Community Place - Jackson Nursing Home
General Information
UPDATEFederal Provider Number
255285
Provider Name
COMMUNITY PLACE
Provider Address
1129 LANGLEY AVE
JACKSON, MS 39204
JACKSON, MS 39204
Provider Phone Number
(601) 355-0617
Provider SSA County
240
Provider County Name
Hinds
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
50
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COMMUNITY PLACE
Date First Approved to Provide Medicare and Medicaid services
2002-04-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
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
2.79200
Reported LPN Staffing Hours per Resident per Day
1.22400
Reported RN Staffing Hours per Resident per Day
0.47100
Reported Licensed Staffing Hours per Resident per Day
1.69500
Reported Total Nurse Staffing Hours per Resident per Day
4.48700
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00300
Expected CNA Staffing Hours per Resident per Day
2.37470
Expected LPN Staffing Hours per Resident per Day
0.57719
Expected RN Staffing Hours per Resident per Day
0.80748
Expected Total Nurse Staffing Hours per Resident per Day
3.75937
Adjusted CNA Staffing Hours per Resident per Day
2.88488
Adjusted LPN Staffing Hours per Resident per Day
1.76012
Adjusted RN Staffing Hours per Resident per Day
0.43584
Adjusted Total Nurse Staffing Hours per Resident per Day
4.81108
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
7
Cycle 1 Health Deficiency Score
432
Cycle 1 Standard Survey Health Date
2015-01-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
432
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-11-26
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2013-01-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
244.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
411483
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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