01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2024-11-06 | 6 | 2024-11-06 | 2 |
| Cycle 2 | 2023-09-21 | 1 | 2023-09-21 | 0 |
| Cycle 3 | 2022-03-14 | 4 | 2022-03-14 | 4 |
CMS CCN 3753732026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Perry Green Valley Nursing Center, Llc
1103 Birch Street · Perry, OK 73077 · Noble County
Certified beds112CMS provider file
Recent citation rows17current CMS citation release
Penalty rows1current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
17 rows in the current release
1 rows carry G–L scope/severity codes; 0 carry J–L. 2 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-05-30 · HEALTHF0689Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2025-06-10 · complaint2024-11-06 · HEALTHF0689Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2024-11-292024-11-06 · HEALTHF0700Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Correction field: Deficient, Provider has date of correction · 2024-12-032024-11-06 · HEALTHF0809Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.
Correction field: Deficient, Provider has date of correction · 2024-12-032024-11-06 · HEALTHF0848Severity E · pattern; potential for more than minimal harm
Administration Deficiencies
Provide a neutral and fair arbitration process and agree to arbitrator and venue.
Correction field: Deficient, Provider has date of correction · 2024-12-032024-11-06 · HEALTHF0880Severity E · pattern; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2024-12-03 · complaint2024-11-06 · HEALTHF0909Severity E · pattern; potential for more than minimal harm
Environmental Deficiencies
Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame.
Correction field: Deficient, Provider has date of correction · 2024-11-292024-11-06 · FIREK0291Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Install emergency lighting that can last at least 1 1/2 hours.
Correction field: Deficient, Provider has date of correction · 2024-11-262024-11-06 · FIREK0293Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Have properly located and lighted "Exit" signs.
Correction field: Deficient, Provider has date of correction · 2024-11-262022-03-14 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2022-04-152022-03-14 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2022-04-072022-03-14 · HEALTHF0759Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
Correction field: Deficient, Provider has date of correction · 2022-04-152022-03-14 · HEALTHF0880Severity E · pattern; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2022-04-292022-03-14 · FIREK0321Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Correction field: Deficient, Provider has date of correction · 2022-04-082022-03-14 · FIREK0324Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2022-04-082022-03-14 · FIREK0353Severity C · widespread; potential for minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2022-04-082022-03-14 · FIREK0761Severity C · widespread; potential for minimal harm
Miscellaneous Deficiencies
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Correction field: Deficient, Provider has date of correction · 2022-04-0803 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2025-05-30 | Fine | $8,278 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- HMLC LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 06/05/2012
- CHAPPELL 2012 SUCCESSION TRUSTOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTEREST75% · since 06/05/2012
- GOLDEN AGE NURSING HOME OF GUTHRIE INC.Organization · 5% OR GREATER INDIRECT OWNERSHIP INTEREST8% · since 06/05/2012
- MARY LOU CHAPPELL TRUSTOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTEREST10% · since 01/01/2017
- WALLER, WILLIAMIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 02/03/2023
- HASTINGS, TANDIEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 07/01/2007
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours3.99per resident day
RN hours0.41per resident day
Weekend nurse hours3.72per resident day
Staff turnover40.9%CMS reported field
06 / LOCAL RECORDS
Open the Oklahoma ledger →Other published facilities nearby
No second facility in the same city met the directory rule.