Memorial Nursing Center - Frederick Nursing Home
General Information
UPDATEFederal Provider Number
37E454
Provider Name
MEMORIAL NURSING CENTER
Provider Address
319 EAST JOSEPHINE
FREDERICK, OK 73542
FREDERICK, OK 73542
Provider Phone Number
5803357565
Provider SSA County
700
Provider County Name
Tillman
Ownership Type
Government - City/county
Number of Certified Beds
30
Number of Residents in Certified Beds
19
Provider Type
Medicaid
Provider Resides in Hospital
Y
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1988-05-27
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.83421
Reported LPN Staffing Hours per Resident per Day
1.26316
Reported RN Staffing Hours per Resident per Day
0.57105
Reported Licensed Staffing Hours per Resident per Day
1.83421
Reported Total Nurse Staffing Hours per Resident per Day
5.66842
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.11763
Expected LPN Staffing Hours per Resident per Day
0.53386
Expected RN Staffing Hours per Resident per Day
0.73219
Expected Total Nurse Staffing Hours per Resident per Day
3.38368
Adjusted CNA Staffing Hours per Resident per Day
4.44270
Adjusted LPN Staffing Hours per Resident per Day
1.96385
Adjusted RN Staffing Hours per Resident per Day
0.58275
Adjusted Total Nurse Staffing Hours per Resident per Day
6.75265
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-06-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-07-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-05-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
15.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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