Colorado Nursing Homes >> Fort Collins Nursing Homes >> Good Samaritan Society - Fort Collins Village

Good Samaritan Society - Fort Collins Village - Fort Collins Nursing Home

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Federal Provider Number
65227
Provider Name
GOOD SAMARITAN SOCIETY - FORT COLLINS VILLAGE
Provider Address
508 WEST TRILBY ROAD
FORT COLLINS, CO 80525
Provider Phone Number
(970) 226-4909
Provider SSA County
340
Provider County Name
Larimer
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
64
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
1986-03-01
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
2
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
2.32333
Reported LPN Staffing Hours per Resident per Day
0.50250
Reported RN Staffing Hours per Resident per Day
1.15250
Reported Licensed Staffing Hours per Resident per Day
1.65500
Reported Total Nurse Staffing Hours per Resident per Day
3.97833
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14500
Expected CNA Staffing Hours per Resident per Day
2.40728
Expected LPN Staffing Hours per Resident per Day
0.55392
Expected RN Staffing Hours per Resident per Day
0.88554
Expected Total Nurse Staffing Hours per Resident per Day
3.84674
Adjusted CNA Staffing Hours per Resident per Day
2.36813
Adjusted LPN Staffing Hours per Resident per Day
0.75295
Adjusted RN Staffing Hours per Resident per Day
0.97246
Adjusted Total Nurse Staffing Hours per Resident per Day
4.16879
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-06-10
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
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-06-26
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
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
36
Cycle 3 Standard Health Survey Date
2012-07-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
38.66700
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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