Northside Nursing Home - Sapulpa Nursing Home
General Information
UPDATEFederal Provider Number
375523
Provider Name
NORTHSIDE NURSING HOME
Provider Address
102 EAST LINE
SAPULPA, OK 74067
SAPULPA, OK 74067
Provider Phone Number
9182240833
Provider SSA County
180
Provider County Name
Creek
Ownership Type
For profit - Corporation
Number of Certified Beds
69
Number of Residents in Certified Beds
54
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ARBOR VILLAGE NURSING LLC
Date First Approved to Provide Medicare and Medicaid services
2008-01-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
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
2.65185
Reported LPN Staffing Hours per Resident per Day
0.89352
Reported RN Staffing Hours per Resident per Day
0.27222
Reported Licensed Staffing Hours per Resident per Day
1.16574
Reported Total Nurse Staffing Hours per Resident per Day
3.81759
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.08245
Expected LPN Staffing Hours per Resident per Day
0.55960
Expected RN Staffing Hours per Resident per Day
0.70420
Expected Total Nurse Staffing Hours per Resident per Day
3.34626
Adjusted CNA Staffing Hours per Resident per Day
3.12461
Adjusted LPN Staffing Hours per Resident per Day
1.32526
Adjusted RN Staffing Hours per Resident per Day
0.28884
Adjusted Total Nurse Staffing Hours per Resident per Day
4.59867
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
52
Cycle 1 Standard Survey Health Date
2014-02-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2013-03-08
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
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
32
Total Weighted Health Survey Score
52.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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
Nursiong Homes Nearby
Arbor Village
310 West Taft |
SAPULPA OK 74066 | 1.1 miles away
Ranch Terrace Nursing Home, Inc
1310 East Cleveland |
SAPULPA OK 74066 | 1.3 miles away
The Gardens
1165 South Brenner Road |
SAPULPA OK 74066 | 2.1 miles away
Cimarron Pointe Care Center
404 East Cimarron |
MANNFORD OK 74044 | 15.9 miles away
Rainbow Health Care Community And Rainbow Assisted
111 East Washington |
BRISTOW OK 74010 | 19.7 miles away
Drumright Nursing Home
Pine & Bristow |
DRUMRIGHT OK 74030 | 27.7 miles away
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