Minnesota Nursing Homes >> Howard Lake Nursing Homes >> Good Samaritan Society - Howard Lake

Good Samaritan Society - Howard Lake - Howard Lake Nursing Home

General Information

UPDATE
Federal Provider Number
245278
Provider Name
GOOD SAMARITAN SOCIETY - HOWARD LAKE
Provider Address
413 13TH AVENUE
HOWARD LAKE, MN 55349
Provider Phone Number
3205433800
Provider SSA County
850
Provider County Name
Wright
Ownership Type
Non profit - Corporation
Number of Certified Beds
35
Number of Residents in Certified Beds
32
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
1985-04-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
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
2.30000
Reported LPN Staffing Hours per Resident per Day
0.46719
Reported RN Staffing Hours per Resident per Day
0.81719
Reported Licensed Staffing Hours per Resident per Day
1.28438
Reported Total Nurse Staffing Hours per Resident per Day
3.58438
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10469
Expected CNA Staffing Hours per Resident per Day
2.31506
Expected LPN Staffing Hours per Resident per Day
0.59471
Expected RN Staffing Hours per Resident per Day
0.80888
Expected Total Nurse Staffing Hours per Resident per Day
3.71865
Adjusted CNA Staffing Hours per Resident per Day
2.43773
Adjusted LPN Staffing Hours per Resident per Day
0.65203
Adjusted RN Staffing Hours per Resident per Day
0.75488
Adjusted Total Nurse Staffing Hours per Resident per Day
3.88536
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-10-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-11-01
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
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2013-01-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
36.66700
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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