Good Samaritan Society - Spokane Valley - Spokane Valley Nursing Home
General Information
UPDATEFederal Provider Number
505099
Provider Name
GOOD SAMARITAN SOCIETY - SPOKANE VALLEY
Provider Address
EAST 17121 EIGHTH AVENUE
SPOKANE VALLEY, WA 99016
SPOKANE VALLEY, WA 99016
Provider Phone Number
(509) 924-6161
Provider SSA County
310
Provider County Name
Spokane
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
97
Number of Residents in Certified Beds
86
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
1967-01-01
Continuing Care Retirement Community
Y
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
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
5
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
2.39826
Reported LPN Staffing Hours per Resident per Day
0.49244
Reported RN Staffing Hours per Resident per Day
1.41860
Reported Licensed Staffing Hours per Resident per Day
1.91105
Reported Total Nurse Staffing Hours per Resident per Day
4.30930
Reported Physical Therapist Staffing Hours per Resident Per Day
0.17791
Expected CNA Staffing Hours per Resident per Day
2.51917
Expected LPN Staffing Hours per Resident per Day
0.55755
Expected RN Staffing Hours per Resident per Day
0.82236
Expected Total Nurse Staffing Hours per Resident per Day
3.89909
Adjusted CNA Staffing Hours per Resident per Day
2.33593
Adjusted LPN Staffing Hours per Resident per Day
0.73307
Adjusted RN Staffing Hours per Resident per Day
1.28894
Adjusted Total Nurse Staffing Hours per Resident per Day
4.45498
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2015-04-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
88
Cycle 2 Standard Health Survey Date
2014-02-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
88
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-12-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
46.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
1040
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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