Good Samaritan Society - West Union - West Union Nursing Home
General Information
UPDATEFederal Provider Number
165187
Provider Name
GOOD SAMARITAN SOCIETY - WEST UNION
Provider Address
201 HALL STREET
WEST UNION, IA 52175
WEST UNION, IA 52175
Provider Phone Number
5634223814
Provider SSA County
320
Provider County Name
Fayette
Ownership Type
Non profit - Corporation
Number of Certified Beds
71
Number of Residents in Certified Beds
60
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
1993-10-01
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
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
2.05250
Reported LPN Staffing Hours per Resident per Day
0.42333
Reported RN Staffing Hours per Resident per Day
0.62667
Reported Licensed Staffing Hours per Resident per Day
1.05000
Reported Total Nurse Staffing Hours per Resident per Day
3.10250
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.25544
Expected LPN Staffing Hours per Resident per Day
0.55119
Expected RN Staffing Hours per Resident per Day
0.78724
Expected Total Nurse Staffing Hours per Resident per Day
3.59386
Adjusted CNA Staffing Hours per Resident per Day
2.23292
Adjusted LPN Staffing Hours per Resident per Day
0.63747
Adjusted RN Staffing Hours per Resident per Day
0.59480
Adjusted Total Nurse Staffing Hours per Resident per Day
3.47978
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-02-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-01-10
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
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2011-12-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
20.66700
Number of Facility Reported Incidents
1
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
Nursiong Homes Nearby
Maple Crest Manor
100 Bolger Drive |
FAYETTE IA 52142 | 8.9 miles away
Mercy Hospital Of The Franciscan Sisters
201 Eighth Avenue Se |
OELWEIN IA 50662 | 21 miles away
Grandview Healthcare Center
800 Fifth Street Se |
OELWEIN IA 50662 | 21.2 miles away
Oelwein Health Care Center
600 Seventh Street Se |
OELWEIN IA 50662 | 21.4 miles away
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