Contact Information

GOOD SAMARITAN SOCIETY-QUIBURI MISSION
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
850 SOUTH HIGHWAY 80
BENSON, AZ 85602
(520) 586-2372
Non profit - Corporation
Medicare certification date2: November 20, 1992
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

  56 residents

  60 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 2
Facility reported incidents 2
Number of fines 1
Number of penalties 1
Number of payment denials None

Staffing

Staffing for 56 residents Arizona Average National Average
Hours by Registered Nurse (RN) per resident per day 57 minutes 49 minutes 41 minutes
Hours by Licensed Practial Nurse (LPN & LVN) per resident per day 30 minutes 1 hour, 5 minutes 53 minutes
Hours by Certified Nursing Assistant (CNA) per resident per day 2 hours, 17 minutes 2 hours, 25 minutes 2 hours, 20 minutes
Physical therapy (PT) staff hours per resident per day 9 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
  • DEUTH, MICHAEL
  • GARD, ALAN
  • GRINDAL, HARALD
  • HALAAS, GWEN
  • KRZMARZICK, HEATHER
  • LAAVEG, LEE
  • MELBY, LISA
  • PHILLIPPE, TIMOTHY
  • RACEK, JOHN
  • ROBINSON, DINA
  • SCHUMANN, JILL
  • THOMPSON, DALE

MANAGING EMPLOYEE

  • HERDINA, JOSEPH
  • PETERSON, DANIELLE

OFFICER

  • HERDINA, JOSEPH
  • HORAZDOVSKY, DAVID
  • KAPUSTA, THOMAS
  • PETERSON, BERGEN
  • SYVERSON, THOMAS
  • TRIBBLE, GEORGE

Nursing Home Report

In 2016, GOOD SAMARITAN SOCIETY-QUIBURI MISSION charged a total of $1,032,831 for 56 Medicare Beneficiaries. The average age of residents at this skilled nursing facility is about 79.

The report covers only calendar year 2016.

Chronic Condition of Residents
Atrial Fibrillation 27% Alzheimer's 46%
Asthma 43% Cancer 18%
Congestive Heart Failure 50% Kidney Disease 68%
COPD 41% Depression 27%
Diabetes 46% Hyperlipidemia 70%
Hypertension n/a Ischemic Heart Disease 64%
Osteoporosis 16% RA / OA 46%
Schizophrenia 5% Stroke 18%
Demographics
Medicare Beneficiaries 56 Average Age 79
Male 29 Female 27
White 52
Black 0
Asian 0
Hispanic n/a
American Indian n/a
Other 0

Health & Fire Inspection

Most recent health inspection: Feb 05, 2018; fire safety inspection: Feb 02, 2018

Health Deficiencies as of 02/05/2018
Freedom from Abuse, Neglect, and Exploitation 4
Quality of Life and Care 1
Resident Assessment and Care Planning 3
Nursing and Physician Services 1
Resident Rights 3
Nutrition and Dietary Deficiencies 2
Pharmacy Service 1
Environmental Deficiencies 1
Administration Deficiencies 1
Fire Deficiencies as of 02/02/2018
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