Good Samaritan Society - Pine River - Pine River Nursing Home

General Information

UPDATE
Federal Provider Number
245476
Provider Name
GOOD SAMARITAN SOCIETY - PINE RIVER
Provider Address
518 JEFFERSON AVENUE, PO BOX 29
PINE RIVER, MN 56474
Provider Phone Number
2185874423
Provider SSA County
100
Provider County Name
Cass
Ownership Type
Non profit - Corporation
Number of Certified Beds
56
Number of Residents in Certified Beds
52
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
1987-05-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
1.67596
Reported LPN Staffing Hours per Resident per Day
0.87500
Reported RN Staffing Hours per Resident per Day
1.00673
Reported Licensed Staffing Hours per Resident per Day
1.88173
Reported Total Nurse Staffing Hours per Resident per Day
3.55769
Reported Physical Therapist Staffing Hours per Resident Per Day
0.15192
Expected CNA Staffing Hours per Resident per Day
2.55745
Expected LPN Staffing Hours per Resident per Day
0.63030
Expected RN Staffing Hours per Resident per Day
0.97201
Expected Total Nurse Staffing Hours per Resident per Day
4.15977
Adjusted CNA Staffing Hours per Resident per Day
1.60797
Adjusted LPN Staffing Hours per Resident per Day
1.15223
Adjusted RN Staffing Hours per Resident per Day
0.77389
Adjusted Total Nurse Staffing Hours per Resident per Day
3.44747
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-04-04
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-01-10
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2011-11-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
14.66700
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

Nursiong Homes Nearby

Golden Livingcenter - Walker

209 Birchwood Avenue West Po Box 700 | WALKER MN 56484 | 27 miles away

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