Oregon Nursing Homes >> Gresham Nursing Homes >> Good Samaritan Society - Fairlawn Village

Good Samaritan Society - Fairlawn Village - Gresham Nursing Home

General Information

UPDATE
Federal Provider Number
385133
Provider Name
GOOD SAMARITAN SOCIETY - FAIRLAWN VILLAGE
Provider Address
3457 NE DIVISION
GRESHAM, OR 97030
Provider Phone Number
(503) 667-1965
Provider SSA County
250
Provider County Name
Multnomah
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
97
Number of Residents in Certified Beds
60
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
1976-06-14
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
3
Health Inspection Rating Footnote
QM Rating
1
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
3.35833
Reported LPN Staffing Hours per Resident per Day
0.44083
Reported RN Staffing Hours per Resident per Day
0.86333
Reported Licensed Staffing Hours per Resident per Day
1.30417
Reported Total Nurse Staffing Hours per Resident per Day
4.66249
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.44378
Expected LPN Staffing Hours per Resident per Day
0.70375
Expected RN Staffing Hours per Resident per Day
1.17629
Expected Total Nurse Staffing Hours per Resident per Day
4.32381
Adjusted CNA Staffing Hours per Resident per Day
3.37197
Adjusted LPN Staffing Hours per Resident per Day
0.51992
Adjusted RN Staffing Hours per Resident per Day
0.54840
Adjusted Total Nurse Staffing Hours per Resident per Day
4.34663
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-10-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-04-01
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
52
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-02-13
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
26.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
975
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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