Good Samaritan Society - Indianola - Indianola Nursing Home
General Information
UPDATEFederal Provider Number
165186
Provider Name
GOOD SAMARITAN SOCIETY - INDIANOLA
Provider Address
708 SOUTH JEFFERSON PO BOX 319
INDIANOLA, IA 50125
INDIANOLA, IA 50125
Provider Phone Number
5159612596
Provider SSA County
900
Provider County Name
Warren
Ownership Type
Non profit - Corporation
Number of Certified Beds
131
Number of Residents in Certified Beds
100
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
1993-11-01
Continuing Care Retirement Community
N
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.10950
Reported LPN Staffing Hours per Resident per Day
0.70500
Reported RN Staffing Hours per Resident per Day
0.99100
Reported Licensed Staffing Hours per Resident per Day
1.69600
Reported Total Nurse Staffing Hours per Resident per Day
3.80550
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07150
Expected CNA Staffing Hours per Resident per Day
2.45055
Expected LPN Staffing Hours per Resident per Day
0.54824
Expected RN Staffing Hours per Resident per Day
0.81606
Expected Total Nurse Staffing Hours per Resident per Day
3.81486
Adjusted CNA Staffing Hours per Resident per Day
2.11221
Adjusted LPN Staffing Hours per Resident per Day
1.06732
Adjusted RN Staffing Hours per Resident per Day
0.90737
Adjusted Total Nurse Staffing Hours per Resident per Day
4.02101
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2014-10-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
197
Cycle 2 Standard Health Survey Date
2013-09-04
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
99
Cycle 2 Total Health Score
99
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
60
Cycle 3 Standard Health Survey Date
2012-07-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
140.66700
Number of Facility Reported Incidents
6
Number of Substantiated Complaints
5
Number of Fines
2
Total Amount of Fines in Dollars
10050
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
The Village
1203 North E Street |
INDIANOLA IA 50125 | 1.5 miles away
Westview Of Indianola Care Center
1900 West Third Place |
INDIANOLA IA 50125 | 1.5 miles away
Carlisle Center For Wellness And Rehab
680 Cole Street |
CARLISLE IA 50047 | 10.3 miles away
Norwalk Nursing And Rehabilitation Center
921 Sunset Drive |
NORWALK IA 50211 | 10.7 miles away
Regency Care Center
815 High Road |
NORWALK IA 50211 | 10.9 miles away
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