Good Samaritan Nursing Home - Sayville Nursing Home
General Information
UPDATEFederal Provider Number
335636
Provider Name
GOOD SAMARITAN NURSING HOME
Provider Address
101 ELM ST
SAYVILLE, NY 11782
SAYVILLE, NY 11782
Provider Phone Number
(631) 244-2400
Provider SSA County
700
Provider County Name
Suffolk
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
100
Number of Residents in Certified Beds
97
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GOOD SAMARITAN HOSPITAL MEDICAL CENTER
Date First Approved to Provide Medicare and Medicaid services
1980-01-17
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.70361
Reported LPN Staffing Hours per Resident per Day
0.71598
Reported RN Staffing Hours per Resident per Day
0.42268
Reported Licensed Staffing Hours per Resident per Day
1.13866
Reported Total Nurse Staffing Hours per Resident per Day
2.84227
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07474
Expected CNA Staffing Hours per Resident per Day
2.51300
Expected LPN Staffing Hours per Resident per Day
0.69199
Expected RN Staffing Hours per Resident per Day
1.08554
Expected Total Nurse Staffing Hours per Resident per Day
4.29052
Adjusted CNA Staffing Hours per Resident per Day
1.66341
Adjusted LPN Staffing Hours per Resident per Day
0.85878
Adjusted RN Staffing Hours per Resident per Day
0.29094
Adjusted Total Nurse Staffing Hours per Resident per Day
2.67028
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-12-22
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
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
16
Cycle 2 Standard Health Survey Date
2013-12-03
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-11-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
8.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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