Epworth Villa Health Services - Oklahoma City Nursing Home
General Information
UPDATEFederal Provider Number
375473
Provider Name
EPWORTH VILLA HEALTH SERVICES
Provider Address
14901 NORTH PENN AVENUE
OKLAHOMA CITY, OK 73134
OKLAHOMA CITY, OK 73134
Provider Phone Number
(405) 752-1200
Provider SSA County
540
Provider County Name
Oklahoma
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
87
Number of Residents in Certified Beds
65
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
EPWORTH AT HOME LLC
Date First Approved to Provide Medicare and Medicaid services
2005-01-24
Continuing Care Retirement Community
Y
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
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
4.90846
Reported LPN Staffing Hours per Resident per Day
1.29231
Reported RN Staffing Hours per Resident per Day
1.25462
Reported Licensed Staffing Hours per Resident per Day
2.54692
Reported Total Nurse Staffing Hours per Resident per Day
7.45539
Reported Physical Therapist Staffing Hours per Resident Per Day
0.26846
Expected CNA Staffing Hours per Resident per Day
2.58025
Expected LPN Staffing Hours per Resident per Day
0.58652
Expected RN Staffing Hours per Resident per Day
1.00384
Expected Total Nurse Staffing Hours per Resident per Day
4.17062
Adjusted CNA Staffing Hours per Resident per Day
4.66771
Adjusted LPN Staffing Hours per Resident per Day
1.82878
Adjusted RN Staffing Hours per Resident per Day
0.93386
Adjusted Total Nurse Staffing Hours per Resident per Day
7.20563
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-11-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-10-01
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2012-08-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
26.66700
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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