Contact Information

GOOD SAMARITAN SOCIETY-PRESCOTT VILLAGE
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
1030 SCOTT DRIVE
PRESCOTT, AZ 86301
(928) 778-2450
Non profit - Corporation
Medicare certification date2: May 19, 1988
The is the date the nursing home was certified to participate in the Medicare program.

1 Nursing homes can be run by private for-profit corporations, non-profit corporations, religious affiliated organizations or government entities.

2 Agencies that are Medicare Certified are able to participate in Medicare related programs.


Nursing Home Information

  52 residents

  58 certified beds

  Participates in Medicare and Medicaid

  Continuing Care Retirement Community

  In hospital

  Resident Council only

  Automatic sprinklers in all required areas

Quality rating
Health inspection rating
Staffing rating
Substantiated complaints 1
Facility reported incidents None
Number of fines None
Number of penalties None
Number of payment denials None

Staffing

Staffing for 52 residents Arizona Average National Average
Hours by Registered Nurse (RN) per resident per day 1 hour, 33 minutes 49 minutes 41 minutes
Hours by Licensed Practial Nurse (LPN & LVN) per resident per day 4 minutes 1 hour, 5 minutes 53 minutes
Hours by Certified Nursing Assistant (CNA) per resident per day 2 hours, 31 minutes 2 hours, 25 minutes 2 hours, 20 minutes
Physical therapy (PT) staff hours per resident per day 6 minutes 10 minutes 7 minutes

Staffing hours per resident is the total number of hours worked by the staff divided by the total number of residents. It doesn't necessarily show the number of nursing staff present at any given time or the amount of care given to any one resident.

Ownership

5% OR GREATER DIRECT OWNERSHIP INTEREST

  • THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

DIRECTOR

  • BOLLIG, REBECCA
  • BUCKNEBERG, NORVAL
  • CAMERO, PATRICIA
  • ESPINOSA, JAVIER
  • GARD, ALAN
  • HALAAS, GWEN
  • KRZMARZICK, HEATHER
  • LAAVEG, LEE
  • MELBY, LISA
  • PETERSEN, SCOTT
  • PHILLIPPE, TIMOTHY
  • RACEK, JOHN
  • ROBINSON, DINA
  • SCHUMANN, JILL
  • THOMPSON, DALE

MANAGING EMPLOYEE

  • GASSER, ANGELA
  • HERDINA, JOSEPH

OFFICER

  • HAM-QUICK, MISTY
  • HERDINA, JOSEPH
  • HORAZDOVSKY, DAVID
  • KAPUSTA, THOMAS
  • PETERSON, BERGEN
  • SYVERSON, THOMAS
  • TRIBBLE, GEORGE

OPERATIONAL/MANAGERIAL CONTROL

  • HORAZDOVSKY, DAVID

Nursing Home Report

In 2016, GOOD SAMARITAN SOCIETY-PRESCOTT VILLAGE charged a total of $2,753,832 for 204 Medicare Beneficiaries. The average age of residents at this skilled nursing facility is about 81.

The report covers only calendar year 2016.

Chronic Condition of Residents
Atrial Fibrillation 30% Alzheimer's 41%
Asthma 32% Cancer 17%
Congestive Heart Failure 34% Kidney Disease 50%
COPD 28% Depression 35%
Diabetes 31% Hyperlipidemia 58%
Hypertension n/a Ischemic Heart Disease 53%
Osteoporosis 17% RA / OA 58%
Schizophrenia 5% Stroke 12%
Demographics
Medicare Beneficiaries 204 Average Age 81
Male 82 Female 122
White 194
Black n/a
Asian 0
Hispanic n/a
American Indian n/a
Other n/a

Health & Fire Inspection

Most recent health inspection: Jan 10, 2018; fire safety inspection: Jan 12, 2018

Health Deficiencies as of 01/10/2018
Freedom from Abuse, Neglect, and Exploitation None
Quality of Life and Care 1
Resident Assessment and Care Planning 1
Nursing and Physician Services None
Resident Rights 1
Nutrition and Dietary Deficiencies None
Pharmacy Service 1
Environmental Deficiencies 1
Administration Deficiencies 1
Fire Deficiencies as of 01/12/2018
Emergency Preparedness 3
Automatic Sprinkler Systems None
Construction Deficiencies None
Services Deficiencies None
Corridor Walls and Doors None
Egress Deficiencies None
Electrical Deficiencies None
Emergency Plans and Fire Drills None
Fire Alarm Systems None
Smoke Deficiencies None
Interior Deficiencies None
Gas, Vacuum, and Electrical Systems None
Hazardous Area None
Illumination and Emergency Power None
Laboratories Deficiencies None
Medical Gases and Anesthetizing Areas None
Smoking Regulations None
Miscellaneous Regulations 1

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See also