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Good Samaritan Home Care Services of Vincennes in

(812) 885-2767328 N 2ND St, Suite 300, Vincennes, IN 47591
CMS Certification Number 157217 · Proprietary · Medicare-certified since 05/01/1991
9deficiencies 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 2026-02-24

· Recertification · 3 deficiencies · CMS source report (PDF)
Moderate Infection Prevention

The agency staff failed to follow infection control techniques for hand hygiene and wound care in 2 of 3 wound care observations (RN 1, RN 2); and failed to maintain appropriate bag technique in 1 of 1 home visit observations with an LPN.

Source: CMS Form 2567, inspection 2026-02-24, tag G0682 · view on CMS
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Minor Only As Ordered By A Physician

The agency failed to provide services as ordered by the physician for 1 of 1 active records reviewed with patients receiving HHA services (Patient #1), 10 of 10 active records reviewed with patients receiving SN services (Patients #2, #3, #4, #6, #7, #8, #9, #10, #11, #12), and 4 of 5 inactive…

Source: CMS Form 2567, inspection 2026-02-24, tag G0580 · view on CMS
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Minor Responsible For All Day-To-Day Operations

The Administrator failed to ensure staff completed all documentation on the day patient visits were assigned for 5 of 10 record reviews without home visits (Patients #8, 10, #11, #12, #16) Findings include: 1. The revised policy "Documentation in the Medical Record," dated 05/08/2025, required…

Source: CMS Form 2567, inspection 2026-02-24, tag G0948 · view on CMS
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Inspection 2023-03-24

· Recertification · 6 deficiencies · CMS source report (PDF)
Moderate Infection Prevention

The agency failed to ensure standard infection control precautions were followed for 2 of 2 home visit observations involving wound care.

Source: CMS Form 2567, inspection 2023-03-24, tag G0682 · view on CMS
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Minor Participate In Care

The agency failed to ensure written instructions for medications, changes in care to be furnished, and frequency of visits, were provided and maintained for 1 or 2 home visit observation with Occupational Therapy services (Patient #5); and 2 of 3 home visit observations with Skilled Nursing…

Source: CMS Form 2567, inspection 2023-03-24, tag G0434 · view on CMS
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Minor Plan Of Care Must Include The Following

The agency failed to ensure the Plan of Care specified orientation and a psychosocial assessment on the Plan of Care for 7 of 7 record reviews with home visits, with the potential to affect all 175 active records.

Source: CMS Form 2567, inspection 2023-03-24, tag G0574 · view on CMS
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Minor Development And Evaluation Of Plan Of Care

The agency failed to provide instruction, education, and reinforcement as indicated on the plan of care for 1 of 2 home visit observations in an Assisted Living Facility (ALF).

Source: CMS Form 2567, inspection 2023-03-24, tag G0708 · view on CMS
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Minor Preparing Clinical Notes

The agency failed to ensure accurate information was recorded in the patients’ medical record for 1 of 2 wound record reviews.

Source: CMS Form 2567, inspection 2023-03-24, tag G0716 · view on CMS
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Minor Responsible For All Day-To-Day Operations

The agency failed to ensure all administrator and managing personnel were reported to the state agency for 1 of 1 home health agency.

Source: CMS Form 2567, inspection 2023-03-24, tag G0948 · view on CMS
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