Cycle 1
Health 2024-03-14 · Fire 2024-03-14
6 health deficiencies
Top issue: Infection Control (2 deficiencies)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Sapulpa, OK
Arbor Village
3-star overall rating with 3-star inspections with 6 recent health deficiencies
310 W Taft Ave, Sapulpa, OK
(918) 224-6012
Overall
3 / 5
CMS overall stars
Health inspections
3 / 5
Survey and complaint cycles
Staffing
4 / 5
RN + nurse staffing
Quality measures
2 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
142
Certified beds
Average residents
63
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Rivers Edge Operations
Operator or chain grouping
Approved since
1996-11-04
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
7 facilities
Chain averages 2 overall / 2 health / 2 staffing / 2 quality stars
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
0.25
Registered nurse staffing · state 0.34 · national 0.68
LPN hours / resident day
0.98
Licensed practical nurse staffing · state 0.92 · national 0.87
Aide hours / resident day
2.52
Nurse aide staffing · state 2.57 · national 2.35
Total nurse hours
3.75
All reported nurse hours · state 3.84 · national 3.89
Licensed hours
1.23
RN + LPN hours · state 1.27 · national 1.54
Weekend hours
3.34
Weekend nurse staffing · state 3.49 · national 3.43
Weekend RN hours
0.18
Weekend registered nurse coverage · state 0.29 · national 0.47
Physical therapist
0.02
Reported PT staffing · state 0.03 · national 0.07
Adjusted RN hours
0.34
CMS adjusted RN staffing hours
Adjusted total hours
5.11
CMS adjusted total nurse staffing hours
Case-mix index
1.00
Higher values indicate more complex resident acuity
RN turnover
20%
Annual RN turnover · state 55% · national 45%
Total nurse turnover
46%
Annual nurse turnover · state 56% · national 46%
SNF VBP
Value-based purchasing
Program rank
6,848
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
31.54
Composite VBP score used to determine payment impact.
Payment multiplier
0.9866
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
0
Baseline 19.45% · Performance 21.87% · Measure score 0 · Achievement 0 · Improvement 0
Healthcare-associated infections
0
Baseline 5.38% · Performance 7.84% · Measure score 0 · Achievement 0 · Improvement 0
Total nurse turnover
6.61
Baseline 100.00% · Performance 46.58% · Measure score 6.61 · Achievement 4.18 · Improvement 6.61
Adjusted total nurse staffing
6.01
Baseline 4.53 hours · Performance 4.79 hours · Measure score 6.01 · Achievement 6.01 · Improvement 1.52
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 12.3% |
10.72%
1.6 pts worse
|
No Different than the National Rate · Eligible stays 79 · Observed rate 17.72% · Lower 95% interval 8.57% |
| Discharge to community | 47.15% |
50.57%
3.4 pts worse
|
No Different than the National Rate · Eligible stays 39 · Observed rate 41.03% · Lower 95% interval 34.32% |
| Medicare spending per beneficiary | 0.75 |
1.02
0.3 pts better
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 40 · Denominator 40 |
| Falls with major injury | 5% |
0.77%
4.2 pts worse
|
Numerator 2 · Denominator 40 |
| Discharge self-care score | 31.03% |
53.69%
22.7 pts worse
|
Numerator 9 · Denominator 29 |
| Discharge mobility score | 24.14% |
50.94%
26.8 pts worse
|
Numerator 7 · Denominator 29 |
| Pressure ulcers or injuries, new or worsened | 2.5% |
2.29%
0.2 pts worse
|
Numerator 1 · Denominator 40 · Adjusted rate 2.81% |
| Healthcare-associated infections requiring hospitalization | 7.84% |
7.12%
0.7 pts worse
|
No Different than the National Rate · Eligible stays 44 · Observed rate 11.36% · Lower 95% interval 4.05% |
| Staff COVID-19 vaccination coverage | 2.08% |
8.2%
6.1 pts worse
|
Numerator 2 · Denominator 96 |
| Staff flu vaccination coverage | 13.13% |
42%
28.9 pts worse
|
Numerator 13 · Denominator 99 |
| Discharge function score | 44.83% |
56.45%
11.6 pts worse
|
Numerator 13 · Denominator 29 |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 15 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 4 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | Not Available |
25.2%
|
Numerator Not Available · Denominator 19 · Too few residents or stays to report publicly. |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 2.8 |
2.3
0.5 pts worse
|
1.9
