Covenant Health & Rehab Of Vicksburg, Lp - Vicksburg Nursing Home
General Information
UPDATEFederal Provider Number
255140
Provider Name
COVENANT HEALTH & REHAB OF VICKSBURG, LP
Provider Address
2850 PORTER'S CHAPEL ROAD
VICKSBURG, MS 39180
VICKSBURG, MS 39180
Provider Phone Number
(601) 638-9211
Provider SSA County
740
Provider County Name
Warren
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
107
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COVENANT HEALTH & REHAB OF VICKSBURG, LLC
Date First Approved to Provide Medicare and Medicaid services
1991-08-29
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
1
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
2
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
1.89393
Reported LPN Staffing Hours per Resident per Day
0.72383
Reported RN Staffing Hours per Resident per Day
0.59393
Reported Licensed Staffing Hours per Resident per Day
1.31776
Reported Total Nurse Staffing Hours per Resident per Day
3.21169
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02150
Expected CNA Staffing Hours per Resident per Day
2.46824
Expected LPN Staffing Hours per Resident per Day
0.67881
Expected RN Staffing Hours per Resident per Day
1.00317
Expected Total Nurse Staffing Hours per Resident per Day
4.15022
Adjusted CNA Staffing Hours per Resident per Day
1.88277
Adjusted LPN Staffing Hours per Resident per Day
0.88505
Adjusted RN Staffing Hours per Resident per Day
0.44238
Adjusted Total Nurse Staffing Hours per Resident per Day
3.11935
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-11-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-12-13
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
19
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
6
Cycle 3 Health Deficiency Score
132
Cycle 3 Standard Health Survey Date
2012-11-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
132
Total Weighted Health Survey Score
60.00000
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
2
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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