01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2024-08-29 | 11 | 2024-08-29 | 1 |
| Cycle 2 | 2023-07-27 | 6 | 2023-07-27 | 2 |
| Cycle 3 | 2022-11-28 | 5 | 2022-11-28 | 1 |
CMS CCN 3753342026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Shady Rest Care Center
210 South Adair · Pryor, OK 74361 · Mayes County
Certified beds65CMS provider file
Recent citation rows26current 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
26 rows in the current release
1 rows carry G–L scope/severity codes; 1 carry J–L. 3 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-07-09 · HEALTHF0689Severity J · isolated immediate jeopardy
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: Past Non-Compliance · 2025-06-19 · complaint2024-08-29 · HEALTHF0578Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Correction field: Deficient, Provider has date of correction · 2024-10-282024-08-29 · 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 · 2024-10-282024-08-29 · HEALTHF0584Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Correction field: Deficient, Provider has date of correction · 2024-10-28 · complaint2024-08-29 · HEALTHF0636Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
Correction field: Deficient, Provider has date of correction · 2024-10-282024-08-29 · HEALTHF0656Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2024-10-282024-08-29 · HEALTHF0657Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Correction field: Deficient, Provider has date of correction · 2024-10-28 · complaint2024-08-29 · HEALTHF0758Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2024-10-282024-08-29 · HEALTHF0800Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.
Correction field: Deficient, Provider has date of correction · 2024-10-28 · complaint2024-08-29 · HEALTHF0801Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
Correction field: Deficient, Provider has date of correction · 2024-10-28 · complaint2024-08-29 · HEALTHF0806Severity D · isolated; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Correction field: Deficient, Provider has date of correction · 2024-10-28 · complaint2024-08-29 · HEALTHF0908Severity E · pattern; potential for more than minimal harm
Environmental Deficiencies
Keep all essential equipment working safely.
Correction field: Deficient, Provider has date of correction · 2024-10-282024-08-29 · FIREK0362Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.
Correction field: Deficient, Provider has date of correction · 2024-11-042024-08-06 · HEALTHF0584Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Correction field: Deficient, Provider has date of correction · 2024-09-13 · complaint2023-07-27 · HEALTHF0623Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Correction field: Deficient, Provider has date of correction · 2023-08-252023-07-27 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2023-08-252023-07-27 · HEALTHF0661Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
Correction field: Deficient, Provider has date of correction · 2023-08-252023-07-27 · HEALTHF0755Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Correction field: Deficient, Provider has date of correction · 2023-08-252023-07-27 · 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 · 2023-08-252023-07-27 · FIREK0372Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Correction field: Deficient, Provider has date of correction · 2023-08-252022-11-28 · HEALTHF0578Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Correction field: Deficient, Provider has date of correction · 2022-12-262022-11-28 · HEALTHF0582Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Correction field: Deficient, Provider has date of correction · 2022-12-262022-11-28 · HEALTHF0661Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
Correction field: Deficient, Provider has date of correction · 2022-12-262022-11-28 · HEALTHF0692Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Correction field: Deficient, Provider has date of correction · 2022-12-2603 / 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 |
|---|---|---|---|
| 2025-07-09 | Fine | $14,069 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- ANGELUS HOLDINGS LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST13% · since 12/12/2025
- BGM ESTATE LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST38% · since 12/15/2011
- PHILIP MARION GREEN EXEMPT TR CU GILBERT F GREEN TROrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST11% · since 12/12/2025
- TIFFANY SEAY EXEMPT TROrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST14% · since 12/12/2025
- PHILIP M. GREEN REVOCABLE TRUSTOrganization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 12/12/2025
- MITCHELL, KELLYIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST9% · since 12/06/2011
- MITCHELL, MARCINDAIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST9% · since 12/15/2011
- MITCHELL, ROBERTIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST9% · since 12/15/2011
- TABOR, ANGELAIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST9% · since 12/15/2011
- BELT, MIRANDAIndividual · CORPORATE OFFICERNOT APPLICABLE · since 12/09/2024
- PITTS, JACIIndividual · CORPORATE OFFICERNOT APPLICABLE · since 12/09/2024
- TAYLOR, SANDRAIndividual · CORPORATE OFFICERNOT APPLICABLE · since 12/15/2011
- BROWN, JACKIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/01/2019
- LOWRIMORE, MORGANIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/07/2025
- ANGELUS HOLDINGS LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 12/12/2025
- PHILIP M. GREEN REVOCABLE TRUSTOrganization · ADP OF THE SNFNOT APPLICABLE · since 12/12/2025
- PHILIP MARION GREEN EXEMPT TR CU GILBERT F GREEN TROrganization · ADP OF THE SNFNOT APPLICABLE · since 12/12/2025
- TIFFANY SEAY EXEMPT TROrganization · ADP OF THE SNFNOT APPLICABLE · since 12/12/2025
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 hours3.89per resident day
RN hours0.27per resident day
Weekend nurse hours3.86per resident day
Staff turnover57.1%CMS reported field
06 / LOCAL RECORDS
Open the Pryor ledger →