0.9 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.8 · Observed 3.5 · Expected 2.4 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 2.7 |
2.9
0.2 pts better
|
1.8
0.9 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.7 · Observed 3.2 · Expected 2.0 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 99.1% |
90.3%
8.8 pts better
|
93.4%
5.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 98.3% · Q2 100.0% · Q3 100.0% · Q4 98.2% · 4Q avg 99.1% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 98.4% |
94.6%
3.8 pts better
|
95.5%
2.9 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 98.4% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 0.9% |
4.5%
3.6 pts better
|
3.3%
2.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.7% · Q2 1.8% · Q3 0.0% · Q4 0.0% · 4Q avg 0.9% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 11.3% |
3.3%
8 pts worse
|
11.4%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 7.5% · Q2 18.0% · Q3 4.7% · Q4 14.3% · 4Q avg 11.3% |
| Percentage of long-stay residents who lose too much weight | 6.0% |
3.6%
2.4 pts worse
|
5.4%
0.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 12.2% · Q2 6.8% · Q3 0.0% · Q4 4.2% · 4Q avg 6.0% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 34.8% |
25.3%
9.5 pts worse
|
19.6%
15.2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 29.1% · Q2 33.3% · Q3 42.6% · Q4 35.4% · 4Q avg 34.8% |
| Percentage of long-stay residents who received an antipsychotic medication | 12.3% |
18.6%
6.3 pts better
|
16.7%
4.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 11.6% · Q2 12.5% · Q3 15.2% · Q4 10.5% · 4Q avg 12.3% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.1%
0.1 pts better
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 15.9% |
15.5%
0.4 pts worse
|
16.3%
0.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q2 14.5% · Q3 21.7% · Q4 18.8% · 4Q avg 15.9% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 12.9% |
14.1%
1.2 pts better
|
14.9%
2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 14.8% · Q2 19.1% · Q3 13.0% · Q4 4.3% · 4Q avg 12.9% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 1.4% |
2.1%
0.7 pts better
|
1.0%
0.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 1.8% · Q3 2.1% · Q4 1.9% · 4Q avg 1.4% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 6.1% |
2.8%
3.3 pts worse
|
1.7%
4.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 9.1% · Q2 11.3% · Q3 2.0% · Q4 1.8% · 4Q avg 6.1% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 22.9% |
17.8%
5.1 pts worse
|
19.8%
3.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 25.8% · Q2 28.9% · Q3 13.7% · Q4 22.4% · 4Q avg 22.9% |
| Percentage of long-stay residents with pressure ulcers | 4.2% |
5.1%
0.9 pts better
|
5.1%
0.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 6.3% · Q2 5.7% · Q3 2.4% · Q4 2.3% · 4Q avg 4.2% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 38.9% |
75.0%
36.1 pts worse
|
81.7%
42.8 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 55.8% · Q2 38.3% · Q3 30.4% · Q4 35.5% · 4Q avg 38.9% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 8.2% |
17.1%
8.9 pts better
|
12.0%
3.8 pts better
|
Short Stay · 20240701-20250630 · Adjusted 8.2% · Observed 8.7% · Expected 11.9% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 2.4% |
1.9%
0.5 pts worse
|
1.6%
0.8 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 3.7% · Q3 3.2% · Q4 2.5% · 4Q avg 2.4% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 47.9% |
74.0%
26.1 pts worse
|
79.7%
31.8 pts worse
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 47.9% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 27.1% |
27.0%
0.1 pts worse
|
23.9%
3.2 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 27.1% · Observed 30.4% · Expected 26.8% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2023-01-26 · Fire 2023-01-26
3 health deficiencies
Top issue: Resident Assessment and Care Planning (2 deficiencies)
3 fire-safety deficiencies
Top issue: Smoke (2 deficiencies)
Cycle 3
Health 2019-05-06 · Fire 2019-05-06
3 health deficiencies
Top issue: Nutrition and Dietary (1 deficiency)
6 fire-safety deficiencies
Top issue: Smoke (3 deficiencies)
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2023-01-26
K347 · Smoke Deficiencies
Fire Safety
Properly provide smoke detection systems in areas open to corridors.
