Good Samaritan Society-scandia Village
Good Samaritan Society-scandia Village Information
| Facility Name | Good Samaritan Society-scandia Village |
| Location | 10560 Applewood Rd, Sister Bay, WI 54234 |
| County (SSA Code) | Door (140) |
| Phone Number | 920-854-2317 |
| Certification(s) | Medicare and Medicaid |
| Number of Beds | 50 |
| Average Number of Residents | 41.8 |
| 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 | 1992-10-11 |
| Reported Nurse Aide Staffing Hours per Resident per Day | 2.40009 |
| Reported LPN Staffing Hours per Resident per Day | 0.30987 |
| Reported RN Staffing - Hours per Resident per Day | 1.10428 |
| Reported Licensed Staffing - Hours per Resident per Day (RN + LPN) | 1.41416 |
| Reported Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.81425 |
| Reported Physical Therapy Staffing - Hours per Resident Per Day | 0.05705 |
| Case-Mix Nurse Aide Staffing - Hours per Resident per Day | 2.01575 |
| Case-Mix LPN Staffing - Hours per Resident per Day | 0.64565 |
| Case-Mix RN Staffing - Hours per Resident per Day | 0.29052 |
| Case-Mix Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 2.95193 |
| Adjusted Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 4.11952 |
| Total Weighted Health Survey Score for three cycles | 37.333 |
| Rating cycle 1 Standard Survey Health Date | 2020-01-30 |
| Rating cycle 1 - Health Deficiency Score | 5 |
| Rating cycle 1 - Total Health Inspection Score | 24 |
| Date of Rating cycle 2 Standard Health Survey Date | 2019-03-20 |
| Rating cycle 2 - Health Deficiency Score | 24 |
| Date of Rating cycle 3 Standard Health Survey Date | 2017-12-07 |
| Rating cycle 3 - Health Deficiency Score | 20 |
| Rating cycle 3 - Total Health Inspection Score | 20 |
| Number of Facility-Reported Incidents | 1 |
| Number of Substantiated Complaints | 2 |
| Number of Substantiated Complaints | 2 |
| Total Number of Penalties | 0 |
| Data Filing Date | 2020-10-01 |
| Page Last Updated | 2020-11-28 |