Good Samaritan Society Northwood Retirement Comm - Jasper Nursing Home
General Information
UPDATEFederal Provider Number
155282
Provider Name
GOOD SAMARITAN SOCIETY NORTHWOOD RETIREMENT COMM
Provider Address
2515 NEWTON ST
JASPER, IN 47547
JASPER, IN 47547
Provider Phone Number
8124821722
Provider SSA County
180
Provider County Name
Dubois
Ownership Type
Non profit - Church related
Number of Certified Beds
107
Number of Residents in Certified Beds
104
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GREENE COUNTY GENERAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1986-06-01
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
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
3
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
2.68798
Reported LPN Staffing Hours per Resident per Day
1.06250
Reported RN Staffing Hours per Resident per Day
0.87837
Reported Licensed Staffing Hours per Resident per Day
1.94087
Reported Total Nurse Staffing Hours per Resident per Day
4.62885
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05481
Expected CNA Staffing Hours per Resident per Day
2.58556
Expected LPN Staffing Hours per Resident per Day
0.65680
Expected RN Staffing Hours per Resident per Day
1.07894
Expected Total Nurse Staffing Hours per Resident per Day
4.32130
Adjusted CNA Staffing Hours per Resident per Day
2.55090
Adjusted LPN Staffing Hours per Resident per Day
1.34269
Adjusted RN Staffing Hours per Resident per Day
0.60830
Adjusted Total Nurse Staffing Hours per Resident per Day
4.31778
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2015-03-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2014-01-29
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-12-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
49.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
2925
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Timbers Of Jasper The
2909 Howard Dr |
JASPER IN 47546 | 0.4 mile away
St Charles Health Campus
3150 St Charles St |
JASPER IN 47546 | 0.5 mile away
Cathedral Health Care Center
520 W 9th St |
JASPER IN 47546 | 1.2 miles away
Skilled Caring Center Of Memorial Hospital
800 W Ninth St |
JASPER IN 47546 | 1.2 miles away
Brookside Village Inc
1111 Church Ave |
JASPER IN 47546 | 2.8 miles away
Waters Of Huntingburg, The
1712 Leland Dr |
HUNTINGBURG IN 47542 | 7 miles away
Hildegard Health Center Inc
802 E 10th St |
FERDINAND IN 47532 | 13.6 miles away
Scenic Hills Care Center
311 E First St |
FERDINAND IN 47532 | 14.1 miles away
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