Mississippi Nursing Homes >> Rolling Fork Nursing Homes >> Heritage Manor Of Rolling Fork

Heritage Manor Of Rolling Fork - Rolling Fork Nursing Home

General Information

UPDATE
Federal Provider Number
255220
Provider Name
HERITAGE MANOR OF ROLLING FORK
Provider Address
431 WEST RACE STREET / PO BOX 279
ROLLING FORK, MS 39159
Provider Phone Number
6628736218
Provider SSA County
620
Provider County Name
Sharkey
Ownership Type
For profit - Corporation
Number of Certified Beds
54
Number of Residents in Certified Beds
44
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ROLLING FORK HEALTHCARE, LLC
Date First Approved to Provide Medicare and Medicaid services
1996-01-01
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
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.85795
Reported LPN Staffing Hours per Resident per Day
0.83636
Reported RN Staffing Hours per Resident per Day
0.42159
Reported Licensed Staffing Hours per Resident per Day
1.25795
Reported Total Nurse Staffing Hours per Resident per Day
4.11590
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.51459
Expected LPN Staffing Hours per Resident per Day
0.64061
Expected RN Staffing Hours per Resident per Day
0.89228
Expected Total Nurse Staffing Hours per Resident per Day
4.04748
Adjusted CNA Staffing Hours per Resident per Day
2.78874
Adjusted LPN Staffing Hours per Resident per Day
1.08362
Adjusted RN Staffing Hours per Resident per Day
0.35304
Adjusted Total Nurse Staffing Hours per Resident per Day
4.09904
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
88
Cycle 1 Standard Survey Health Date
2014-05-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
88
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
92
Cycle 2 Standard Health Survey Date
2013-06-07
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
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
679
Cycle 3 Standard Health Survey Date
2012-08-03
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
340
Cycle 3 Total Health Score
1019
Total Weighted Health Survey Score
244.50000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
75628
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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