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Good Samaritan Society - Park River

Summary: Good Samaritan Society - Park River is located in Park River, North Dakota. It was first approved by Medicare and Medicaid to provide nursing home services on 1984-01-01. It currently has 54 certified beds and 43 residents in the certified beds. Good Samaritan Society - Park River earned a 3-star overall rating in the lasted Medicare and Medicaid Health Inspections (2015-08-01) [1]. See following table for more details.

Information of Good Samaritan Society - Park River

Nursing Home Profile
Address 301 S COUNTY RD 12B, Park River, ND 58270
Phone 701-284-7115
Number Certified Beds / Residents in Certified Beds 54 / 43
Certification Medicare and Medicaid
Ratings
Overall Rating ★★★ ☆☆ (3)  
Health Inspection Rating ★★ ☆☆☆ (2)
Quality Rating ★★ ☆☆☆ (2)
Staffing Rating ★★★★★ (5)
RN Staffing Rating ★★★★★ (5)
Staff and Nurse Hour Statistics
Reported CNA Staffing Hours per Resident per Day 2.45349
Reported LPN Staffing Hours per Resident per Day 0.51744
Reported RN Staffing Hours per Resident per Day 0.93837
Reported Licensed Staffing Hours per Resident per Day 1.45581
Reported Total Nurse Staffing Hours per Resident per Day 3.90930
Reported Physical Therapist Staffing Hours per Resident Per Day 0.01628
Expected CNA Staffing Hours per Resident per Day 2.20517
Expected LPN Staffing Hours per Resident per Day 0.54738
Expected RN Staffing Hours per Resident per Day 0.74638
Expected Total Nurse Staffing Hours per Resident per Day 3.49893
Adjusted CNA Staffing Hours per Resident per Day 2.73001
Adjusted LPN Staffing Hours per Resident per Day 0.78460
Adjusted RN Staffing Hours per Resident per Day 0.93940
Adjusted Total Nurse Staffing Hours per Resident per Day 4.50367
Notes: CNA=Certified nurse attendant;   LPN=Licensed practical nurse
Health Deficiencies & Scores
Cycle 1 Total Number of Health Deficiencies 10
Cycle 1 Number of Standard Health Deficiencies 10
Cycle 1 Number of Complaint Health Deficiencies 0
Cycle 1 Health Deficiency Score 60
Cycle 1 Standard Survey Health Date 2014-07-23
Cycle 1 Number of Health Revisits 2
Cycle 1 Health Revisit Score 30
Cycle 1 Total Health Score 90
Cycle 2 Total Number of Health Deficiencies 7
Cycle 2 Number of Standard Health Deficiencies 7
Cycle 2 Number of Complaint Health Deficiencies 0
Cycle 2 Health Deficiency Score 36
Cycle 2 Standard Survey Health Date 2013-07-18
Cycle 2 Number of Health Revisits 1
Cycle 2 Health Revisit Score 0
Cycle 2 Total Health Score 36
Cycle 3 Total Number of Health Deficiencies 6
Cycle 3 Number of Standard Health Deficiencies 6
Cycle 3 Number of Complaint Health Deficiencies 0
Cycle 3 Health Deficiency Score 28
Cycle 3 Standard Survey Health Date 2012-06-28
Cycle 3 Number of Health Revisits 1
Cycle 3 Health Revisit Score 0
Cycle 2 Total Health Score 28
Total Weighted Health Survey Score 61.667
Complaints, Fines & Penalties
Number of Facility Reported Incidents 0
Number of Substantiated Complaints 0
Number of Fines 0
Total Amount of Fines in Dollars 0
Number of Payment Denials 0
Total Number of Penalties 0
Facility Information
Ownership Non profit - Corporation
Date First Approved to Provide Medicare and Medicaid 1984-01-01
Provider Resides in Hospital NO
Continuing Care Retirement Community N
Special Focus Facility N
Changed Ownership in Last 12 Months N
With a Resident and Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Processing Date 2015-08-01

Ownership Information

Owner NameOwner RoleOwner Type%
The Evangelical Lutheran Good Samaritan Society5% Or Greater Direct Ownership InterestOrganization100%
Connelly, LianeDirectorIndividualn/a
Curtis, ConnieDirectorIndividualn/a
Deuth, MichaelDirectorIndividualn/a
Gard, AlanDirectorIndividualn/a
Grindal, HaraldDirectorIndividualn/a
Gulsvig, NeilDirectorIndividualn/a
Halaas, GwenDirectorIndividualn/a
Hildebrandt, TeresaDirectorIndividualn/a
Holt, JohnDirectorIndividualn/a
Matson, GuyDirectorIndividualn/a
Racek, JohnDirectorIndividualn/a
Samuelson, PhilipDirectorIndividualn/a
St Mary, SharonDirectorIndividualn/a
Stene, DennisDirectorIndividualn/a
Trout, CarlaDirectorIndividualn/a
Gause, SylviaOfficerIndividualn/a
Ham-quick, MistyOfficerIndividualn/a
Herdina, JosephOfficerIndividualn/a
Horazdovsky, DavidOfficerIndividualn/a
Peterson, BergenOfficerIndividualn/a
Tribble, GeorgeOfficerIndividualn/a
Olson, JoanManaging EmployeeIndividualn/a
Scharnberg, MarkManaging EmployeeIndividualn/a