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Good Samaritan Society - Lakota

Summary: Good Samaritan Society - Lakota is located in Lakota, North Dakota. It was first approved by Medicare and Medicaid to provide nursing home services on 1991-04-01. It currently has 49 certified beds and 40 residents in the certified beds. Good Samaritan Society - Lakota 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 - Lakota

Nursing Home Profile
Address 608 4TH AVE SW, Lakota, ND 58344
Phone 701-247-2902
Number Certified Beds / Residents in Certified Beds 49 / 40
Certification Medicare and Medicaid
Ratings
Overall Rating ★★★★ (4)  
Health Inspection Rating ★★★★ (4)
Quality Rating ★★★★ (4)
Staffing Rating ★★★★ (4)
RN Staffing Rating ★★★★ (4)
Staff and Nurse Hour Statistics
Reported CNA Staffing Hours per Resident per Day 2.61000
Reported LPN Staffing Hours per Resident per Day 0.31250
Reported RN Staffing Hours per Resident per Day 0.61500
Reported Licensed Staffing Hours per Resident per Day 0.92750
Reported Total Nurse Staffing Hours per Resident per Day 3.53750
Reported Physical Therapist Staffing Hours per Resident Per Day 0.00500
Expected CNA Staffing Hours per Resident per Day 2.29750
Expected LPN Staffing Hours per Resident per Day 0.54722
Expected RN Staffing Hours per Resident per Day 0.75765
Expected Total Nurse Staffing Hours per Resident per Day 3.60237
Adjusted CNA Staffing Hours per Resident per Day 2.78745
Adjusted LPN Staffing Hours per Resident per Day 0.47399
Adjusted RN Staffing Hours per Resident per Day 0.60652
Adjusted Total Nurse Staffing Hours per Resident per Day 3.95832
Notes: CNA=Certified nurse attendant;   LPN=Licensed practical nurse
Health Deficiencies & Scores
Cycle 1 Total Number of Health Deficiencies 7
Cycle 1 Number of Standard Health Deficiencies 7
Cycle 1 Number of Complaint Health Deficiencies 0
Cycle 1 Health Deficiency Score 24
Cycle 1 Standard Survey Health Date 2015-01-29
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 5
Cycle 2 Number of Standard Health Deficiencies 5
Cycle 2 Number of Complaint Health Deficiencies 0
Cycle 2 Health Deficiency Score 24
Cycle 2 Standard Survey Health Date 2014-02-05
Cycle 2 Number of Health Revisits 1
Cycle 2 Health Revisit Score 0
Cycle 2 Total Health Score 24
Cycle 3 Total Number of Health Deficiencies 3
Cycle 3 Number of Standard Health Deficiencies 3
Cycle 3 Number of Complaint Health Deficiencies 0
Cycle 3 Health Deficiency Score 12
Cycle 3 Standard Survey Health Date 2013-02-21
Cycle 3 Number of Health Revisits 1
Cycle 3 Health Revisit Score 0
Cycle 2 Total Health Score 12
Total Weighted Health Survey Score 22.000
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 1991-04-01
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%
Brown, ElwinDirectorIndividualn/a
Connelly, LianeDirectorIndividualn/a
Deuth, MichaelDirectorIndividualn/a
Grindal, HaraldDirectorIndividualn/a
Gulsvig, NeilDirectorIndividualn/a
Gustafson, KariDirectorIndividualn/a
Halaas, GwenDirectorIndividualn/a
Hildebrandt, TeresaDirectorIndividualn/a
Holt, JohnDirectorIndividualn/a
Johnson, ChristopherDirectorIndividualn/a
Juffer, MicheleDirectorIndividualn/a
Racek, JohnDirectorIndividualn/a
Samuelson, PhilipDirectorIndividualn/a
St Mary, SharonDirectorIndividualn/a
Gause, SylviaOfficerIndividualn/a
Ham-quick, MistyOfficerIndividualn/a
Herdina, JosephOfficerIndividualn/a
Horazdovsky, DavidOfficerIndividualn/a
Nylander, Raye NaeOfficerIndividualn/a
Antoine Grawe, MichelleManaging EmployeeIndividualn/a
Scharnberg, MarkManaging EmployeeIndividualn/a