Clarksdale Nursing Center - Clarksdale Nursing Home

General Information

UPDATE
Federal Provider Number
255267
Provider Name
CLARKSDALE NURSING CENTER
Provider Address
1120 RITCHIE AVE/PO BOX 1304
CLARKSDALE, MS 38614
Provider Phone Number
(662) 627-2591
Provider SSA County
130
Provider County Name
Coahoma
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
112
Number of Residents in Certified Beds
93
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CARE GIVERS, LLC
Date First Approved to Provide Medicare and Medicaid services
2001-01-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
4
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
2.80484
Reported LPN Staffing Hours per Resident per Day
0.96505
Reported RN Staffing Hours per Resident per Day
0.59032
Reported Licensed Staffing Hours per Resident per Day
1.55538
Reported Total Nurse Staffing Hours per Resident per Day
4.36021
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06129
Expected CNA Staffing Hours per Resident per Day
2.32730
Expected LPN Staffing Hours per Resident per Day
0.61573
Expected RN Staffing Hours per Resident per Day
0.92052
Expected Total Nurse Staffing Hours per Resident per Day
3.86355
Adjusted CNA Staffing Hours per Resident per Day
2.95717
Adjusted LPN Staffing Hours per Resident per Day
1.30089
Adjusted RN Staffing Hours per Resident per Day
0.47917
Adjusted Total Nurse Staffing Hours per Resident per Day
4.54907
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-07-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
19
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
6
Cycle 2 Health Deficiency Score
180
Cycle 2 Standard Health Survey Date
2013-04-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
180
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
6
Cycle 3 Health Deficiency Score
164
Cycle 3 Standard Health Survey Date
2012-03-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
164
Total Weighted Health Survey Score
103.33300
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
6
Number of Fines
1
Total Amount of Fines in Dollars
15600
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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