Liberty Community Living Ctr - Liberty Nursing Home
General Information
UPDATEFederal Provider Number
255271
Provider Name
LIBERTY COMMUNITY LIVING CTR
Provider Address
323 INDUSTRIAL PARK DRIVE
LIBERTY, MS 39645
LIBERTY, MS 39645
Provider Phone Number
6016571000
Provider SSA County
20
Provider County Name
Amite
Ownership Type
For profit - Partnership
Number of Certified Beds
80
Number of Residents in Certified Beds
77
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CLC OF LIBERTY, LLC
Date First Approved to Provide Medicare and Medicaid services
2001-01-08
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.81753
Reported LPN Staffing Hours per Resident per Day
0.84870
Reported RN Staffing Hours per Resident per Day
0.67403
Reported Licensed Staffing Hours per Resident per Day
1.52273
Reported Total Nurse Staffing Hours per Resident per Day
3.34026
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05584
Expected CNA Staffing Hours per Resident per Day
2.42799
Expected LPN Staffing Hours per Resident per Day
0.63249
Expected RN Staffing Hours per Resident per Day
1.00308
Expected Total Nurse Staffing Hours per Resident per Day
4.06356
Adjusted CNA Staffing Hours per Resident per Day
1.83678
Adjusted LPN Staffing Hours per Resident per Day
1.11373
Adjusted RN Staffing Hours per Resident per Day
0.50209
Adjusted Total Nurse Staffing Hours per Resident per Day
3.31341
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-09-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-07-02
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
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-06-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
24.00000
Number of Facility Reported Incidents
1
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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