Good Samaritan Society – Forest City
Good Samaritan Society – Forest City Information
| Facility Name | Good Samaritan Society - Forest City |
| Location | 606 South Seventh Street, Forest City, IA 50436 |
| County (SSA Code) | Winnebago (940) |
| Phone Number | 641-585-2232 |
| Certification(s) | Medicare and Medicaid |
| Number of Beds | 56 |
| Average Number of Residents | 35 |
| CCRC Facility? | No |
| Medicare Overall Rating | |
| Survey Rating | |
| Quality Rating | |
| Long Stay Quality Rating | |
| Short Stay Quality Rating | |
| Staff Quality Rating | |
| Registered Nurse Quality Rating |
| Abuse Flag | No |
| Sprinklers Installed | Yes |
| Located In Hospital | No |
| Resident Family Council | Resident |
| Provider Business Name | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| Ownership Type | Non profit - Corporation |
| Date First Approved | 1994-04-01 |
| Reported Nurse Aide Staffing Hours per Resident per Day | 2.54433 |
| Reported LPN Staffing Hours per Resident per Day | 0.62087 |
| Reported RN Staffing - Hours per Resident per Day | 0.63478 |
| Reported Licensed Staffing - Hours per Resident per Day (RN + LPN) | 1.25566 |
| Reported Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.79998 |
| Reported Physical Therapy Staffing - Hours per Resident Per Day | 0.02288 |
| Case-Mix Nurse Aide Staffing - Hours per Resident per Day | 2.04107 |
| Case-Mix LPN Staffing - Hours per Resident per Day | 0.63321 |
| Case-Mix RN Staffing - Hours per Resident per Day | 0.27047 |
| Case-Mix Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 2.94475 |
| Adjusted Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 4.11412 |
| Total Weighted Health Survey Score for three cycles | 117.5 |
| Rating cycle 1 Standard Survey Health Date | 2019-10-10 |
| Rating cycle 1 - Health Deficiency Score | 21 |
| Rating cycle 1 - Total Health Inspection Score | 52 |
| Date of Rating cycle 2 Standard Health Survey Date | 2018-07-26 |
| Rating cycle 2 - Health Deficiency Score | 52 |
| Date of Rating cycle 3 Standard Health Survey Date | 2017-05-04 |
| Rating cycle 3 - Health Deficiency Score | 52 |
| Rating cycle 3 - Total Health Inspection Score | 52 |
| Number of Facility-Reported Incidents | 4 |
| Number of Substantiated Complaints | 6 |
| Number of Substantiated Complaints | 6 |
| Number of Fines | 1 |
| Total Amount of Fines (in Dollars) | 21232 |
| Total Number of Penalties | 1 |
| Data Filing Date | 2020-10-01 |
| Page Last Updated | 2020-11-28 |