Oklahoma Nursing Homes >> Henryetta Nursing Homes >> Fountain View Manor, Inc

Fountain View Manor, Inc - Henryetta Nursing Home

General Information

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Federal Provider Number
375462
Provider Name
FOUNTAIN VIEW MANOR, INC
Provider Address
107 EAST BARCLAY
HENRYETTA, OK 74437
Provider Phone Number
(918) 652-7021
Provider SSA County
550
Provider County Name
Okmulgee
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
119
Number of Residents in Certified Beds
88
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FOUNTAIN VIEW MANOR, INC.
Date First Approved to Provide Medicare and Medicaid services
2003-09-30
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
2.87955
Reported LPN Staffing Hours per Resident per Day
0.92841
Reported RN Staffing Hours per Resident per Day
0.24716
Reported Licensed Staffing Hours per Resident per Day
1.17557
Reported Total Nurse Staffing Hours per Resident per Day
4.05512
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01307
Expected CNA Staffing Hours per Resident per Day
2.27650
Expected LPN Staffing Hours per Resident per Day
0.53224
Expected RN Staffing Hours per Resident per Day
0.74666
Expected Total Nurse Staffing Hours per Resident per Day
3.55540
Adjusted CNA Staffing Hours per Resident per Day
3.10369
Adjusted LPN Staffing Hours per Resident per Day
1.44780
Adjusted RN Staffing Hours per Resident per Day
0.24734
Adjusted Total Nurse Staffing Hours per Resident per Day
4.59745
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2014-05-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
21
Cycle 2 Number of Standard Health Deficiencies
20
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
140
Cycle 2 Standard Health Survey Date
2013-06-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
140
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
9
Cycle 3 Health Deficiency Score
209
Cycle 3 Standard Health Survey Date
2012-05-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
209
Total Weighted Health Survey Score
113.50000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
7
Number of Fines
1
Total Amount of Fines in Dollars
13098
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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