Good Samaritan Home & Rehabilitative Center - Oakland City Nursing Home
General Information
UPDATEFederal Provider Number
155561
Provider Name
GOOD SAMARITAN HOME & REHABILITATIVE CENTER
Provider Address
231 N JACKSON ST
OAKLAND CITY, IN 47660
OAKLAND CITY, IN 47660
Provider Phone Number
(812) 749-4774
Provider SSA County
250
Provider County Name
Gibson
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
103
Number of Residents in Certified Beds
71
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1995-03-23
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
2.37324
Reported LPN Staffing Hours per Resident per Day
0.85282
Reported RN Staffing Hours per Resident per Day
1.30986
Reported Licensed Staffing Hours per Resident per Day
2.16268
Reported Total Nurse Staffing Hours per Resident per Day
4.53592
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07958
Expected CNA Staffing Hours per Resident per Day
2.78292
Expected LPN Staffing Hours per Resident per Day
0.80665
Expected RN Staffing Hours per Resident per Day
1.44006
Expected Total Nurse Staffing Hours per Resident per Day
5.02962
Adjusted CNA Staffing Hours per Resident per Day
2.09249
Adjusted LPN Staffing Hours per Resident per Day
0.87750
Adjusted RN Staffing Hours per Resident per Day
0.67965
Adjusted Total Nurse Staffing Hours per Resident per Day
3.63523
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-12-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
8
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2013-12-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
60
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
24
Cycle 3 Standard Health Survey Date
2012-12-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
36.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
9
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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