Shattuck Nursing Center - Shattuck Nursing Home
General Information
UPDATEFederal Provider Number
370000000000000000000000000000
Provider Name
SHATTUCK NURSING CENTER
Provider Address
201 NORTH ALFALFA
SHATTUCK, OK 73858
SHATTUCK, OK 73858
Provider Phone Number
5809382501
Provider SSA County
220
Provider County Name
Ellis
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
43
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1978-02-20
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
3
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
2
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
2.31860
Reported LPN Staffing Hours per Resident per Day
0.38837
Reported RN Staffing Hours per Resident per Day
0.34767
Reported Licensed Staffing Hours per Resident per Day
0.73605
Reported Total Nurse Staffing Hours per Resident per Day
3.05464
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.07104
Expected LPN Staffing Hours per Resident per Day
0.56092
Expected RN Staffing Hours per Resident per Day
0.78333
Expected Total Nurse Staffing Hours per Resident per Day
3.41529
Adjusted CNA Staffing Hours per Resident per Day
2.74700
Adjusted LPN Staffing Hours per Resident per Day
0.57468
Adjusted RN Staffing Hours per Resident per Day
0.33163
Adjusted Total Nurse Staffing Hours per Resident per Day
3.60524
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2015-04-16
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2014-02-13
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
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2013-03-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
42.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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