Good Samaritan Society - Manzano Del Sol - Albuquerque Nursing Home

General Information

UPDATE
Federal Provider Number
325074
Provider Name
GOOD SAMARITAN SOCIETY - MANZANO DEL SOL
Provider Address
5201 ROMA AVENUE NE
ALBUQUERQUE, NM 87108
Provider Phone Number
5052622311
Provider SSA County
0
Provider County Name
Bernalillo
Ownership Type
Non profit - Corporation
Number of Certified Beds
117
Number of Residents in Certified Beds
83
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
1992-10-01
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
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
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
2.11506
Reported LPN Staffing Hours per Resident per Day
0.38554
Reported RN Staffing Hours per Resident per Day
1.00422
Reported Licensed Staffing Hours per Resident per Day
1.38976
Reported Total Nurse Staffing Hours per Resident per Day
3.50482
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04639
Expected CNA Staffing Hours per Resident per Day
2.43800
Expected LPN Staffing Hours per Resident per Day
0.62823
Expected RN Staffing Hours per Resident per Day
1.01633
Expected Total Nurse Staffing Hours per Resident per Day
4.08256
Adjusted CNA Staffing Hours per Resident per Day
2.12868
Adjusted LPN Staffing Hours per Resident per Day
0.50937
Adjusted RN Staffing Hours per Resident per Day
0.73830
Adjusted Total Nurse Staffing Hours per Resident per Day
3.46047
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-06-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-07-17
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
3
Cycle 3 Number of Complaint Health Deficiencies
3
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
30.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
0
Number of Fines
3
Total Amount of Fines in Dollars
38285
Number of Payment Denials
0
Total Number of Penalties
3
Location
Processing Date
2015-06-01

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