Colorado Nursing Homes >> Simla Nursing Homes >> Good Samaritan Society Simla

Good Samaritan Society Simla - Simla Nursing Home

General Information

UPDATE
Federal Provider Number
06A171
Provider Name
GOOD SAMARITAN SOCIETY SIMLA
Provider Address
320 PUEBLO AVENUE
SIMLA, CO 80835
Provider Phone Number
7195412269
Provider SSA County
190
Provider County Name
Elbert
Ownership Type
Non profit - Corporation
Number of Certified Beds
30
Number of Residents in Certified Beds
28
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1991-05-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
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
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
2.32679
Reported LPN Staffing Hours per Resident per Day
0.57321
Reported RN Staffing Hours per Resident per Day
0.70714
Reported Licensed Staffing Hours per Resident per Day
1.28036
Reported Total Nurse Staffing Hours per Resident per Day
3.60714
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.43119
Expected LPN Staffing Hours per Resident per Day
0.60179
Expected RN Staffing Hours per Resident per Day
0.84798
Expected Total Nurse Staffing Hours per Resident per Day
3.88095
Adjusted CNA Staffing Hours per Resident per Day
2.34833
Adjusted LPN Staffing Hours per Resident per Day
0.79059
Adjusted RN Staffing Hours per Resident per Day
0.62310
Adjusted Total Nurse Staffing Hours per Resident per Day
3.74651
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
72
Cycle 1 Standard Survey Health Date
2014-11-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
72
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-01-29
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2013-01-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
37.33300
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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