Arbor Village - Sapulpa Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
375284
Provider Name
ARBOR VILLAGE
Provider Address
310 WEST TAFT
SAPULPA, OK 74066
SAPULPA, OK 74066
Provider Phone Number
(918) 224-6012
Provider SSA County
180
Provider County Name
Creek
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
142
Number of Residents in Certified Beds
60
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ARBOR VILLAGE NURSING LLC
Date First Approved to Provide Medicare and Medicaid services
1996-11-04
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
4
Overall Rating Footnote
Health Inspection Rating
3
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
2.39750
Reported LPN Staffing Hours per Resident per Day
0.31750
Reported RN Staffing Hours per Resident per Day
0.65750
Reported Licensed Staffing Hours per Resident per Day
0.97500
Reported Total Nurse Staffing Hours per Resident per Day
3.37250
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00333
Expected CNA Staffing Hours per Resident per Day
2.04554
Expected LPN Staffing Hours per Resident per Day
0.61068
Expected RN Staffing Hours per Resident per Day
0.84726
Expected Total Nurse Staffing Hours per Resident per Day
3.50348
Adjusted CNA Staffing Hours per Resident per Day
2.87589
Adjusted LPN Staffing Hours per Resident per Day
0.43152
Adjusted RN Staffing Hours per Resident per Day
0.57985
Adjusted Total Nurse Staffing Hours per Resident per Day
3.88020
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
100
Cycle 1 Standard Survey Health Date
2014-08-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
100
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2013-07-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
68
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
10
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2012-06-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
84.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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