Iowa Nursing Homes >> Villisca Nursing Homes >> Good Samaritan Society - Villisca

Good Samaritan Society - Villisca - Villisca Nursing Home

General Information

UPDATE
Federal Provider Number
165189
Provider Name
GOOD SAMARITAN SOCIETY - VILLISCA
Provider Address
202 NORTH CENTRAL AVENUE
VILLISCA, IA 50864
Provider Phone Number
7128269592
Provider SSA County
680
Provider County Name
Montgomery
Ownership Type
Non profit - Corporation
Number of Certified Beds
46
Number of Residents in Certified Beds
38
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
1993-11-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
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
2
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
2.21447
Reported LPN Staffing Hours per Resident per Day
0.53947
Reported RN Staffing Hours per Resident per Day
0.84868
Reported Licensed Staffing Hours per Resident per Day
1.38816
Reported Total Nurse Staffing Hours per Resident per Day
3.60262
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03947
Expected CNA Staffing Hours per Resident per Day
2.35001
Expected LPN Staffing Hours per Resident per Day
0.63151
Expected RN Staffing Hours per Resident per Day
0.94161
Expected Total Nurse Staffing Hours per Resident per Day
3.92313
Adjusted CNA Staffing Hours per Resident per Day
2.31218
Adjusted LPN Staffing Hours per Resident per Day
0.70903
Adjusted RN Staffing Hours per Resident per Day
0.67346
Adjusted Total Nurse Staffing Hours per Resident per Day
3.70158
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-09-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-08-01
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
3
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-06-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
19.33300
Number of Facility Reported Incidents
1
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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