The Good Samaritan Society-jeffersontown - Jeffersontown Nursing Home
General Information
UPDATEFederal Provider Number
185268
Provider Name
THE GOOD SAMARITAN SOCIETY-JEFFERSONTOWN
Provider Address
3500 GOOD SAMARITAN WAY
JEFFERSONTOWN, KY 40299
JEFFERSONTOWN, KY 40299
Provider Phone Number
(502) 267-7403
Provider SSA County
550
Provider County Name
Jefferson
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
98
Number of Residents in Certified Beds
77
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
1991-07-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.22468
Reported LPN Staffing Hours per Resident per Day
1.21169
Reported RN Staffing Hours per Resident per Day
0.55325
Reported Licensed Staffing Hours per Resident per Day
1.76494
Reported Total Nurse Staffing Hours per Resident per Day
3.98962
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07403
Expected CNA Staffing Hours per Resident per Day
2.33926
Expected LPN Staffing Hours per Resident per Day
0.62606
Expected RN Staffing Hours per Resident per Day
1.00707
Expected Total Nurse Staffing Hours per Resident per Day
3.97239
Adjusted CNA Staffing Hours per Resident per Day
2.33351
Adjusted LPN Staffing Hours per Resident per Day
1.60641
Adjusted RN Staffing Hours per Resident per Day
0.41049
Adjusted Total Nurse Staffing Hours per Resident per Day
4.04838
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
312
Cycle 1 Standard Survey Health Date
2014-10-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
312
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-10-31
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
149
Cycle 3 Standard Health Survey Date
2012-11-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
149
Total Weighted Health Survey Score
188.83300
Number of Facility Reported Incidents
6
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
99060
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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