Country Club Care - Duncan Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
375495
Provider Name
COUNTRY CLUB CARE
Provider Address
1904 NORTH HIGHWAY 81
DUNCAN, OK 73533
DUNCAN, OK 73533
Provider Phone Number
(580) 255-4600
Provider SSA County
680
Provider County Name
Stephens
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
104
Number of Residents in Certified Beds
91
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
KANAKUK, INC.
Date First Approved to Provide Medicare and Medicaid services
2005-04-30
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
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.74560
Reported LPN Staffing Hours per Resident per Day
0.54121
Reported RN Staffing Hours per Resident per Day
0.06264
Reported Licensed Staffing Hours per Resident per Day
0.60385
Reported Total Nurse Staffing Hours per Resident per Day
3.34945
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00495
Expected CNA Staffing Hours per Resident per Day
2.02447
Expected LPN Staffing Hours per Resident per Day
0.54827
Expected RN Staffing Hours per Resident per Day
0.79348
Expected Total Nurse Staffing Hours per Resident per Day
3.36622
Adjusted CNA Staffing Hours per Resident per Day
3.32773
Adjusted LPN Staffing Hours per Resident per Day
0.81931
Adjusted RN Staffing Hours per Resident per Day
0.05899
Adjusted Total Nurse Staffing Hours per Resident per Day
4.01082
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2015-03-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2014-04-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2013-02-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
42.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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