Lakeside Health And Rehabilitation Center - Quitman Nursing Home
General Information
UPDATEFederal Provider Number
255288
Provider Name
LAKESIDE HEALTH AND REHABILITATION CENTER
Provider Address
191 HIGHWAY 511 EAST
QUITMAN, MS 39355
QUITMAN, MS 39355
Provider Phone Number
6017762141
Provider SSA County
110
Provider County Name
Clarke
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
118
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MS LAKESIDE LLC
Date First Approved to Provide Medicare and Medicaid services
2002-08-01
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
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
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
2.29915
Reported LPN Staffing Hours per Resident per Day
0.93008
Reported RN Staffing Hours per Resident per Day
0.77119
Reported Licensed Staffing Hours per Resident per Day
1.70127
Reported Total Nurse Staffing Hours per Resident per Day
4.00042
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02119
Expected CNA Staffing Hours per Resident per Day
2.34473
Expected LPN Staffing Hours per Resident per Day
0.68255
Expected RN Staffing Hours per Resident per Day
1.06775
Expected Total Nurse Staffing Hours per Resident per Day
4.09503
Adjusted CNA Staffing Hours per Resident per Day
2.40601
Adjusted LPN Staffing Hours per Resident per Day
1.13100
Adjusted RN Staffing Hours per Resident per Day
0.53967
Adjusted Total Nurse Staffing Hours per Resident per Day
3.93777
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-11-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-12-06
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
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-11-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
14.00000
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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