Good Samaritan Society - Curry Village - Brookings Nursing Home
General Information
UPDATEFederal Provider Number
385165
Provider Name
GOOD SAMARITAN SOCIETY - CURRY VILLAGE
Provider Address
1 PARK AVENUE
BROOKINGS, OR 97415
BROOKINGS, OR 97415
Provider Phone Number
5414693111
Provider SSA County
70
Provider County Name
Curry
Ownership Type
Non profit - Corporation
Number of Certified Beds
71
Number of Residents in Certified Beds
42
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
1985-02-01
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
2
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
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
3.02976
Reported LPN Staffing Hours per Resident per Day
0.80833
Reported RN Staffing Hours per Resident per Day
0.50714
Reported Licensed Staffing Hours per Resident per Day
1.31548
Reported Total Nurse Staffing Hours per Resident per Day
4.34523
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09405
Expected CNA Staffing Hours per Resident per Day
2.60489
Expected LPN Staffing Hours per Resident per Day
0.64647
Expected RN Staffing Hours per Resident per Day
1.05858
Expected Total Nurse Staffing Hours per Resident per Day
4.30994
Adjusted CNA Staffing Hours per Resident per Day
2.85391
Adjusted LPN Staffing Hours per Resident per Day
1.03781
Adjusted RN Staffing Hours per Resident per Day
0.35797
Adjusted Total Nurse Staffing Hours per Resident per Day
4.06391
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-06-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-01-10
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
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2011-08-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
26.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
1300
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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