Lake Country Nursing Center - Marietta Nursing Home
General Information
UPDATEFederal Provider Number
375310
Provider Name
LAKE COUNTRY NURSING CENTER
Provider Address
301 C E COLSTON DRIVE
MARIETTA, OK 73448
MARIETTA, OK 73448
Provider Phone Number
5802763318
Provider SSA County
420
Provider County Name
Love
Ownership Type
Non profit - Corporation
Number of Certified Beds
69
Number of Residents in Certified Beds
60
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SCG LAKE COUNTRY LLC
Date First Approved to Provide Medicare and Medicaid services
1997-08-01
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
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
2.36833
Reported LPN Staffing Hours per Resident per Day
0.77917
Reported RN Staffing Hours per Resident per Day
0.23667
Reported Licensed Staffing Hours per Resident per Day
1.01583
Reported Total Nurse Staffing Hours per Resident per Day
3.38417
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00250
Expected CNA Staffing Hours per Resident per Day
2.32592
Expected LPN Staffing Hours per Resident per Day
0.60327
Expected RN Staffing Hours per Resident per Day
0.79714
Expected Total Nurse Staffing Hours per Resident per Day
3.72633
Adjusted CNA Staffing Hours per Resident per Day
2.49844
Adjusted LPN Staffing Hours per Resident per Day
1.07200
Adjusted RN Staffing Hours per Resident per Day
0.22184
Adjusted Total Nurse Staffing Hours per Resident per Day
3.66077
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
16
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
148
Cycle 1 Standard Survey Health Date
2014-06-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
148
Cycle 2 Total Number of Health Deficiencies
20
Cycle 2 Number of Standard Health Deficiencies
20
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
132
Cycle 2 Standard Health Survey Date
2013-07-17
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
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2012-04-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
128.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
2
Total Amount of Fines in Dollars
6000
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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