Nebraska Nursing Homes >> Bloomfield Nursing Homes >> Good Samaritan Society - Bloomfield

Good Samaritan Society - Bloomfield - Bloomfield Nursing Home

General Information

UPDATE
Federal Provider Number
285156
Provider Name
GOOD SAMARITAN SOCIETY - BLOOMFIELD
Provider Address
P O BOX 307, 300 NORTH SECOND ST
BLOOMFIELD, NE 68718
Provider Phone Number
4023732531
Provider SSA County
530
Provider County Name
Knox
Ownership Type
Non profit - Corporation
Number of Certified Beds
70
Number of Residents in Certified Beds
41
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Date First Approved to Provide Medicare and Medicaid services
1994-11-01
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.30976
Reported LPN Staffing Hours per Resident per Day
0.54268
Reported RN Staffing Hours per Resident per Day
0.77317
Reported Licensed Staffing Hours per Resident per Day
1.31585
Reported Total Nurse Staffing Hours per Resident per Day
3.62561
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05610
Expected CNA Staffing Hours per Resident per Day
2.28065
Expected LPN Staffing Hours per Resident per Day
0.56512
Expected RN Staffing Hours per Resident per Day
0.82207
Expected Total Nurse Staffing Hours per Resident per Day
3.66784
Adjusted CNA Staffing Hours per Resident per Day
2.48502
Adjusted LPN Staffing Hours per Resident per Day
0.79705
Adjusted RN Staffing Hours per Resident per Day
0.70275
Adjusted Total Nurse Staffing Hours per Resident per Day
3.98449
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-02-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
96
Cycle 2 Standard Health Survey Date
2012-11-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2011-08-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
61.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
0
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01

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