Good Samaritan Society - George - George Nursing Home

General Information

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Federal Provider Number
165247
Provider Name
GOOD SAMARITAN SOCIETY - GEORGE
Provider Address
324 FIRST AVENUE NORTH
GEORGE, IA 51237
Provider Phone Number
(712) 475-3391
Provider SSA County
590
Provider County Name
Lyon
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
45
Number of Residents in Certified Beds
26
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
1995-03-01
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
3
Overall Rating Footnote
Health Inspection Rating
3
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
2.25192
Reported LPN Staffing Hours per Resident per Day
0.15962
Reported RN Staffing Hours per Resident per Day
0.80769
Reported Licensed Staffing Hours per Resident per Day
0.96731
Reported Total Nurse Staffing Hours per Resident per Day
3.21923
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.33370
Expected LPN Staffing Hours per Resident per Day
0.57410
Expected RN Staffing Hours per Resident per Day
0.85848
Expected Total Nurse Staffing Hours per Resident per Day
3.76628
Adjusted CNA Staffing Hours per Resident per Day
2.36771
Adjusted LPN Staffing Hours per Resident per Day
0.23077
Adjusted RN Staffing Hours per Resident per Day
0.70299
Adjusted Total Nurse Staffing Hours per Resident per Day
3.44541
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
2014-08-14
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
7
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-06-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-05-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
30.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
5
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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