Good Samaritan Society - Minneapolis
815 N Rothsay Street, Minneapolis, KS 67467


Good Samaritan Society - Minneapolis is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 175282. The address is 815 N Rothsay Street, Minneapolis, KS 67467. The zip code is 67467. The phone number is 7853922162.


Good Samaritan Society - Minneapolis · 815 N Rothsay Street, Minneapolis, KS 67467

Federal Provider Number 175282
Provider Name GOOD SAMARITAN SOCIETY - MINNEAPOLIS
Address 815 N ROTHSAY STREET
MINNEAPOLIS, KS 67467
Phone Number 7853922162
SSA County Code 710
County Name Ottawa
Ownership Type Non profit - Church related
Certified Beds 64
Certified Beds Residents 56
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 03/01/1994
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 2
Health Inspection Rating 1
Quality Measure Rating 2
Staffing Rating 4
RN Staffing Rating 3
Reported CNA Staffing Hours per Resident per Day 2.73214
Reported LPN Staffing Hours per Resident per Day 1.11518
Reported RN Staffing Hours per Resident per Day 0.48393
Reported Licensed Staffing Hours per Resident per Day 1.59911
Reported Total Nurse Staffing Hours per Resident per Day 4.33125
Reported Physical Therapist Staffing Hours per Resident Per Day 0.00982
Expected CNA Staffing Hours per Resident per Day 2.31751
Expected LPN Staffing Hours per Resident per Day 0.53986
Expected RN Staffing Hours per Resident per Day 0.78909
Expected Total Nurse Staffing Hours per Resident per Day 3.64646
Adjusted CNA Staffing Hours per Resident per Day 2.89269
Adjusted LPN Staffing Hours per Resident per Day 1.71452
Adjusted RN Staffing Hours per Resident per Day 0.45824
Adjusted Total Nurse Staffing Hours per Resident per Day 4.78788
Cycle 1 Total Number of Health Deficiencies 23
Cycle 1 Number of Standard Health Deficiencies 17
Cycle 1 Number of Complaint Health Deficiencies 8
Cycle 1 Health Deficiency Score 176
Cycle 1 Standard Survey Health Date 05/26/2016
Cycle 1 Number of Health Revisits 2
Cycle 1 Health Revisit Score 88
Cycle 1 Total Health Score 264
Cycle 2 Total Number of Health Deficiencies 34
Cycle 2 Number of Standard Health Deficiencies 8
Cycle 2 Number of Complaint Health Deficiencies 26
Cycle 2 Health Deficiency Score 704
Cycle 2 Standard Health Survey Date 02/04/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 704
Cycle 3 Total Number of Health Deficiencies 16
Cycle 3 Number of Standard Health Deficiencies 15
Cycle 3 Number of Complaint Health Deficiencies 1
Cycle 3 Health Deficiency Score 120
Cycle 3 Standard Health Survey Date 11/04/2013
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 120
Total Weighted Health Survey Score 386.667
Number of Facility Reported Incidents 13
Number of Substantiated Complaints 3
Number of Fines 3
Total Amount of Fines in Dollars $312460.00
Number of Payment Denials 3
Total Number of Penalties 6
Processing Date 08/01/2017

Owner or Manager · Good Samaritan Society - Minneapolis

Owner Name Role Association Date
CAMERO, PATRICIA (Individual) DIRECTOR since 06/16/2015
DEUTH, MICHAEL (Individual) DIRECTOR since 06/19/2012
GARD, ALAN (Individual) DIRECTOR since 06/24/2014
GRINDAL, HARALD (Individual) DIRECTOR since 06/19/2012
HALAAS, GWEN (Individual) DIRECTOR since 06/25/2013
HAM-QUICK, MISTY (Individual) OFFICER since 12/11/2010
HERDINA, JOSEPH (Individual) OFFICER since 01/22/2010
HORAZDOVSKY, DAVID (Individual) OFFICER since 07/02/2003
KAPUSTA, THOMAS (Individual) OFFICER since 01/29/2015
KRZMARZICK, HEATHER (Individual) DIRECTOR since 06/16/2015
LAAVEG, LEE (Individual) DIRECTOR since 06/28/2016
MARCH-CURTIS, CONNIE (Individual) DIRECTOR since 06/24/2014
PARRA, RICHARD (Individual) MANAGING EMPLOYEE since 04/04/2016
PETERSON, BERGEN (Individual) OFFICER since 01/17/2015
RACEK, JOHN (Individual) DIRECTOR since 06/25/2013
ROBINSON, DINA (Individual) DIRECTOR since 06/28/2016
SCHARNBERG, MARK (Individual) MANAGING EMPLOYEE since 12/27/2010
SCHUMANN, JILL (Individual) DIRECTOR since 06/15/2015
ST MARY, SHARON (Individual) DIRECTOR since 06/14/2011
STENE, DENNIS (Individual) DIRECTOR since 06/24/2014
SYVERSON, THOMAS (Individual) OFFICER since 02/28/2014
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 05/01/1991
THOMPSON, DALE (Individual) DIRECTOR since 01/01/2016
TRIBBLE, GEORGE (Individual) OFFICER since 12/01/2014

street_number: 815
route: North Rothsay Avenue (N Rothsay Ave)
locality, political: Minneapolis
admin_level_2, political: Ottawa County
admin_level_1, political: Kansas (KS)
country, political: United States (US)
postal_code: 67467
postal_code_suffix: 1637
types : street_address
latitude: 39.1293195
longitude: -97.7016142
latlng: (39.1293195, -97.7016142)


67467 · Nursing Home

Ottawa County Health Center Ltcu 215 E 8th Street, Minneapolis, KS 67467

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