Southern Oaks Nursing & Rehabilitation Center
1524 Glen Oaks Place, Shreveport, LA 71103


Southern Oaks Nursing & Rehabilitation Center is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 195558. The address is 1524 Glen Oaks Place, Shreveport, LA 71103. The zip code is 71103. The phone number is 3182210911.


Southern Oaks Nursing & Rehabilitation Center · 1524 Glen Oaks Place, Shreveport, LA 71103

Federal Provider Number 195558
Provider Name SOUTHERN OAKS NURSING & REHABILITATION CENTER
Address 1524 GLEN OAKS PLACE
SHREVEPORT, LA 71103
Phone Number 3182210911
SSA County Code 80
County Name Caddo
Ownership Type For profit - Corporation
Certified Beds 61
Certified Beds Residents 59
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name SOUTHERN OAKS NURSING & REHABILITATION CENTER, LLC
Date First Approved to Provide Medicare Medicaid Services 10/24/2002
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 2
Health Inspection Rating 1
Quality Measure Rating 5
Staffing Rating 2
RN Staffing Rating 2
Reported CNA Staffing Hours per Resident per Day 2.06271
Reported LPN Staffing Hours per Resident per Day 1.04237
Reported RN Staffing Hours per Resident per Day 0.55254
Reported Licensed Staffing Hours per Resident per Day 1.59492
Reported Total Nurse Staffing Hours per Resident per Day 3.65762
Reported Physical Therapist Staffing Hours per Resident Per Day 0.0339
Expected CNA Staffing Hours per Resident per Day 2.37542
Expected LPN Staffing Hours per Resident per Day 0.70074
Expected RN Staffing Hours per Resident per Day 1.39813
Expected Total Nurse Staffing Hours per Resident per Day 4.47428
Adjusted CNA Staffing Hours per Resident per Day 2.13069
Adjusted LPN Staffing Hours per Resident per Day 1.23465
Adjusted RN Staffing Hours per Resident per Day 0.29529
Adjusted Total Nurse Staffing Hours per Resident per Day 3.29517
Cycle 1 Total Number of Health Deficiencies 2
Cycle 1 Number of Standard Health Deficiencies 2
Cycle 1 Health Deficiency Score 12
Cycle 1 Standard Survey Health Date 04/27/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 12
Cycle 2 Total Number of Health Deficiencies 8
Cycle 2 Number of Standard Health Deficiencies 8
Cycle 2 Number of Complaint Health Deficiencies 8
Cycle 2 Health Deficiency Score 470
Cycle 2 Standard Health Survey Date 05/24/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 470
Cycle 3 Total Number of Health Deficiencies 4
Cycle 3 Number of Complaint Health Deficiencies 4
Cycle 3 Health Deficiency Score 28
Cycle 3 Standard Health Survey Date 06/18/2015
Cycle 3 Total Health Score 28
Total Weighted Health Survey Score 167.333
Number of Substantiated Complaints 6
Number of Fines 1
Total Amount of Fines in Dollars $143000.00
Total Number of Penalties 1
Processing Date 08/01/2017

Owner or Manager · Southern Oaks Nursing & Rehabilitation Center

Owner Name Role Association Date
BAILEY PITTMAN, CAROLE (Individual) MANAGING EMPLOYEE since 11/25/2013
KISATCHIE CORPORATION (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 12/01/2008
KISATCHIE CORPORATION (Organization) OPERATIONAL/MANAGERIAL CONTROL since 12/01/2006
PRICE, TEDDY (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2006
PRICE, TEDDY (Individual) DIRECTOR since 12/01/2006

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