Oklahoma Methodist Manor, Inc. - Tulsa Nursing Home
General Information
UPDATEFederal Provider Number
375454
Provider Name
OKLAHOMA METHODIST MANOR, INC.
Provider Address
4134 EAST 31ST STREET
TULSA, OK 74135
TULSA, OK 74135
Provider Phone Number
(918) 743-2565
Provider SSA County
710
Provider County Name
Tulsa
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
84
Number of Residents in Certified Beds
73
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
OKLAHOMA METHODIST MANOR INC
Date First Approved to Provide Medicare and Medicaid services
2003-11-01
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
1
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.45205
Reported LPN Staffing Hours per Resident per Day
1.31438
Reported RN Staffing Hours per Resident per Day
1.25274
Reported Licensed Staffing Hours per Resident per Day
2.56712
Reported Total Nurse Staffing Hours per Resident per Day
6.01917
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07808
Expected CNA Staffing Hours per Resident per Day
2.39686
Expected LPN Staffing Hours per Resident per Day
0.65601
Expected RN Staffing Hours per Resident per Day
1.09948
Expected Total Nurse Staffing Hours per Resident per Day
4.15235
Adjusted CNA Staffing Hours per Resident per Day
3.53392
Adjusted LPN Staffing Hours per Resident per Day
1.66298
Adjusted RN Staffing Hours per Resident per Day
0.85136
Adjusted Total Nurse Staffing Hours per Resident per Day
5.84312
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2015-02-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
20
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
10
Cycle 2 Health Deficiency Score
120
Cycle 2 Standard Health Survey Date
2014-01-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
120
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
6
Cycle 3 Health Deficiency Score
431
Cycle 3 Standard Health Survey Date
2012-10-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
431
Total Weighted Health Survey Score
135.83300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
Number of Fines
1
Total Amount of Fines in Dollars
24863
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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