North Dakota Nursing Homes >> Devils Lake Nursing Homes >> Good Samaritan Society - Devils Lake

Good Samaritan Society - Devils Lake - Devils Lake Nursing Home

General Information

UPDATE
Federal Provider Number
355100
Provider Name
GOOD SAMARITAN SOCIETY - DEVILS LAKE
Provider Address
302 7TH AVE NE
DEVILS LAKE, ND 58301
Provider Phone Number
7016626580
Provider SSA County
350
Provider County Name
Ramsey
Ownership Type
Non profit - Corporation
Number of Certified Beds
48
Number of Residents in Certified Beds
47
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
1991-03-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
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
2.09043
Reported LPN Staffing Hours per Resident per Day
0.64787
Reported RN Staffing Hours per Resident per Day
0.68936
Reported Licensed Staffing Hours per Resident per Day
1.33723
Reported Total Nurse Staffing Hours per Resident per Day
3.42766
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00426
Expected CNA Staffing Hours per Resident per Day
2.47463
Expected LPN Staffing Hours per Resident per Day
0.59438
Expected RN Staffing Hours per Resident per Day
0.86954
Expected Total Nurse Staffing Hours per Resident per Day
3.93855
Adjusted CNA Staffing Hours per Resident per Day
2.07275
Adjusted LPN Staffing Hours per Resident per Day
0.90469
Adjusted RN Staffing Hours per Resident per Day
0.59237
Adjusted Total Nurse Staffing Hours per Resident per Day
3.50803
Cycle 1 Total Number of Health Deficiencies
19
Cycle 1 Number of Standard Health Deficiencies
19
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
132
Cycle 1 Standard Survey Health Date
2014-12-18
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
132
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2014-01-23
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
30
Cycle 2 Total Health Score
30
Cycle 3 Total Number of Health Deficiencies
16
Cycle 3 Number of Standard Health Deficiencies
15
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
80
Cycle 3 Standard Health Survey Date
2013-01-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
80
Total Weighted Health Survey Score
109.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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

Eventide Heartland

620 14th Ave Ne | DEVILS LAKE ND 58301 | 0.6 mile away

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