Good Samaritan Society – Grand Island Village
Good Samaritan Society – Grand Island Village Information
| Facility Name | Good Samaritan Society - Grand Island Village |
| Location | 4061 Timberline Street & 4055 Timberline Street, Grand Island, NE 68803 |
| County (SSA Code) | Hall (390) |
| Phone Number | 308-384-3535 |
| Certification(s) | Medicare and Medicaid |
| Number of Beds | 67 |
| Average Number of Residents | 45.8 |
| CCRC Facility? | Yes |
| Medicare Overall Rating | |
| Survey Rating | |
| Quality Rating | |
| Long Stay Quality Rating | |
| Short Stay Quality Rating | |
| Staff Quality Rating | |
| Registered Nurse Quality Rating |
| Abuse Flag | Yes |
| 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 | 2010-09-01 |
| Reported Nurse Aide Staffing Hours per Resident per Day | 2.77625 |
| Reported LPN Staffing Hours per Resident per Day | 1.65392 |
| Reported RN Staffing - Hours per Resident per Day | 0.54471 |
| Reported Licensed Staffing - Hours per Resident per Day (RN + LPN) | 2.19863 |
| Reported Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 4.97488 |
| Reported Physical Therapy Staffing - Hours per Resident Per Day | 0.12074 |
| Case-Mix Nurse Aide Staffing - Hours per Resident per Day | 2.04771 |
| Case-Mix LPN Staffing - Hours per Resident per Day | 0.68044 |
| Case-Mix RN Staffing - Hours per Resident per Day | 0.29071 |
| Case-Mix Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.01887 |
| Adjusted Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 5.25391 |
| Total Weighted Health Survey Score for three cycles | 139.333 |
| Rating cycle 1 Standard Survey Health Date | 2019-09-26 |
| Rating cycle 1 - Health Deficiency Score | 27 |
| Rating cycle 1 - Total Health Inspection Score | 104 |
| Date of Rating cycle 2 Standard Health Survey Date | 2018-06-11 |
| Rating cycle 2 - Health Deficiency Score | 104 |
| Date of Rating cycle 3 Standard Health Survey Date | 2017-05-25 |
| Rating cycle 3 - Health Deficiency Score | 28 |
| Rating cycle 3 - Total Health Inspection Score | 28 |
| Number of Facility-Reported Incidents | 12 |
| Number of Substantiated Complaints | 9 |
| Number of Substantiated Complaints | 9 |
| Number of Payment Denials | 1 |
| Total Number of Penalties | 1 |
| Data Filing Date | 2020-10-01 |
| Page Last Updated | 2020-11-28 |