Good Samaritan Care Center - Cole Camp Nursing Home
General Information
UPDATEFederal Provider Number
265770
Provider Name
GOOD SAMARITAN CARE CENTER
Provider Address
403 WEST MAIN
COLE CAMP, MO 65325
COLE CAMP, MO 65325
Provider Phone Number
(660) 668-4515
Provider SSA County
70
Provider County Name
Benton
Provider Website
Provider Description
Ownership Type
Non profit - Other
Number of Certified Beds
66
Number of Residents in Certified Beds
64
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GOOD SAMARITAN NURSING HOME
Date First Approved to Provide Medicare and Medicaid services
2003-12-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
5
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
3.41719
Reported LPN Staffing Hours per Resident per Day
0.69922
Reported RN Staffing Hours per Resident per Day
0.73984
Reported Licensed Staffing Hours per Resident per Day
1.43906
Reported Total Nurse Staffing Hours per Resident per Day
4.85625
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00703
Expected CNA Staffing Hours per Resident per Day
2.30162
Expected LPN Staffing Hours per Resident per Day
0.55840
Expected RN Staffing Hours per Resident per Day
0.77042
Expected Total Nurse Staffing Hours per Resident per Day
3.63044
Adjusted CNA Staffing Hours per Resident per Day
3.64299
Adjusted LPN Staffing Hours per Resident per Day
1.03932
Adjusted RN Staffing Hours per Resident per Day
0.71754
Adjusted Total Nurse Staffing Hours per Resident per Day
5.39193
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-05-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-04-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-04-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
14.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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