Copiah Living Center - Crystal Springs Nursing Home
General Information
UPDATEFederal Provider Number
255291
Provider Name
COPIAH LIVING CENTER
Provider Address
806 WEST GEORGETOWN STREET
CRYSTAL SPRINGS, MS 39059
CRYSTAL SPRINGS, MS 39059
Provider Phone Number
(601) 892-1880
Provider SSA County
140
Provider County Name
Copiah
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
60
Number of Residents in Certified Beds
56
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COPIAH COMMUNITY CARE CENTER, LLC
Date First Approved to Provide Medicare and Medicaid services
2002-09-01
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
4
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.40357
Reported LPN Staffing Hours per Resident per Day
0.71518
Reported RN Staffing Hours per Resident per Day
0.75089
Reported Licensed Staffing Hours per Resident per Day
1.46607
Reported Total Nurse Staffing Hours per Resident per Day
3.86964
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01786
Expected CNA Staffing Hours per Resident per Day
2.76443
Expected LPN Staffing Hours per Resident per Day
0.61719
Expected RN Staffing Hours per Resident per Day
0.99635
Expected Total Nurse Staffing Hours per Resident per Day
4.37797
Adjusted CNA Staffing Hours per Resident per Day
2.13340
Adjusted LPN Staffing Hours per Resident per Day
0.96178
Adjusted RN Staffing Hours per Resident per Day
0.56312
Adjusted Total Nurse Staffing Hours per Resident per Day
3.56287
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-07-01
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-08-23
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2012-09-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
11.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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