Fairview Fellowship Home For Senior Citizens, Inc - Fairview Nursing Home
General Information
UPDATEFederal Provider Number
375427
Provider Name
FAIRVIEW FELLOWSHIP HOME FOR SENIOR CITIZENS, INC
Provider Address
605 EAST STATE ROAD
FAIRVIEW, OK 73737
FAIRVIEW, OK 73737
Provider Phone Number
5802273783
Provider SSA County
460
Provider County Name
Major
Ownership Type
Non profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
67
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FAIRVIEW FELLOWSHIP HOME FOR SENIOR CITIZENS INC
Date First Approved to Provide Medicare and Medicaid services
2003-01-31
Continuing Care Retirement Community
N
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.32239
Reported LPN Staffing Hours per Resident per Day
0.35821
Reported RN Staffing Hours per Resident per Day
0.50448
Reported Licensed Staffing Hours per Resident per Day
0.86269
Reported Total Nurse Staffing Hours per Resident per Day
4.18508
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00448
Expected CNA Staffing Hours per Resident per Day
2.00559
Expected LPN Staffing Hours per Resident per Day
0.51783
Expected RN Staffing Hours per Resident per Day
0.76539
Expected Total Nurse Staffing Hours per Resident per Day
3.28881
Adjusted CNA Staffing Hours per Resident per Day
4.06471
Adjusted LPN Staffing Hours per Resident per Day
0.57415
Adjusted RN Staffing Hours per Resident per Day
0.49249
Adjusted Total Nurse Staffing Hours per Resident per Day
5.12940
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-05-07
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-07-09
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-08-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
9.33300
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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