Good Samaritan Society - Jackson
601 West Jackson, Jackson, MN 56143

Good Samaritan Society - Jackson is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 245455. The address is 601 West Jackson, Jackson, MN 56143. The zip code is 56143. The phone number is 5078473100.

Good Samaritan Society - Jackson · 601 West Jackson, Jackson, MN 56143

Federal Provider Number 245455
Address 601 WEST JACKSON
Phone Number 5078473100
SSA County Code 310
County Name Jackson
Ownership Type Non profit - Corporation
Certified Beds 57
Certified Beds Residents 43
Provider Type Medicare and Medicaid
Resides in Hospital false
Date First Approved to Provide Medicare Medicaid Services 04/01/1987
Continuing Care Retirement Community true
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Both
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 5
Reported CNA Staffing Hours per Resident per Day 2.41047
Reported LPN Staffing Hours per Resident per Day 0.63721
Reported RN Staffing Hours per Resident per Day 1.04884
Reported Licensed Staffing Hours per Resident per Day 1.68605
Reported Total Nurse Staffing Hours per Resident per Day 4.09652
Reported Physical Therapist Staffing Hours per Resident Per Day 0.01628
Expected CNA Staffing Hours per Resident per Day 2.50576
Expected LPN Staffing Hours per Resident per Day 0.61843
Expected RN Staffing Hours per Resident per Day 0.84907
Expected Total Nurse Staffing Hours per Resident per Day 3.97326
Adjusted CNA Staffing Hours per Resident per Day 2.36039
Adjusted LPN Staffing Hours per Resident per Day 0.8552
Adjusted RN Staffing Hours per Resident per Day 0.92301
Adjusted Total Nurse Staffing Hours per Resident per Day 4.15595
Cycle 1 Total Number of Health Deficiencies 9
Cycle 1 Number of Standard Health Deficiencies 9
Cycle 1 Health Deficiency Score 36
Cycle 1 Standard Survey Health Date 03/09/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 36
Cycle 2 Total Number of Health Deficiencies 8
Cycle 2 Number of Standard Health Deficiencies 6
Cycle 2 Number of Complaint Health Deficiencies 2
Cycle 2 Health Deficiency Score 52
Cycle 2 Standard Health Survey Date 05/26/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 52
Cycle 3 Total Number of Health Deficiencies 2
Cycle 3 Number of Standard Health Deficiencies 2
Cycle 3 Health Deficiency Score 12
Cycle 3 Standard Health Survey Date 08/20/2015
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 12
Total Weighted Health Survey Score 37.333
Number of Substantiated Complaints 1
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Good Samaritan Society - Jackson

Owner Name Role Association Date
BROWN, ELWIN (Individual) DIRECTOR since 06/14/2011
CONNELLY, LIANE (Individual) DIRECTOR since 06/25/2013
DEUTH, MICHAEL (Individual) DIRECTOR since 06/19/2012
GAUSE, SYLVIA (Individual) OFFICER since 07/20/1993
GRINDAL, HARALD (Individual) DIRECTOR since 06/19/2012
GULSVIG, NEIL (Individual) DIRECTOR since 06/23/2009
GUSTAFSON, KARI (Individual) DIRECTOR since 06/14/2011
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
HILDEBRANDT, TERESA (Individual) DIRECTOR since 06/25/2013
HOLT, JOHN (Individual) DIRECTOR since 06/22/2010
HORAZDOVSKY, DAVID (Individual) OFFICER since 07/02/2003
HORMANN, GORDON (Individual) MANAGING EMPLOYEE since 07/19/2007
JOHNSON, CHRISTOPHER (Individual) DIRECTOR since 07/22/2008
JUFFER, MICHELE (Individual) DIRECTOR since 06/22/2010
MATSON, GUY (Individual) DIRECTOR since 06/25/2013
NYLANDER, RAYE NAE (Individual) DIRECTOR since 07/19/2007
NYLANDER, RAYE NAE (Individual) OFFICER since 01/01/2002
RACEK, JOHN (Individual) DIRECTOR since 06/25/2013
SAMUELSON, PHILIP (Individual) DIRECTOR since 06/25/2013
ST MARY, SHARON (Individual) DIRECTOR since 06/14/2011
since 04/01/1987

