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Good Samaritan Society - Mohall

Summary: Good Samaritan Society - Mohall is located in Mohall, North Dakota. It was first approved by Medicare and Medicaid to provide nursing home services on 1991-02-01. It currently has 57 certified beds and 48 residents in the certified beds. Good Samaritan Society - Mohall earned a 4-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 - Mohall

Nursing Home Profile
Address 602 E MAIN ST, Mohall, ND 58761
Phone 701-756-6831
Number Certified Beds / Residents in Certified Beds 57 / 48
Certification Medicare and Medicaid
Ratings
Overall Rating ★★★★ (4)  
Health Inspection Rating ★★★ ☆☆ (3)
Quality Rating ★★ ☆☆☆ (2)
Staffing Rating ★★★★ (4)
RN Staffing Rating ★★★★★ (5)
Staff and Nurse Hour Statistics
Reported CNA Staffing Hours per Resident per Day 2.27813
Reported LPN Staffing Hours per Resident per Day 0.41354
Reported RN Staffing Hours per Resident per Day 0.86458
Reported Licensed Staffing Hours per Resident per Day 1.27813
Reported Total Nurse Staffing Hours per Resident per Day 3.55625
Reported Physical Therapist Staffing Hours per Resident Per Day 0.00000
Expected CNA Staffing Hours per Resident per Day 2.38360
Expected LPN Staffing Hours per Resident per Day 0.64289
Expected RN Staffing Hours per Resident per Day 0.85166
Expected Total Nurse Staffing Hours per Resident per Day 3.87815
Adjusted CNA Staffing Hours per Resident per Day 2.34513
Adjusted LPN Staffing Hours per Resident per Day 0.53390
Adjusted RN Staffing Hours per Resident per Day 0.75854
Adjusted Total Nurse Staffing Hours per Resident per Day 3.69632
Notes: CNA=Certified nurse attendant;   LPN=Licensed practical nurse
Health Deficiencies & Scores
Cycle 1 Total Number of Health Deficiencies 5
Cycle 1 Number of Standard Health Deficiencies 5
Cycle 1 Number of Complaint Health Deficiencies 0
Cycle 1 Health Deficiency Score 24
Cycle 1 Standard Survey Health Date 2015-05-07
Cycle 1 Number of Health Revisits 1
Cycle 1 Health Revisit Score 0
Cycle 1 Total Health Score 24
Cycle 2 Total Number of Health Deficiencies 9
Cycle 2 Number of Standard Health Deficiencies 9
Cycle 2 Number of Complaint Health Deficiencies 8
Cycle 2 Health Deficiency Score 44
Cycle 2 Standard Survey Health Date 2014-04-16
Cycle 2 Number of Health Revisits 1
Cycle 2 Health Revisit Score 0
Cycle 2 Total Health Score 44
Cycle 3 Total Number of Health Deficiencies 9
Cycle 3 Number of Standard Health Deficiencies 9
Cycle 3 Number of Complaint Health Deficiencies 0
Cycle 3 Health Deficiency Score 52
Cycle 3 Standard Survey Health Date 2013-04-18
Cycle 3 Number of Health Revisits 1
Cycle 3 Health Revisit Score 0
Cycle 2 Total Health Score 52
Total Weighted Health Survey Score 35.333
Complaints, Fines & Penalties
Number of Facility Reported Incidents 0
Number of Substantiated Complaints 4
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 1991-02-01
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%
The Evangelical Lutheran Good Samaritan SocietyOperational/managerial ControlOrganizationn/a
Brown, ElwinDirectorIndividualn/a
Bussler, LoriDirectorIndividualn/a
Degroot Nesdahl, AndreaDirectorIndividualn/a
Deuth, MichaelDirectorIndividualn/a
Grindal, HaraldDirectorIndividualn/a
Gulsvig, NeilDirectorIndividualn/a
Gustafson, KariDirectorIndividualn/a
Haugen, PatriciaDirectorIndividualn/a
Hildebrandt, TeresaDirectorIndividualn/a
Holt, JohnDirectorIndividualn/a
Johnson, ChristopherDirectorIndividualn/a
Juffer, MicheleDirectorIndividualn/a
Moorman, JackDirectorIndividualn/a
Randall, JoannaDirectorIndividualn/a
St Mary, SharonDirectorIndividualn/a
Gause, SylviaOfficerIndividualn/a
Ham-quick, MistyOfficerIndividualn/a
Herdina, JosephOfficerIndividualn/a
Horazdovsky, DavidOfficerIndividualn/a
Moegenburg, CynthiaOfficerIndividualn/a
Nylander, Raye NaeOfficerIndividualn/a
Sheckler, RobertManaging EmployeeIndividualn/a