Good Samaritan Society-florida Lutheran - Deland Nursing Home
General Information
UPDATEFederal Provider Number
105937
Provider Name
GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN
Provider Address
450 NORTH MCDONALD AVENUE
DELAND, FL 32724
DELAND, FL 32724
Provider Phone Number
(386) 738-0212
Provider SSA County
630
Provider County Name
Volusia
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
51
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
1997-01-17
Continuing Care Retirement Community
Y
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.80980
Reported LPN Staffing Hours per Resident per Day
0.05196
Reported RN Staffing Hours per Resident per Day
1.41863
Reported Licensed Staffing Hours per Resident per Day
1.47059
Reported Total Nurse Staffing Hours per Resident per Day
4.28039
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11667
Expected CNA Staffing Hours per Resident per Day
2.44945
Expected LPN Staffing Hours per Resident per Day
0.58202
Expected RN Staffing Hours per Resident per Day
0.92707
Expected Total Nurse Staffing Hours per Resident per Day
3.95854
Adjusted CNA Staffing Hours per Resident per Day
2.81467
Adjusted LPN Staffing Hours per Resident per Day
0.07410
Adjusted RN Staffing Hours per Resident per Day
1.14339
Adjusted Total Nurse Staffing Hours per Resident per Day
4.35863
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-06-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
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
8
Cycle 2 Standard Health Survey Date
2013-05-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-02-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
16.00000
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
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