Good Samaritan Society - Woodland
100 Buffalo Hills Lane, Brainerd, MN 56401


Good Samaritan Society - Woodland is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 245488. The address is 100 Buffalo Hills Lane, Brainerd, MN 56401. The zip code is 56401. The phone number is 2188291429.


Good Samaritan Society - Woodland · 100 Buffalo Hills Lane, Brainerd, MN 56401

Federal Provider Number 245488
Provider Name GOOD SAMARITAN SOCIETY - WOODLAND
Address 100 BUFFALO HILLS LANE
BRAINERD, MN 56401
Phone Number 2188291429
SSA County Code 170
County Name Crow Wing
Ownership Type Non profit - Corporation
Certified Beds 42
Certified Beds Residents 36
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 07/01/1987
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 Both
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 4
Health Inspection Rating 4
Quality Measure Rating 4
Staffing Rating 4
RN Staffing Rating 5
Reported CNA Staffing Hours per Resident per Day 2.53611
Reported LPN Staffing Hours per Resident per Day 0.375
Reported RN Staffing Hours per Resident per Day 1.21806
Reported Licensed Staffing Hours per Resident per Day 1.59306
Reported Total Nurse Staffing Hours per Resident per Day 4.12917
Reported Physical Therapist Staffing Hours per Resident Per Day 0.01944
Expected CNA Staffing Hours per Resident per Day 2.56842
Expected LPN Staffing Hours per Resident per Day 0.60317
Expected RN Staffing Hours per Resident per Day 0.96778
Expected Total Nurse Staffing Hours per Resident per Day 4.13937
Adjusted CNA Staffing Hours per Resident per Day 2.42283
Adjusted LPN Staffing Hours per Resident per Day 0.51602
Adjusted RN Staffing Hours per Resident per Day 0.94044
Adjusted Total Nurse Staffing Hours per Resident per Day 4.02096
Cycle 1 Total Number of Health Deficiencies 1
Cycle 1 Number of Standard Health Deficiencies 1
Cycle 1 Health Deficiency Score 16
Cycle 1 Standard Survey Health Date 05/04/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 16
Cycle 2 Standard Health Survey Date 03/25/2016
Cycle 3 Total Number of Health Deficiencies 7
Cycle 3 Number of Standard Health Deficiencies 7
Cycle 3 Health Deficiency Score 32
Cycle 3 Standard Health Survey Date 12/31/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 32
Total Weighted Health Survey Score 13.333
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Good Samaritan Society - Woodland

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
GRAMS, JENNIFER (Individual) MANAGING EMPLOYEE since 01/31/2010
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
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) OFFICER 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 07/01/1987
TRIBBLE, GEORGE (Individual) OFFICER since 12/01/2014
TROUT, CARLA (Individual) DIRECTOR since 06/24/2014

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