Good Samaritan Society - Bethany - Brainerd Nursing Home
General Information
UPDATEFederal Provider Number
245500
Provider Name
GOOD SAMARITAN SOCIETY - BETHANY
Provider Address
804 WRIGHT STREET
BRAINERD, MN 56401
BRAINERD, MN 56401
Provider Phone Number
(218) 829-1407
Provider SSA County
170
Provider County Name
Crow Wing
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
114
Number of Residents in Certified Beds
111
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
1988-01-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.92297
Reported LPN Staffing Hours per Resident per Day
0.90405
Reported RN Staffing Hours per Resident per Day
1.04865
Reported Licensed Staffing Hours per Resident per Day
1.95270
Reported Total Nurse Staffing Hours per Resident per Day
3.87567
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07973
Expected CNA Staffing Hours per Resident per Day
2.60277
Expected LPN Staffing Hours per Resident per Day
0.62294
Expected RN Staffing Hours per Resident per Day
0.95554
Expected Total Nurse Staffing Hours per Resident per Day
4.18126
Adjusted CNA Staffing Hours per Resident per Day
1.81283
Adjusted LPN Staffing Hours per Resident per Day
1.20455
Adjusted RN Staffing Hours per Resident per Day
0.82001
Adjusted Total Nurse Staffing Hours per Resident per Day
3.73630
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-06-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
14
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2013-04-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
64
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
28
Cycle 3 Standard Health Survey Date
2012-03-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
46.00000
Number of Facility Reported Incidents
1
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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