Good Samaritan Society - Algona
412 West Kennedy Street, Algona, IA 50511


Good Samaritan Society - Algona is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 165190. The address is 412 West Kennedy Street, Algona, IA 50511. The zip code is 50511. The phone number is 5152952414.


Good Samaritan Society - Algona · 412 West Kennedy Street, Algona, IA 50511

Federal Provider Number 165190
Provider Name GOOD SAMARITAN SOCIETY - ALGONA
Address 412 WEST KENNEDY STREET
ALGONA, IA 50511
Phone Number 5152952414
SSA County Code 540
County Name Kossuth
Ownership Type Non profit - Corporation
Certified Beds 90
Certified Beds Residents 81
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Date First Approved to Provide Medicare Medicaid Services 12/01/1993
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 4
Health Inspection Rating 2
Quality Measure Rating 5
Staffing Rating 4
RN Staffing Rating 4
Reported CNA Staffing Hours per Resident per Day 2.65062
Reported LPN Staffing Hours per Resident per Day 0.44444
Reported RN Staffing Hours per Resident per Day 0.63086
Reported Licensed Staffing Hours per Resident per Day 1.07531
Reported Total Nurse Staffing Hours per Resident per Day 3.72592
Expected CNA Staffing Hours per Resident per Day 2.43584
Expected LPN Staffing Hours per Resident per Day 0.55303
Expected RN Staffing Hours per Resident per Day 0.767
Expected Total Nurse Staffing Hours per Resident per Day 3.75587
Adjusted CNA Staffing Hours per Resident per Day 2.67005
Adjusted LPN Staffing Hours per Resident per Day 0.66702
Adjusted RN Staffing Hours per Resident per Day 0.61458
Adjusted Total Nurse Staffing Hours per Resident per Day 3.99876
Cycle 1 Total Number of Health Deficiencies 7
Cycle 1 Number of Standard Health Deficiencies 3
Cycle 1 Number of Complaint Health Deficiencies 4
Cycle 1 Health Deficiency Score 64
Cycle 1 Standard Survey Health Date 12/01/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 64
Cycle 2 Total Number of Health Deficiencies 13
Cycle 2 Number of Standard Health Deficiencies 8
Cycle 2 Number of Complaint Health Deficiencies 13
Cycle 2 Health Deficiency Score 76
Cycle 2 Standard Health Survey Date 11/19/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 76
Cycle 3 Total Number of Health Deficiencies 1
Cycle 3 Number of Standard Health Deficiencies 1
Cycle 3 Number of Complaint Health Deficiencies 1
Cycle 3 Health Deficiency Score 20
Cycle 3 Standard Health Survey Date 10/16/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 20
Total Weighted Health Survey Score 60.667
Number of Facility Reported Incidents 4
Number of Substantiated Complaints 4
Number of Fines 1
Total Amount of Fines in Dollars $54340.00
Number of Payment Denials 1
Total Number of Penalties 2
Processing Date 08/01/2017

Owner or Manager · Good Samaritan Society - Algona

Owner Name Role Association Date
CONNELLY, LIANE (Individual) DIRECTOR since 06/25/2013
DEUTH, MICHAEL (Individual) DIRECTOR since 06/19/2012
GARD, ALAN (Individual) DIRECTOR since 06/24/2014
GAUSE, SYLVIA (Individual) OFFICER since 07/20/1993
GRINDAL, HARALD (Individual) DIRECTOR since 06/19/2012
GULSVIG, NEIL (Individual) DIRECTOR since 06/23/2009
HALAAS, GWEN (Individual) DIRECTOR since 06/25/2013
HAM-QUICK, MISTY (Individual) OFFICER since 12/11/2010
HERDINA, JOSEPH (Individual) OFFICER since 01/22/2012
HILDEBRANDT, TERESA (Individual) DIRECTOR since 06/23/2009
HOLT, JOHN (Individual) DIRECTOR since 06/22/2010
HORAZDOVSKY, DAVID (Individual) OFFICER since 07/02/2003
KERN, JOHN (Individual) MANAGING EMPLOYEE since 07/18/2007
MARCH-CURTIS, CONNIE (Individual) DIRECTOR since 06/24/2014
MATSON, GUY (Individual) DIRECTOR since 06/25/2013
PETERSON, BERGEN (Individual) OFFICER since 01/17/2015
RACEK, JOHN (Individual) DIRECTOR since 06/25/2013
SAMUELSON, PHILIP (Individual) DIRECTOR since 06/25/2013
SCHARNBERG, MARK (Individual) MANAGING EMPLOYEE since 12/27/2010
ST MARY, SHARON (Individual) DIRECTOR since 06/14/2011
STENE, DENNIS (Individual) DIRECTOR since 06/24/2014
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 12/01/1993
TRIBBLE, GEORGE (Individual) OFFICER since 12/01/2014
TROUT, CARLA (Individual) DIRECTOR since 06/24/2014

50511 · Nursing Home

Algona Manor Care Center 2221 East Mcgregor Street, Algona, IA 50511

Algona · Nursing Home

Algona Manor Care Center 2221 East Mcgregor Street, Algona, IA 50511

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