Good Samaritan Society - International Falls - International Falls Nursing Home
General Information
UPDATEFederal Provider Number
245318
Provider Name
GOOD SAMARITAN SOCIETY - INTERNATIONAL FALLS
Provider Address
2201 KEENAN DRIVE
INTERNATIONAL FALLS, MN 56649
INTERNATIONAL FALLS, MN 56649
Provider Phone Number
(218) 283-8313
Provider SSA County
350
Provider County Name
Koochiching
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
54
Number of Residents in Certified Beds
53
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
1986-06-01
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
2
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.19811
Reported LPN Staffing Hours per Resident per Day
0.98868
Reported RN Staffing Hours per Resident per Day
0.49057
Reported Licensed Staffing Hours per Resident per Day
1.47925
Reported Total Nurse Staffing Hours per Resident per Day
3.67736
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10755
Expected CNA Staffing Hours per Resident per Day
2.35175
Expected LPN Staffing Hours per Resident per Day
0.57200
Expected RN Staffing Hours per Resident per Day
0.85680
Expected Total Nurse Staffing Hours per Resident per Day
3.78054
Adjusted CNA Staffing Hours per Resident per Day
2.29340
Adjusted LPN Staffing Hours per Resident per Day
1.43463
Adjusted RN Staffing Hours per Resident per Day
0.42782
Adjusted Total Nurse Staffing Hours per Resident per Day
3.92088
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
40
Cycle 1 Standard Survey Health Date
2015-01-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2014-03-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2013-08-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
38.00000
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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Nursiong Homes Nearby
Littlefork Medical Center
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LITTLEFORK MN 56653 | 14 miles away