Saint Simeons Episcopal Home - Tulsa Nursing Home
General Information
UPDATEFederal Provider Number
375554
Provider Name
SAINT SIMEONS EPISCOPAL HOME
Provider Address
3701 MARTIN LUTHER KING JR BLVD
TULSA, OK 74106
TULSA, OK 74106
Provider Phone Number
9184253583
Provider SSA County
710
Provider County Name
Tulsa
Ownership Type
Non profit - Church related
Number of Certified Beds
55
Number of Residents in Certified Beds
45
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
ST SIMEONS EPISCOPAL HOME, INC
Date First Approved to Provide Medicare and Medicaid services
2013-06-29
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.73889
Reported LPN Staffing Hours per Resident per Day
0.84556
Reported RN Staffing Hours per Resident per Day
0.38000
Reported Licensed Staffing Hours per Resident per Day
1.22556
Reported Total Nurse Staffing Hours per Resident per Day
4.96445
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00667
Expected CNA Staffing Hours per Resident per Day
2.61307
Expected LPN Staffing Hours per Resident per Day
0.66785
Expected RN Staffing Hours per Resident per Day
0.98958
Expected Total Nurse Staffing Hours per Resident per Day
4.27050
Adjusted CNA Staffing Hours per Resident per Day
3.51085
Adjusted LPN Staffing Hours per Resident per Day
1.05086
Adjusted RN Staffing Hours per Resident per Day
0.28693
Adjusted Total Nurse Staffing Hours per Resident per Day
4.68592
Cycle 1 Total Number of Health Deficiencies
18
Cycle 1 Number of Standard Health Deficiencies
18
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
160
Cycle 1 Standard Survey Health Date
2014-08-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
160
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-05-15
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
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
-0001-11-30
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
115.20000
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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Manorcare Health Services-tulsa
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TULSA OK 74129 | 8.1 miles away
Colonial Manor Nursing Home, Inc
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Sherwood Manor Nursing Home
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Tulsa Nursing Center
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The Villages At Southern Hills
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