North County Center For Nursing And Rehabilitation - Collinsville Nursing Home
General Information
UPDATEFederal Provider Number
375504
Provider Name
NORTH COUNTY CENTER FOR NURSING AND REHABILITATION
Provider Address
2300 WEST BROADWAY
COLLINSVILLE, OK 74021
COLLINSVILLE, OK 74021
Provider Phone Number
(918) 371-2545
Provider SSA County
710
Provider County Name
Tulsa
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
119
Number of Residents in Certified Beds
65
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
NORTH COUNTY SENIOR LIVING, LLC
Date First Approved to Provide Medicare and Medicaid services
2006-12-20
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
1
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
2.91538
Reported LPN Staffing Hours per Resident per Day
1.10077
Reported RN Staffing Hours per Resident per Day
0.30077
Reported Licensed Staffing Hours per Resident per Day
1.40154
Reported Total Nurse Staffing Hours per Resident per Day
4.31692
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01000
Expected CNA Staffing Hours per Resident per Day
2.25250
Expected LPN Staffing Hours per Resident per Day
0.59045
Expected RN Staffing Hours per Resident per Day
0.94830
Expected Total Nurse Staffing Hours per Resident per Day
3.79125
Adjusted CNA Staffing Hours per Resident per Day
3.17579
Adjusted LPN Staffing Hours per Resident per Day
1.54736
Adjusted RN Staffing Hours per Resident per Day
0.23699
Adjusted Total Nurse Staffing Hours per Resident per Day
4.58980
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-06-05
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
20
Cycle 1 Total Health Score
60
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
76
Cycle 2 Standard Health Survey Date
2013-07-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
76
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2012-05-03
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
32
Cycle 3 Total Health Score
96
Total Weighted Health Survey Score
71.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
Number of Fines
1
Total Amount of Fines in Dollars
2275
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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