Good Samaritan Society - Mountain Home - Mountain Home Nursing Home
General Information
UPDATEFederal Provider Number
45250
Provider Name
GOOD SAMARITAN SOCIETY - MOUNTAIN HOME
Provider Address
300 GOOD SAMARITAN DRIVE
MOUNTAIN HOME, AR 72653
MOUNTAIN HOME, AR 72653
Provider Phone Number
(870) 425-2494
Provider SSA County
20
Provider County Name
Baxter
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
70
Number of Residents in Certified Beds
63
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
1994-12-01
Continuing Care Retirement Community
Y
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
2.27222
Reported LPN Staffing Hours per Resident per Day
0.96349
Reported RN Staffing Hours per Resident per Day
0.66111
Reported Licensed Staffing Hours per Resident per Day
1.62460
Reported Total Nurse Staffing Hours per Resident per Day
3.89682
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01825
Expected CNA Staffing Hours per Resident per Day
2.41047
Expected LPN Staffing Hours per Resident per Day
0.56208
Expected RN Staffing Hours per Resident per Day
0.83830
Expected Total Nurse Staffing Hours per Resident per Day
3.81084
Adjusted CNA Staffing Hours per Resident per Day
2.31297
Adjusted LPN Staffing Hours per Resident per Day
1.42275
Adjusted RN Staffing Hours per Resident per Day
0.58927
Adjusted Total Nurse Staffing Hours per Resident per Day
4.12184
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2015-01-23
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
20
Cycle 1 Total Health Score
60
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
28
Cycle 2 Standard Health Survey Date
2014-03-21
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
14
Cycle 2 Total Health Score
42
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
265
Cycle 3 Standard Health Survey Date
2013-04-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
265
Total Weighted Health Survey Score
88.16700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
Number of Fines
2
Total Amount of Fines in Dollars
6500
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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