Good Samaritan Society Sioux Falls Village - Sioux Falls Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
435045
Provider Name
GOOD SAMARITAN SOCIETY SIOUX FALLS VILLAGE
Provider Address
3901 S MARION RD
SIOUX FALLS, SD 57106
SIOUX FALLS, SD 57106
Provider Phone Number
(605) 361-3311
Provider SSA County
490
Provider County Name
Minnehaha
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
188
Number of Residents in Certified Beds
182
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
1990-07-01
Continuing Care Retirement Community
Y
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
2.48352
Reported LPN Staffing Hours per Resident per Day
0.33132
Reported RN Staffing Hours per Resident per Day
0.96154
Reported Licensed Staffing Hours per Resident per Day
1.29286
Reported Total Nurse Staffing Hours per Resident per Day
3.77638
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07170
Expected CNA Staffing Hours per Resident per Day
2.53200
Expected LPN Staffing Hours per Resident per Day
0.57322
Expected RN Staffing Hours per Resident per Day
0.86564
Expected Total Nurse Staffing Hours per Resident per Day
3.97085
Adjusted CNA Staffing Hours per Resident per Day
2.40672
Adjusted LPN Staffing Hours per Resident per Day
0.47974
Adjusted RN Staffing Hours per Resident per Day
0.82998
Adjusted Total Nurse Staffing Hours per Resident per Day
3.83349
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
6
Cycle 1 Health Deficiency Score
88
Cycle 1 Standard Survey Health Date
2014-07-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
88
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-08-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
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
28
Cycle 3 Standard Health Survey Date
2012-09-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
63.33300
Number of Facility Reported Incidents
4
Number of Substantiated Complaints
2
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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