Liberty Health & Rehab Of Indianola, Llc - Indianola Nursing Home
General Information
UPDATEFederal Provider Number
255185
Provider Name
LIBERTY HEALTH & REHAB OF INDIANOLA, LLC
Provider Address
401 HIGHWAY 82 WEST
INDIANOLA, MS 38751
INDIANOLA, MS 38751
Provider Phone Number
(662) 887-2682
Provider SSA County
660
Provider County Name
Sunflower
Provider Website
Provider Description
Ownership Type
For profit - Limited Liability
Number of Certified Beds
75
Number of Residents in Certified Beds
73
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LIBERTY HEALTH & REHAB OF INDIANOLA, LLC
Date First Approved to Provide Medicare and Medicaid services
1994-11-28
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
2
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
1
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
2.03493
Reported LPN Staffing Hours per Resident per Day
0.85685
Reported RN Staffing Hours per Resident per Day
0.56164
Reported Licensed Staffing Hours per Resident per Day
1.41849
Reported Total Nurse Staffing Hours per Resident per Day
3.45342
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08973
Expected CNA Staffing Hours per Resident per Day
2.58622
Expected LPN Staffing Hours per Resident per Day
0.73934
Expected RN Staffing Hours per Resident per Day
1.22592
Expected Total Nurse Staffing Hours per Resident per Day
4.55149
Adjusted CNA Staffing Hours per Resident per Day
1.93066
Adjusted LPN Staffing Hours per Resident per Day
0.96191
Adjusted RN Staffing Hours per Resident per Day
0.34232
Adjusted Total Nurse Staffing Hours per Resident per Day
3.05843
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2015-04-02
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2014-03-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2013-04-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
22.00000
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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