Good Samaritan Society - Scribner - Scribner Nursing Home

General Information

UPDATE
Federal Provider Number
285196
Provider Name
GOOD SAMARITAN SOCIETY - SCRIBNER
Provider Address
815 LOGAN STREET
SCRIBNER, NE 68057
Provider Phone Number
4026642527
Provider SSA County
260
Provider County Name
Dodge
Ownership Type
Non profit - Corporation
Number of Certified Beds
73
Number of Residents in Certified Beds
36
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
1996-08-01
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
1
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.33611
Reported LPN Staffing Hours per Resident per Day
0.67778
Reported RN Staffing Hours per Resident per Day
0.51806
Reported Licensed Staffing Hours per Resident per Day
1.19583
Reported Total Nurse Staffing Hours per Resident per Day
3.53195
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12639
Expected CNA Staffing Hours per Resident per Day
2.32116
Expected LPN Staffing Hours per Resident per Day
0.57880
Expected RN Staffing Hours per Resident per Day
0.81838
Expected Total Nurse Staffing Hours per Resident per Day
3.71835
Adjusted CNA Staffing Hours per Resident per Day
2.46950
Adjusted LPN Staffing Hours per Resident per Day
0.97193
Adjusted RN Staffing Hours per Resident per Day
0.47300
Adjusted Total Nurse Staffing Hours per Resident per Day
3.82883
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-05-28
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
7
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2013-02-21
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
32
Cycle 3 Standard Health Survey Date
2011-11-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
52.66700
Number of Facility Reported Incidents
20
Number of Substantiated Complaints
4
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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