SCANDIA VILLAGE GOOD SAMARITAN 3111 - SISTER BAY, WI

United States hospital / nursing home:
SCANDIA VILLAGE GOOD SAMARITAN 3111 - SISTER BAY, WI

SCANDIA VILLAGE GOOD SAMARITAN 3111
290 SMITH DRIVE
SISTER BAY, WI 54234


RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTIONS SNF/NF (DUALLY CERTIFIED)

Services provided by SCANDIA VILLAGE GOOD SAMARITAN 3111:

  • Dietary services are provided onsite to non residents
  • Dietary services are provided onsite to residents
  • Housekeeping services are provided onsite to residents
  • Nursing services are provided onsite to residents
  • Occupational therapy services are provided onsite to non residents
  • Occupational therapy services are provided onsite to residents
  • Field 1 - Indicates other activity services provided by staff onsite to residents
  • Pharmacy services are provided onsite to residents
  • Physical therapy services are provided onsite to non residents
  • Physical therapy services are provided onsite to residents
  • Physician services are provided onsite to residents
  • Social work services are provided onsite to residents
  • Speech/language pathology services are provided onsite to non residents
  • Speech/language pathology services are provided onsite to residents

Beds - Total (Total number of beds in a facility, including those in non-Participating or non-licensed areas): 60

Beds - Total certified (Number of beds in Medicare and/or Medicaid certified areas within a facility): 60

Lpn/lvn - Full time (The number of full-time equivalent licensed practical/ vocational nurses employed by a facility on a full time basis): 2.31

Registered nurse - Full time (The number of full-time equivalent registered nurses employed by a facility on a full time basis): 1.17

Change of ownership counter (The number of times a change of ownership (chow) has taken place for a particular provider): 2

Current fms survey date (Current fms survey date): Nov 2001

Prior change of ownership (The date of a prior change of ownership): Apr 1993

Program participation (Indicates if the provider participates in Medicare, Medicaid, or both programs): MEDICARE AND MEDICAID

Administrator - Full time (The number of full-time equivalent administrative staff employed on a full time basis by a facility): 1.14

Administrator - Part time (The number of full-time equivalent administrative staff employed on a part-time basis by a facility): 3.07

Beds - Snf/nf (Number of beds certified for both Medicare and Medicaid skilled nursing care in a long term care facility): 60

Cert nurse aides - Full time (The number of full-time equivalent certified nurse aides employed by a facility on a full time basis): 14.27

Cert nurse aides - Part time (The number of full-time equivalent certified nurse aides employed by a facility on a part time basis): 10.87

Dietitians - Part time (The number of full-time equivalent dietitians employed by a facility on a part time basis): 0.24

Food service - Full time (The number of full-time equivalent food service personnel employed by a facility on a full time basis): 3.57

Food service - Part time (The number of full-time equivalent food service personnel employed by a facility on a part time basis): 5.27

Housekeeping - Part time (The number of full-time equivalent housekeeping personnel employed by a facility on a part time basis): 7.79

Medical director - Contract (The number of full-time equivalent medical directors under contrcat to a facility): 0.06

Multi-Facility organization name (The name of the multi-Facility organization that owns the facility): EVANGELICAL LUTHERAN GOOD SAMARITAN

Multi-Facility organization owned (Indicates if a facility is owned by an organization that owns (or leases) two or more nursing facilities): Yes

Nurses with admin duties-Part time (Number of full-time equivalent nurses with administrative duties employed by a facility on a part time basis): 1.86

Occupational therapist - Contract (The number of full-time equivalent occupational therapists under contract to a facility): 0.87

Organized resident group (Indicates if the facility has an organized residents group): Yes

Other - Part time (The number of full-time equivalent persons not included in any other categories employed by the facility on a part-time basis): 2.56

Other activities staff-Full time (Number of full-time staff hours for other activities): 1.16

Other activities staff-Part time (Number of part time staff hours provided by other activ ities staff): 1

Pharmacists - Contract (The number of full-time equivalent pharmacists under contract to a facility): 0.06

Physical therapists - Contract (The number of full-time equivalent physical therapists under contract to a facility): 0.96

Physical therapy aide - Part time (The number of full-time equivalent physical therapy aide employed by a facility on a part time basis): 1.10

Registered nurse - Part time (The number of full-time equivalent registered nurses employed by a facility on a part time basis): 4.80

Rn director of nursing - Full time (The number of full-time equivalent rn director of nursing employed by a facility on a full time basis): 1.03

Social worker - Full time (The number of full-time equivalent social workers employed by a facility on a full time basis): 1.07

Special care beds-Alzheimers (The number of beds in a unit identified and dedicated by the facility for residents with alzeheimers): 15

Speech pathologist - Contract (The number of full-time equivalent speech pathologists under contract to a facility): 0.09

Compliance: status (Indicates if a provider or supplier is in compliance with program requirements): IN COMPLIANCE

Current survey date (The date of the health or life safety code survey, whichever is later. the "official" survey date for the provider): Oct 2001

Eligibility code (Indicates if a facility is eligible to participate in the Medicare and/or Medicaid programs): ELIGIBLE TO PARTICIPATE

Participation date (The date a facility is first approved to provide Medicare and/or Medicaid services): Oct 1992