Good Samaritan Society - Woodland - Brainerd Nursing Home
General Information
UPDATEFederal Provider Number
245488
Provider Name
GOOD SAMARITAN SOCIETY - WOODLAND
Provider Address
100 BUFFALO HILLS LANE
BRAINERD, MN 56401
BRAINERD, MN 56401
Provider Phone Number
(218) 829-1429
Provider SSA County
170
Provider County Name
Crow Wing
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
42
Number of Residents in Certified Beds
40
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
1987-07-01
Continuing Care Retirement Community
N
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
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
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
2.16125
Reported LPN Staffing Hours per Resident per Day
0.55250
Reported RN Staffing Hours per Resident per Day
1.09000
Reported Licensed Staffing Hours per Resident per Day
1.64250
Reported Total Nurse Staffing Hours per Resident per Day
3.80375
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03875
Expected CNA Staffing Hours per Resident per Day
2.55970
Expected LPN Staffing Hours per Resident per Day
0.66140
Expected RN Staffing Hours per Resident per Day
1.06929
Expected Total Nurse Staffing Hours per Resident per Day
4.29039
Adjusted CNA Staffing Hours per Resident per Day
2.07175
Adjusted LPN Staffing Hours per Resident per Day
0.69334
Adjusted RN Staffing Hours per Resident per Day
0.76167
Adjusted Total Nurse Staffing Hours per Resident per Day
3.57370
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-12-31
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
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
8
Cycle 2 Standard Health Survey Date
2014-01-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2013-06-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
23.33300
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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