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Inspection Detail
Case Status: CLOSED
Inspection: 1522597.015 - Evangelical Lutheran Good Samaritan Society - Syracuse
Inspection Information - Office: Omaha Area Office
Inspection Nr: 1522597.015
Report ID: 0728900
Date Opened: 03/30/2021
Site Address:
Evangelical Lutheran Good Samaritan Society - Syracuse
1622 Walnut St.
Syracuse, NE 68446
Mailing Address:
Po Box F1, Syracuse, NE 68446
Union Status: NonUnion
SIC:
NAICS: 623110/Nursing Care Facilities
Inspection Type: Fat/Cat
Scope: Complete
Advanced Notice: N
Ownership: Private
Safety/Health: Health
Close Conference: 04/23/2021
Emphasis: N:Covid-19
Case Closed: 08/04/2021
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 1752042 |
Case Status: CLOSED
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 1 | 1 | ||||
| Current Violations | 1 | 1 | ||||
| Initial Penalty | $10,445 | $0 | $0 | $0 | $0 | $10,445 |
| Current Penalty | $10,445 | $0 | $0 | $0 | $0 | $10,445 |
| FTA Penalty | $0 | $0 | $0 | $0 | $0 | $0 |
| # | Citation ID | Citaton Type | Standard Cited | Issuance Date | Abatement Due Date | Current Penalty | Initial Penalty | FTA Penalty | Contest | Latest Event | Note |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1. | 01001A | Serious | 19100134 E01 | 06/28/2021 | $10,445 | $10,445 | $0 | Z - Issued | |||
| 2. | 01001B | Serious | 19100134 F02 | 06/28/2021 | 08/02/2021 | $0 | $0 | $0 | Z - Issued |
Investigation Summary
Investigation Nr: 134440.015
Event: 02/24/2021
Employee with COVID-19 infection dies
In early 2021, a 72-year-old woman employee was working at a nursing care or skilled nursing facility. She worked in the kitchen. For some reason, she contracted COVID-19. At 8:00 a.m. on February 24, 2021, she died of complications of COVID-19.
Keywords: Infectious Disease
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 1522597.015 | 72 | F | Fatality |