Good Samaritan Society - Lemars - Le Mars Nursing Home

General Information

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Federal Provider Number
165205
Provider Name
GOOD SAMARITAN SOCIETY - LEMARS
Provider Address
1140 LINCOLN STREET NE
LE MARS, IA 51031
Provider Phone Number
(712) 546-4101
Provider SSA County
740
Provider County Name
Plymouth
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
65
Number of Residents in Certified Beds
62
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
2.75484
Reported LPN Staffing Hours per Resident per Day
0.53629
Reported RN Staffing Hours per Resident per Day
0.73065
Reported Licensed Staffing Hours per Resident per Day
1.26694
Reported Total Nurse Staffing Hours per Resident per Day
4.02178
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01371
Expected CNA Staffing Hours per Resident per Day
2.35466
Expected LPN Staffing Hours per Resident per Day
0.60391
Expected RN Staffing Hours per Resident per Day
0.91986
Expected Total Nurse Staffing Hours per Resident per Day
3.87842
Adjusted CNA Staffing Hours per Resident per Day
2.87072
Adjusted LPN Staffing Hours per Resident per Day
0.73707
Adjusted RN Staffing Hours per Resident per Day
0.59351
Adjusted Total Nurse Staffing Hours per Resident per Day
4.17989
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2015-04-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
72
Cycle 2 Standard Health Survey Date
2014-01-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
72
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
20
Cycle 3 Standard Health Survey Date
2012-11-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
37.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
3
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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