Good Samaritan Society - Mountain View Manor - Eureka Nursing Home
General Information
UPDATEFederal Provider Number
275084
Provider Name
GOOD SAMARITAN SOCIETY - MOUNTAIN VIEW MANOR
Provider Address
10 MOUNTAIN VIEW DR
EUREKA, MT 59917
EUREKA, MT 59917
Provider Phone Number
4062972541
Provider SSA County
260
Provider County Name
Lincoln
Ownership Type
Non profit - Corporation
Number of Certified Beds
49
Number of Residents in Certified Beds
41
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
1978-01-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
2.16220
Reported LPN Staffing Hours per Resident per Day
0.32317
Reported RN Staffing Hours per Resident per Day
0.75732
Reported Licensed Staffing Hours per Resident per Day
1.08049
Reported Total Nurse Staffing Hours per Resident per Day
3.24269
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.38797
Expected LPN Staffing Hours per Resident per Day
0.60729
Expected RN Staffing Hours per Resident per Day
0.84760
Expected Total Nurse Staffing Hours per Resident per Day
3.84287
Adjusted CNA Staffing Hours per Resident per Day
2.22171
Adjusted LPN Staffing Hours per Resident per Day
0.44168
Adjusted RN Staffing Hours per Resident per Day
0.66761
Adjusted Total Nurse Staffing Hours per Resident per Day
3.40136
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-07-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-06-06
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
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-05-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
16.66700
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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