with potential for more than minimal harm | Deficient, Provider has date of correction · July 15, 2026 |
| F880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Standard survey · Cycle 1 | D: isolated, no actual harm, with potential for more than minimal harm | Deficient, Provider has date of correction · July 15, 2026 |
Health Deficiencies. Data from CMS, updated September 1, 2026. CMS Provider Data Catalog · How we rate · Corrections