Forest Hills Care And Rehabilitation Center - Broken Arrow Nursing Home
General Information
UPDATEFederal Provider Number
375392
Provider Name
FOREST HILLS CARE AND REHABILITATION CENTER
Provider Address
4300 WEST HOUSTON
BROKEN ARROW, OK 74012
BROKEN ARROW, OK 74012
Provider Phone Number
(918) 254-5000
Provider SSA County
710
Provider County Name
Tulsa
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
159
Number of Residents in Certified Beds
103
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
FOREST HILLS HEALTH CARE
Date First Approved to Provide Medicare and Medicaid services
2001-02-20
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
2
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
1
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
2.07913
Reported LPN Staffing Hours per Resident per Day
1.00680
Reported RN Staffing Hours per Resident per Day
0.38010
Reported Licensed Staffing Hours per Resident per Day
1.38689
Reported Total Nurse Staffing Hours per Resident per Day
3.46603
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11214
Expected CNA Staffing Hours per Resident per Day
2.76910
Expected LPN Staffing Hours per Resident per Day
0.70254
Expected RN Staffing Hours per Resident per Day
1.25286
Expected Total Nurse Staffing Hours per Resident per Day
4.72450
Adjusted CNA Staffing Hours per Resident per Day
1.84232
Adjusted LPN Staffing Hours per Resident per Day
1.18946
Adjusted RN Staffing Hours per Resident per Day
0.22669
Adjusted Total Nurse Staffing Hours per Resident per Day
2.95719
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2014-04-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
8
Cycle 2 Health Deficiency Score
177
Cycle 2 Standard Health Survey Date
2013-01-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
177
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2011-10-27
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
94.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
6
Number of Fines
1
Total Amount of Fines in Dollars
9458
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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