Minnesota Nursing Homes >> Clearbrook Nursing Homes >> Good Samaritan Society - Clearbrook

Good Samaritan Society - Clearbrook - Clearbrook Nursing Home

General Information

UPDATE
Federal Provider Number
245523
Provider Name
GOOD SAMARITAN SOCIETY - CLEARBROOK
Provider Address
305 3RD AVENUE SOUTHWEST
CLEARBROOK, MN 56634
Provider Phone Number
2187763157
Provider SSA County
140
Provider County Name
Clearwater
Ownership Type
Non profit - Corporation
Number of Certified Beds
43
Number of Residents in Certified Beds
34
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
1988-02-01
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
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
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.09265
Reported LPN Staffing Hours per Resident per Day
1.12794
Reported RN Staffing Hours per Resident per Day
0.76324
Reported Licensed Staffing Hours per Resident per Day
1.89118
Reported Total Nurse Staffing Hours per Resident per Day
3.98383
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02500
Expected CNA Staffing Hours per Resident per Day
2.41899
Expected LPN Staffing Hours per Resident per Day
0.60087
Expected RN Staffing Hours per Resident per Day
0.88878
Expected Total Nurse Staffing Hours per Resident per Day
3.90865
Adjusted CNA Staffing Hours per Resident per Day
2.12268
Adjusted LPN Staffing Hours per Resident per Day
1.55805
Adjusted RN Staffing Hours per Resident per Day
0.64165
Adjusted Total Nurse Staffing Hours per Resident per Day
4.10843
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2015-02-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2014-03-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-12-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
42.66700
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

Nursiong Homes Nearby

Cornerstone Nsg & Rehab Center

416 Seventh Street Northeast | BAGLEY MN 56621 | 11.3 miles away

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