Wisconsin Nursing Homes >> Sister Bay Nursing Homes >> Good Samaritan Society-scandia Village

Good Samaritan Society-scandia Village - Sister Bay Nursing Home

General Information

UPDATE
Federal Provider Number
525494
Provider Name
GOOD SAMARITAN SOCIETY-SCANDIA VILLAGE
Provider Address
10560 APPLEWOOD RD
SISTER BAY, WI 54234
Provider Phone Number
9208542317
Provider SSA County
140
Provider County Name
Door
Ownership Type
Non profit - Corporation
Number of Certified Beds
60
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
1992-10-11
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
4
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
2.70865
Reported LPN Staffing Hours per Resident per Day
0.43558
Reported RN Staffing Hours per Resident per Day
0.84615
Reported Licensed Staffing Hours per Resident per Day
1.28173
Reported Total Nurse Staffing Hours per Resident per Day
3.99038
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03846
Expected CNA Staffing Hours per Resident per Day
2.52788
Expected LPN Staffing Hours per Resident per Day
0.58618
Expected RN Staffing Hours per Resident per Day
0.86536
Expected Total Nurse Staffing Hours per Resident per Day
3.97942
Adjusted CNA Staffing Hours per Resident per Day
2.62917
Adjusted LPN Staffing Hours per Resident per Day
0.61675
Adjusted RN Staffing Hours per Resident per Day
0.73062
Adjusted Total Nurse Staffing Hours per Resident per Day
4.04200
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-07-17
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
38
Cycle 1 Total Health Score
114
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-05-23
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
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-04-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
69.66700
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

Door County Memorial Hospital Snf

323 S 18th Ave | STURGEON BAY WI 54235 | 26.7 miles away

Golden Livingcenter-dorchester

200 N Seventh Ave | STURGEON BAY WI 54235 | 26.8 miles away

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