Good Samaritan Society - Sherman County - Goodland Nursing Home
General Information
UPDATEFederal Provider Number
175361
Provider Name
GOOD SAMARITAN SOCIETY - SHERMAN COUNTY
Provider Address
208 W 2ND ST
GOODLAND, KS 67735
GOODLAND, KS 67735
Provider Phone Number
7858907517
Provider SSA County
900
Provider County Name
Sherman
Ownership Type
Non profit - Church related
Number of Certified Beds
57
Number of Residents in Certified Beds
48
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
1996-04-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.83750
Reported LPN Staffing Hours per Resident per Day
0.11771
Reported RN Staffing Hours per Resident per Day
0.61979
Reported Licensed Staffing Hours per Resident per Day
0.73750
Reported Total Nurse Staffing Hours per Resident per Day
3.57500
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11354
Expected CNA Staffing Hours per Resident per Day
2.39814
Expected LPN Staffing Hours per Resident per Day
0.62006
Expected RN Staffing Hours per Resident per Day
0.99345
Expected Total Nurse Staffing Hours per Resident per Day
4.01165
Adjusted CNA Staffing Hours per Resident per Day
2.90324
Adjusted LPN Staffing Hours per Resident per Day
0.15756
Adjusted RN Staffing Hours per Resident per Day
0.46616
Adjusted Total Nurse Staffing Hours per Resident per Day
3.59215
Cycle 1 Total Number of Health Deficiencies
17
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
17
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2015-02-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
27
Cycle 2 Number of Standard Health Deficiencies
20
Cycle 2 Number of Complaint Health Deficiencies
21
Cycle 2 Health Deficiency Score
244
Cycle 2 Standard Health Survey Date
2013-12-11
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
122
Cycle 2 Total Health Score
122
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2012-08-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
166.00000
Number of Facility Reported Incidents
6
Number of Substantiated Complaints
10
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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