Sequoyah Manor, Llc - Sallisaw Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
375173
Provider Name
SEQUOYAH MANOR, LLC
Provider Address
615 EAST REDWOOD
SALLISAW, OK 74955
SALLISAW, OK 74955
Provider Phone Number
(918) 775-4881
Provider SSA County
670
Provider County Name
Sequoyah
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
162
Number of Residents in Certified Beds
107
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SEQUOYAH MANOR LLC
Date First Approved to Provide Medicare and Medicaid services
1994-05-01
Continuing Care Retirement Community
N
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
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
1
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
2.26028
Reported LPN Staffing Hours per Resident per Day
0.63692
Reported RN Staffing Hours per Resident per Day
0.26495
Reported Licensed Staffing Hours per Resident per Day
0.90187
Reported Total Nurse Staffing Hours per Resident per Day
3.16215
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00140
Expected CNA Staffing Hours per Resident per Day
2.10285
Expected LPN Staffing Hours per Resident per Day
0.56889
Expected RN Staffing Hours per Resident per Day
0.81158
Expected Total Nurse Staffing Hours per Resident per Day
3.48333
Adjusted CNA Staffing Hours per Resident per Day
2.63739
Adjusted LPN Staffing Hours per Resident per Day
0.92925
Adjusted RN Staffing Hours per Resident per Day
0.24393
Adjusted Total Nurse Staffing Hours per Resident per Day
3.65923
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2015-04-02
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
92
Cycle 2 Standard Health Survey Date
2014-01-31
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
92
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
76
Cycle 3 Standard Health Survey Date
2013-03-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
76
Total Weighted Health Survey Score
71.33300
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
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