Contact Information

GOOD SAMARITAN SOCIETY - FORT COLLINS VILLAGE
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
508 WEST TRILBY ROAD
FORT COLLINS, CO 80525
(970) 226-4909
Non profit - Corporation
Medicare certification date2: March 01, 1986
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

  59 residents

  64 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 None
Facility reported incidents None
Number of fines None
Number of penalties None
Number of payment denials None

Staffing

Staffing for 59 residents Colorado Average National Average
Hours by Registered Nurse (RN) per resident per day 1 hour, 21 minutes 55 minutes 41 minutes
Hours by Licensed Practial Nurse (LPN & LVN) per resident per day 23 minutes 40 minutes 53 minutes
Hours by Certified Nursing Assistant (CNA) per resident per day 2 hours, 13 minutes 2 hours, 21 minutes 2 hours, 20 minutes
Physical therapy (PT) staff hours per resident per day 7 minutes 7 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
  • PITZL, FRED

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 - FORT COLLINS VILLAGE charged a total of $1,272,346 for 49 Medicare Beneficiaries. The average age of residents at this skilled nursing facility is about 85.

The report covers only calendar year 2016.

Chronic Condition of Residents
Atrial Fibrillation 27% Alzheimer's 39%
Asthma 29% Cancer 16%
Congestive Heart Failure 49% Kidney Disease 55%
COPD 24% Depression 27%
Diabetes 29% Hyperlipidemia 53%
Hypertension n/a Ischemic Heart Disease 59%
Osteoporosis 16% RA / OA 73%
Schizophrenia 0% Stroke 14%
Demographics
Medicare Beneficiaries 49 Average Age 85
Male 22 Female 27
White 48
Black 0
Asian 0
Hispanic 0
American Indian n/a
Other n/a

Health & Fire Inspection

Most recent health inspection: Nov 16, 2017; fire safety inspection: Dec 05, 2017

Health Deficiencies as of 11/16/2017
Freedom from Abuse, Neglect, and Exploitation None
Quality of Life and Care 2
Resident Assessment and Care Planning None
Nursing and Physician Services None
Resident Rights None
Nutrition and Dietary Deficiencies None
Pharmacy Service None
Environmental Deficiencies 1
Administration Deficiencies None
Fire Deficiencies as of 12/05/2017
Emergency Preparedness None
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 None

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See also