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GOOD SAMARITAN AMBASSADOR

Overall Rating

Address

8100 Medicine Lake Road

New Hope, MN 55427

Contact

7634177130

Certification Date

1968-02-26

Details

CMS Certification Number

245149

Ownership Type

Non profit - Corporation

Number of Certified Beds

77

Average Number of Residents per Day

74.8

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

4

Quality Measure Rating

5

Staffing Rating

5

Staffing

Reported Nurse Aide Staffing Hours per Resident per Day

2.45439

Reported LPN Staffing Hours per Resident per Day

0.49371

Reported RN Staffing Hours per Resident per Day

1.64025

Reported Total Nurse Staffing Hours per Resident per Day

4.58835

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

3.90469

Registered Nurse Hours per Resident per Day on the Weekend

1.21493

Reported Physical Therapist Staffing Hours per Resident Per Day

0.24829

Quality Measures

Long-Stay Quality Measure Rating

4

Short-Stay Quality Measure Rating

5

Inspections

Total Weighted Health Survey Score

22.000

Number of Facility Reported Incidents

2

Number of Substantiated Complaints

0

Number of Citations from Infection Control Inspections

Health Inspections

Rating Cycle 1

Standard Health Survey Date

2023-03-16

Total Number of Health Deficiencies

2

Number of Standard Health Deficiencies

2

Number of Complaint Health Deficiencies

0

Health Deficiency Score

8

Number of Health Revisits

1

Health Revisit Score

0

Total Health Score

8

Rating Cycle 2

Standard Health Survey Date

2022-03-31

Total Number of Health Deficiencies

7

Number of Standard Health Deficiencies

6

Number of Complaint Health Deficiencies

1

Health Deficiency Score

44

Number of Health Revisits

1

Health Revisit Score

0

Total Health Score

44

Rating Cycle 3

Standard Health Survey Date

2020-03-05

Total Number of Health Deficiencies

6

Number of Standard Health Deficiencies

6

Number of Complaint Health Deficiencies

0

Health Deficiency Score

20

Number of Health Revisits

1

Health Revisit Score

0

Total Health Score

20

Penalties

Number of Fines

1

Total Amount of Fines in Dollars

9750.00

Number of Payment Denials

0

Total Number of Penalties

1