Jackson · Nursing Home

Monticello House 1115 K Land Drive, Po Box 740, Jackson, MO 63755
Jackson Manor Nursing Home 710 Broadridge, Jackson, MO 63755
Four Winds Nursing Facility 215 Seth Avenue, Jackson, OH 45640
Hinds County Nursing & Rehabilitation Ctr LLC 3454 Albermarle Rd, Jackson, MS 39213
Northbrooke Health Care Center 121 Physicians Dr, Jackson, TN 38305
Villa Feliciana Chronic Disease 5002 Highway 10, Jackson, LA 70748
Maplewood Health Care Center 100 Cherrywood Place, Jackson, TN 38305
Community Place 1129 Langley Ave, Jackson, MS 39204
Vista Grande Villa 2251 Springport Rd, Jackson, MI 49202
Countryside Care Center 2121 Robinson Rd, Jackson, MI 49203
Manhattan Nursing and Rehabilitation Center LLC 4540 Manhattan Rd, Jackson, MS 39206
Chadwick Nursing and Rehabilitation Center LLC 1900 Chadwick Drive, Jackson, MS 39204
Allegra Nursing and Rehab 434 W North St, Jackson, MI 49202
Willow Creek Retirement Center 49 Willow Creek Lane, Jackson, MS 39272
Magnolia Senior Care, LLC 3701 Peter Quinn Drive, Jackson, MS 39213
Belhaven Senior Care, LLC 1004 North St, Jackson, MS 39202
Kit Carson Nursing & Rehabilitation Center 811 Court Street, Jackson, CA 95642
Laurelwood Healthcare Center 200 Birch St, Jackson, TN 38301
Forest Cove Nursing and Rehab Center 45 Forest Cove, Jackson, TN 38301
Heartland of Jackson 8668 State Route 93, Jackson, OH 45640
Westbury Medical Care and Rehab 922 Mcdonough Road, Jackson, GA 30233
Compere Nh Inc 865 North Street, Jackson, MS 39202
Cottage Grove Nursing Home 1116 Forest Avenue, Jackson, MS 39206
Pleasant Hills Com Liv Center 1600 Raymond Rd, Jackson, MS 39204
Jackson Health Care Facility 2616 North College Avenue, Jackson, AL 36545
West Tn Transitional Care 597 West Forest Avenue, Jackson, TN 38301
Ridgecrest Health Campus 703 Robinson Rd, Jackson, MI 49203
Lakeland Nursing and Rehabilitation Center LLC 3680 Lakeland Lane, Jackson, MS 39216
Faith Haven Senior Care Centre 6531 W Michigan Avenue, Jackson, MI 49201
Nim Henson Geriatric Center 420 Jett Drive, Jackson, KY 41339
St John's Nursing Home 625 East Broadway, Jackson, WY 83001
Jackson County Medical Care Facility 524 Lansing Ave, Jackson, MI 49201
Care One At Jackson 11 History Lane, Jackson, NJ 08527
Northampton Nursing and Rehabilitation Center Hwy 305 North, Jackson, NC 27845
Louisiana War Veterans Home 4739 Highway 10, Jackson, LA 70748
Mission Convalescent Home 118 Glass St, Jackson, TN 38301
Bartley Healthcare Nursing & Rehabilitation 175 Bartley Road, Jackson, NJ 08527
Forest Hill Nursing Center 927 Cooper Rd, Jackson, MS 39212

MN · Nursing Home

Johnson Memorial Hosp & Home 1282 Walnut Street, Dawson, MN 56232
Belgrade Nursing Home 103 School Street, Po Box 340, Belgrade, MN 56312
Park Health and Rehabilitation Center 4415 West 36 1/2 Street, Saint Louis Park, MN 55416
Benedictine Living Community Winsted 551 Fourth Street North, Winsted, MN 55395
Regina Senior Living 1175 Nininger Road, Hastings, MN 55033
Elim Home - Milaca 730 Second Street Southeast, Po Box 157, Milaca, MN 56353
Good Samaritan Society - Waconia and Westview Acre 333 Fifth Street West, Waconia, MN 55387
Mn Veterans Home Minneapolis 5101 Minnehaha Avenue South, Minneapolis, MN 55417
Assumption Home 715 North First Street, Cold Spring, MN 56320
Renvilla Health Center 205 Southeast Elm Avenue, Renville, MN 56284
Meadow Manor 210 East Grand Avenue, Po Box 365, Grand Meadow, MN 55936
Grand Avenue Rest Home 3956 Grand Avenue S0uth, Minneapolis, MN 55409
Bethel Care Center 420 Marshall Avenue, Saint Paul, MN 55102
Sylvan Court 112 St Olaf Avenue South, Canby, MN 56220
St Raphaels Health & Rehab Center 601 Grant Avenue, Eveleth, MN 55734
Cerenity Care Center - White Bear Lake 1900 Webber Street, White Bear Lake, MN 55110
Minnesota Valley Hlth Ctr-long 621 South 4th Street, Le Sueur, MN 56058
Ecumen Scenic Shores 402 - 13th Avenue, Two Harbors, MN 55616
Essentia Health Virginia Care Cent 901 9th Street North, Virginia, MN 55792
St Johns Lutheran Home 901 Luther Place, Albert Lea, MN 56007
New Brighton Care Center 805 Sixth Avenue Northwest, New Brighton, MN 55112
Mcintosh Senior Living 600 Northeast Riverside Avenue, Mcintosh, MN 56556
Fairview University Trans Serv 2450 Riverside Avenue South, Minneapolis, MN 55454
Perham Living 735 Third Street Southwest, Perham, MN 56573
Courage Kenny Rehabilitation Institute's Trp 3915 Golden Valley Road, Golden Valley, MN 55422
Benedictine Living Ctr Fridley 520 Osborne Road Northeast, Fridley, MN 55432
Meadow Lane Rehabilitation & Healthcare Ctr 2209 Utah Avenue, Benson, MN 56215
Three Links Care Center 815 Forest Avenue, Northfield, MN 55057
Northfield Hospital Long Term Care Center 2000 North Avenue, Northfield, MN 55057
Spring Valley Care Center 800 Memorial Drive, Spring Valley, MN 55975
Golden Valley Rehabilitation and Care Center 7505 Country Club Drive, Golden Valley, MN 55427
The Estates At Linden LLC 105 West Linden Street, Stillwater, MN 55082
Southview Acres Health Care Center Inc 2000 Oakdale Avenue, West Saint Paul, MN 55118
Aftenro Home 510 West College Street, Duluth, MN 55811
Clara City Care Center 1012 North Division Street Po Box 797, Clara City, MN 56222
Ebenezer Ridges Geriatric Care Center 13820 Community Drive, Burnsville, MN 55337
Guardian Angels Health & Rehab Center 1500 East Third Avenue, Hibbing, MN 55746
Benedictine Living Community of New London 100 Glen Oaks Drive, New London, MN 56273
The Estates At Fridley LLC 5700 East River Road, Fridley, MN 55432
Good Shepherd Lutheran Home 1115 4th Avenue North, Sauk Rapids, MN 56379