Grace Living Center-tahlequah University Northwest - Tahlequah Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
375185
Provider Name
GRACE LIVING CENTER-TAHLEQUAH UNIVERSITY NORTHWEST
Provider Address
1201 NORTH VINITA AVENUE
TAHLEQUAH, OK 74464
TAHLEQUAH, OK 74464
Provider Phone Number
(918) 456-6181
Provider SSA County
100
Provider County Name
Cherokee
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
139
Number of Residents in Certified Beds
53
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
UNIVERSITY NORTHWEST LLC
Date First Approved to Provide Medicare and Medicaid services
1994-09-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.07075
Reported LPN Staffing Hours per Resident per Day
1.18302
Reported RN Staffing Hours per Resident per Day
0.32736
Reported Licensed Staffing Hours per Resident per Day
1.51038
Reported Total Nurse Staffing Hours per Resident per Day
3.58113
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
1.95920
Expected LPN Staffing Hours per Resident per Day
0.49997
Expected RN Staffing Hours per Resident per Day
0.67690
Expected Total Nurse Staffing Hours per Resident per Day
3.13607
Adjusted CNA Staffing Hours per Resident per Day
2.59341
Adjusted LPN Staffing Hours per Resident per Day
1.96393
Adjusted RN Staffing Hours per Resident per Day
0.36136
Adjusted Total Nurse Staffing Hours per Resident per Day
4.60295
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
40
Cycle 1 Standard Survey Health Date
2014-07-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2013-04-26
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
56
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
7
Cycle 3 Health Deficiency Score
128
Cycle 3 Standard Health Survey Date
2012-06-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
128
Total Weighted Health Survey Score
60.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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