Broken Arrow Nursing Home, Inc - Broken Arrow Nursing Home
General Information
UPDATEFederal Provider Number
37E318
Provider Name
BROKEN ARROW NURSING HOME, INC
Provider Address
424 NORTH DATE
BROKEN ARROW, OK 74012
BROKEN ARROW, OK 74012
Provider Phone Number
(918) 251-5343
Provider SSA County
710
Provider County Name
Tulsa
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
101
Number of Residents in Certified Beds
86
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1975-07-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
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
2.41279
Reported LPN Staffing Hours per Resident per Day
0.72035
Reported RN Staffing Hours per Resident per Day
0.30291
Reported Licensed Staffing Hours per Resident per Day
1.02326
Reported Total Nurse Staffing Hours per Resident per Day
3.43605
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02500
Expected CNA Staffing Hours per Resident per Day
2.30529
Expected LPN Staffing Hours per Resident per Day
0.55482
Expected RN Staffing Hours per Resident per Day
0.73985
Expected Total Nurse Staffing Hours per Resident per Day
3.59996
Adjusted CNA Staffing Hours per Resident per Day
2.56812
Adjusted LPN Staffing Hours per Resident per Day
1.07764
Adjusted RN Staffing Hours per Resident per Day
0.30592
Adjusted Total Nurse Staffing Hours per Resident per Day
3.84737
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
84
Cycle 1 Standard Survey Health Date
2014-04-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
84
Cycle 2 Total Number of Health Deficiencies
17
Cycle 2 Number of Standard Health Deficiencies
15
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
398
Cycle 2 Standard Health Survey Date
2013-05-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
398
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-03-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
176.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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