Iowa Nursing Homes >> Holstein Nursing Homes >> Good Samaritan Society - Holstein

Good Samaritan Society - Holstein - Holstein Nursing Home

General Information

UPDATE
Federal Provider Number
165207
Provider Name
GOOD SAMARITAN SOCIETY - HOLSTEIN
Provider Address
505 WEST SECOND STREET
HOLSTEIN, IA 51025
Provider Phone Number
7123684304
Provider SSA County
460
Provider County Name
Ida
Ownership Type
Non profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
52
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
1994-04-01
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
2
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
2.53077
Reported LPN Staffing Hours per Resident per Day
0.82115
Reported RN Staffing Hours per Resident per Day
0.53942
Reported Licensed Staffing Hours per Resident per Day
1.36058
Reported Total Nurse Staffing Hours per Resident per Day
3.89134
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02981
Expected CNA Staffing Hours per Resident per Day
2.57514
Expected LPN Staffing Hours per Resident per Day
0.55427
Expected RN Staffing Hours per Resident per Day
0.77287
Expected Total Nurse Staffing Hours per Resident per Day
3.90227
Adjusted CNA Staffing Hours per Resident per Day
2.41142
Adjusted LPN Staffing Hours per Resident per Day
1.22964
Adjusted RN Staffing Hours per Resident per Day
0.52151
Adjusted Total Nurse Staffing Hours per Resident per Day
4.01961
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
28
Cycle 1 Standard Survey Health Date
2014-07-31
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
44
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
0
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2012-06-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
38.66700
Number of Facility Reported Incidents
3
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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