Provider Name: T J SAMSON COMMUNITY HOSPITAL
Address: 1301 N RACE STREET, GLASGOW, KY 42141
Phone: (270) 651-4458
County: Barren (040)
Ownership Type: Non profit - Corporation
Certified Beds: 16
Average Residents Per Day: 6.5 ()
Provider Type: Medicare, Resides in Hospital: No
Legal Business Name: T J SAMSON COMMUNITY HOSPITAL
First Approved Date: November 8, 1993
Affiliated Entity: ()
Retirement Community: N, Special Focus Status:
Ownership Change in Last 12 Months: N
Resident Family Council: None
Sprinkler System Status: Yes
Overall Rating: 5 ()
Health Inspection Rating: 4 ()
QM Rating: 5 ()
Long Stay QM Rating: (2)
Short Stay QM Rating: 5 ()
Staffing Rating: 5 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 1.58977, LPN Staff Hours Per Day: 1.8137, RN Staff Hours Per Day: 7.1140, Licensed Staff Hours Per Day: 8.9278
Total Nurse Staff Hours Per Day, per resident: 10.5176
Weekend Nurse Staff Hours: 9.85147, Weekend RN Staff Hours: 6.9147
PT Staff Hours Per Day, per resident: 0.0000
Nurse Staff Turnover: 31.6, Nurse Turnover Note:
RN Turnover: 33.3, RN Turnover Note:
Admin Left Number: 0, Admin Turnover Note:
Case Mix Nurse Aide Hours Per Day, per resident: 2.4164, Case Mix LPN Hours Per Day: 0.8342, Case Mix RN Hours Per Day: 0.4844
Adjusted Nurse Aide Hours Per Day, per resident: 1.34027, Adjusted LPN Hours Per Day: 1.6045, Adjusted RN Hours Per Day: 5.5335
Total Adjusted Nurse Hours Per Day, per resident: 8.87570
Adjusted Weekend Nurse Hours Per Day, per resident: 8.31355
Health Survey Dates and Scores: Cycle 1: 2023-11-30 (Score: 0), Cycle 2: 2022-03-30 (Score: 16), Cycle 3: 2019-09-17 (Score: 32)
Total Weighted Health Score: 10.667
Reported Incidents: 0, Substantiated Complaints: 0
Infection Control Citations:
Fines and Penalties: Number of Fines: 1, Total Fines in Dollars: 650.00, Payment Denials Number: 0, Total Penalties Number: 1
Location and GPS: 1301 N RACE STREET,GLASGOW,KY,42141 (37.0108, -85.903)
Process Date: 2024-03-01
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:
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 date of correction on 2022-04-20
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 date of correction on 2019-10-25
Type: Health, Deficiency: Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards.
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 2019-10-08
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:
Type: Fire Safety, Tag: 0225, Version: New
Description: Have stairways and smokeproof enclosures used as exits that meet safety requirements.
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 2024-01-14
Type: Fire Safety, Tag: 0321, Version: New
Description: Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
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 2022-04-20