GOOD SAMARITAN SOCIETY -- FORT COLLINS VILLAGE Nursing Home


GOOD SAMARITAN SOCIETY -- FORT COLLINS VILLAGE (CCN: 065227) is a Non profit - Corporation facility located in FORT COLLINS, CO (80525). The facility has an overall rating of 3/5, health inspection rating of 3/5, and a staffing rating of 4/5. It offers 64 certified beds and maintains an average of 41.9 residents per day. The nursing staff includes Nurse Aides, LPNs, and RNs working 3.75091 total hours per resident per day. It has been certified since March 1, 1986 and the last listed health inspection was on January 9, 2024, The facility is located in Larimer county and provides senior and nursing home care.

GOOD SAMARITAN SOCIETY -- FORT COLLINS VILLAGE Summary


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Provider Name: GOOD SAMARITAN SOCIETY -- FORT COLLINS VILLAGE

Address: 508 W TRILBY RD, FORT COLLINS, CO 80525

Phone: (970) 226-4909

County: Larimer (340)

Ownership Type: Non profit - Corporation

Certified Beds: 64

Average Residents Per Day: 41.9 ()

Provider Type: Medicare and Medicaid, Resides in Hospital: No

Legal Business Name: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

First Approved Date: March 1, 1986

Affiliated Entity: EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (214)

Retirement Community: N, Special Focus Status:

Ownership Change in Last 12 Months: N

Resident Family Council: Resident

Sprinkler System Status: Yes

Overall Rating: 3 ()

Health Inspection Rating: 3 ()

QM Rating: 2 ()

Long Stay QM Rating: 2 ()

Short Stay QM Rating: (2)

Staffing Rating: 4 ()

Staffing Report Note:

PT Staffing Note:

Nurse Aide Staff Hours Per Day, per resident: 2.02107, LPN Staff Hours Per Day: 0.4015, RN Staff Hours Per Day: 1.3282, Licensed Staff Hours Per Day: 1.7298

Total Nurse Staff Hours Per Day, per resident: 3.75091

Weekend Nurse Staff Hours: 3.48834, Weekend RN Staff Hours: 1.1947

PT Staff Hours Per Day, per resident: 0.0814

Nurse Staff Turnover: 90.2, Nurse Turnover Note:

RN Turnover: 81.3, RN Turnover Note:

Admin Left Number: 1, Admin Turnover Note:

Case Mix Nurse Aide Hours Per Day, per resident: 1.9230, Case Mix LPN Hours Per Day: 0.6397, Case Mix RN Hours Per Day: 0.2917

Adjusted Nurse Aide Hours Per Day, per resident: 2.14113, Adjusted LPN Hours Per Day: 0.4632, Adjusted RN Hours Per Day: 1.7157

Total Adjusted Nurse Hours Per Day, per resident: 4.14195

Adjusted Weekend Nurse Hours Per Day, per resident: 3.85202

Health Survey Dates and Scores: Cycle 1: 2024-01-09 (Score: 48), Cycle 2: 2022-09-21 (Score: 60), Cycle 3: 2019-12-10 (Score: 4)

Total Weighted Health Score: 44.667

Reported Incidents: 0, Substantiated Complaints: 7

Infection Control Citations: 4

Fines and Penalties: Number of Fines: 0, Total Fines in Dollars: 0.00, Payment Denials Number: 0, Total Penalties Number: 0

Location and GPS: 508 W TRILBY RD,FORT COLLINS,CO,80525 (40.4947, -105.086)

Process Date: 2024-03-01


Health Inspection Citations Details

Each record details specific health deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:

Citation on 2024-01-09

Type: Health, Deficiency: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has plan of correction on 2024-02-09

Citation on 2024-01-09

Type: Health, Deficiency: Implement a program that monitors antibiotic use.

Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has plan of correction on 2024-02-09

Citation on 2024-01-09

Type: Health, Deficiency: Develop and implement policies and procedures for flu and pneumonia vaccinations.

Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has plan of correction on 2024-02-09

Citation on 2024-01-09

Type: Health, Deficiency: Provide and implement an infection prevention and control program.

Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has plan of correction on 2024-02-09

Citation on 2022-06-30

Type: Health, Deficiency: Inform each resident of his or her visitation rights and ensure that all visitors enjoy equal visitation privileges.

Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2022-08-01

Citation on 2022-06-30

Type: Health, Deficiency: Provide and implement an infection prevention and control program.

Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2022-08-17

Citation on 2022-06-30

Type: Health, Deficiency: Perform COVID19 testing on residents and staff.

Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2022-08-18

Citation on 2022-06-30

Type: Health, Deficiency: Ensure staff are vaccinated for COVID-19

Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2022-08-02

Citation on 2022-09-21

Type: Health, Deficiency: Ensure medication error rates are not 5 percent or greater.

Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2022-10-21

Citation on 2021-12-16

Type: Health, Deficiency: Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2022-01-26


Fire Safety Citations Details

Each record details specific fire safety deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:

Citation on 2024-01-23

Type: Fire Safety, Tag: 0324, Version: New

Description: Provide properly protected cooking facilities.

Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2024-02-05

Citation on 2024-01-23

Type: Fire Safety, Tag: 0345, Version: New

Description: Have approved installation, maintenance and testing program for fire alarm systems.

Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2024-02-07

Citation on 2024-01-23

Type: Fire Safety, Tag: 0511, Version: New

Description: Have properly installed electrical wiring and gas equipment.

Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2024-02-05

Citation on 2024-01-23

Type: Fire Safety, Tag: 0712, Version: New

Description: Have simulated fire drills held at unexpected times.

Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2024-02-05

Citation on 2022-10-18

Type: Fire Safety, Tag: 0291, Version: New

Description: Install emergency lighting that can last at least 1 1/2 hours.

Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2022-10-24

Citation on 2020-01-07

Type: Fire Safety, Tag: 0211, Version: New

Description: Keep aisles, corridors, and exits free of obstruction in case of emergency.

Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2020-01-17

Citation on 2020-01-07

Type: Fire Safety, Tag: 0353, Version: New

Description: Inspect, test, and maintain automatic sprinkler systems.

Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2020-01-27

Citation on 2020-01-07

Type: Fire Safety, Tag: 0915, Version: New

Description: Have proper power supply for life support equipment.

Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2020-01-17