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THE GOOD SAMARITAN SOCIETY-KISSIMMEE VILLAGE

Overall Rating

Cited for abuse

Address

1500 Southgate Drive

Kissimmee, FL 34746

Contact

4078467201

Certification Date

1987-05-20

Details

CMS Certification Number

105559

Ownership Type

Non profit - Corporation

Number of Certified Beds

161

Average Number of Residents per Day

115.9

Provider Type

Medicare and Medicaid

Legal Business Name

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

Affiliated Entity Name

EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

Affiliated Entity ID

214

Ratings

Health Inspection Rating

1

Quality Measure Rating

4

Staffing Rating

4

Staffing

Reported Nurse Aide Staffing Hours per Resident per Day

2.00861

Reported LPN Staffing Hours per Resident per Day

0.60883

Reported RN Staffing Hours per Resident per Day

0.82088

Reported Total Nurse Staffing Hours per Resident per Day

3.43832

Total Number of Nurse Staff Hours per Resident per Day on the Weekend

3.22009

Registered Nurse Hours per Resident per Day on the Weekend

0.67995

Reported Physical Therapist Staffing Hours per Resident Per Day

0.05874

Quality Measures

Long-Stay Quality Measure Rating

4

Short-Stay Quality Measure Rating

4

Inspections

Total Weighted Health Survey Score

260.167

Number of Facility Reported Incidents

7

Number of Substantiated Complaints

3

Number of Citations from Infection Control Inspections

4

Health Inspections

Rating Cycle 1

Standard Health Survey Date

2024-02-01

Total Number of Health Deficiencies

13

Number of Standard Health Deficiencies

4

Number of Complaint Health Deficiencies

9

Health Deficiency Score

351

Number of Health Revisits

1

Health Revisit Score

0

Total Health Score

351

Rating Cycle 2

Standard Health Survey Date

2022-03-24

Total Number of Health Deficiencies

8

Number of Standard Health Deficiencies

4

Number of Complaint Health Deficiencies

4

Health Deficiency Score

86

Number of Health Revisits

1

Health Revisit Score

0

Total Health Score

86

Rating Cycle 3

Standard Health Survey Date

2020-11-19

Total Number of Health Deficiencies

11

Number of Standard Health Deficiencies

7

Number of Complaint Health Deficiencies

4

Health Deficiency Score

336

Number of Health Revisits

1

Health Revisit Score

0

Total Health Score

336

Penalties

Number of Fines

6

Total Amount of Fines in Dollars

416149.75

Number of Payment Denials

0

Total Number of Penalties

6