Good Samaritan Society - Eugene Village - Eugene Nursing Home
General Information
UPDATEFederal Provider Number
385147
Provider Name
GOOD SAMARITAN SOCIETY - EUGENE VILLAGE
Provider Address
3500 HILYARD STREET
EUGENE, OR 97405
EUGENE, OR 97405
Provider Phone Number
(541) 687-9211
Provider SSA County
190
Provider County Name
Lane
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
106
Number of Residents in Certified Beds
37
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
1981-02-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
4
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
3.56892
Reported LPN Staffing Hours per Resident per Day
1.21216
Reported RN Staffing Hours per Resident per Day
0.93784
Reported Licensed Staffing Hours per Resident per Day
2.15000
Reported Total Nurse Staffing Hours per Resident per Day
5.71892
Reported Physical Therapist Staffing Hours per Resident Per Day
0.17703
Expected CNA Staffing Hours per Resident per Day
2.43664
Expected LPN Staffing Hours per Resident per Day
0.61596
Expected RN Staffing Hours per Resident per Day
1.02498
Expected Total Nurse Staffing Hours per Resident per Day
4.07758
Adjusted CNA Staffing Hours per Resident per Day
3.59391
Adjusted LPN Staffing Hours per Resident per Day
1.63339
Adjusted RN Staffing Hours per Resident per Day
0.68367
Adjusted Total Nurse Staffing Hours per Resident per Day
5.65345
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2015-03-05
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
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2014-02-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
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
2012-07-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
10.00000
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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