Corrected 2023-03-06
F · Potential for more than minimal harm
2023-01-26
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2023-03-31
E · Potential for more than minimal harm
2023-01-26
K521 · Services Deficiencies
Fire Safety
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Corrected 2023-03-31
F · Potential for more than minimal harm
2019-05-06
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2019-06-09
E · Potential for more than minimal harm
2019-05-06
K362 · Smoke Deficiencies
Fire Safety
Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.
Corrected 2019-06-09
E · Potential for more than minimal harm
2019-05-06
K372 · Smoke Deficiencies
Fire Safety
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Corrected 2019-06-09
E · Potential for more than minimal harm
2019-05-06
K522 · Services Deficiencies
Fire Safety
Have an externally vented heating system.
Corrected 2019-06-09
E · Potential for more than minimal harm
2019-05-06
K920 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure proper usage of power strips and extension cords.
Corrected 2019-06-09
C · Minimal harm
2019-05-06
E9 · Emergency Preparedness Deficiencies
Fire Safety
Include a process for Emergency Preparedness collaboration.
Corrected 2019-06-09
Inspection history
Recent health citations
G · Actual harm
2025-08-10
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2025-09-12
F · Potential for more than minimal harm
2025-08-10
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2025-09-12
F · Potential for more than minimal harm
2024-03-14
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2024-04-26
E · Potential for more than minimal harm
2024-03-14
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2024-04-26
D · Potential for more than minimal harm
2024-03-14
F645 · Resident Assessment and Care Planning Deficiencies
Health
PASARR screening for Mental disorders or Intellectual Disabilities
Corrected 2024-04-26
D · Potential for more than minimal harm
2024-03-14
F756 · Pharmacy Service Deficiencies
Health
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Corrected 2024-04-26
D · Potential for more than minimal harm
2024-02-13
F655 · Resident Assessment and Care Planning Deficiencies
Health
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Corrected 2024-03-21
D · Potential for more than minimal harm
2023-01-26
F657 · Resident Assessment and Care Planning Deficiencies
Health
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2023-03-31
D · Potential for more than minimal harm
2023-01-26
F661 · Resident Assessment and Care Planning Deficiencies
Health
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
Corrected 2023-03-31
D · Potential for more than minimal harm
2023-01-26
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2023-03-31
E · Potential for more than minimal harm
2019-05-06
F758 · Pharmacy Service Deficiencies
Health
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Corrected 2019-06-09
E · Potential for more than minimal harm
2019-05-06
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2019-06-09
Penalties and ownership
What sits behind the stars
$0
2025-08-10
Payment Denial
Payment Denial · denial start 2025-09-05 · 7 days
7 day denial
Ownership
Rivers Edge Operations LLC
5% Or Greater Direct Ownership Interest · Organization
Ganz, David
5% Or Greater Indirect Ownership Interest · Individual
Ganz, David
Operational/Managerial Control · Individual
Ganz, David
Corporate Officer · Individual
Johnson, Ernest
W-2 Managing Employee · Individual
Kravetz, Avrohom
5% Or Greater Indirect Ownership Interest · Individual
Oelbaum, Yitzchok
5% Or Greater Indirect Ownership Interest · Individual
Oelbaum, Yitzchok
Operational/Managerial Control · Individual
Oelbaum, Yitzchok
Corporate Officer · Individual
Retter, S. Aryeh
5% Or Greater Indirect Ownership Interest · Individual
Rivers Edge Partners LLC
5% Or Greater Indirect Ownership Interest · Organization
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#3
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