Ms Care Center Of Dekalb - De Kalb Nursing Home
General Information
UPDATEFederal Provider Number
255251
Provider Name
MS CARE CENTER OF DEKALB
Provider Address
220 WILLOW AVENUE
DE KALB, MS 39328
DE KALB, MS 39328
Provider Phone Number
6017435888
Provider SSA County
340
Provider County Name
Kemper
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
59
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
KEMPER COUNTY LTC INC
Date First Approved to Provide Medicare and Medicaid services
1997-11-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
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
3.20000
Reported LPN Staffing Hours per Resident per Day
0.66949
Reported RN Staffing Hours per Resident per Day
0.68305
Reported Licensed Staffing Hours per Resident per Day
1.35254
Reported Total Nurse Staffing Hours per Resident per Day
4.55254
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03898
Expected CNA Staffing Hours per Resident per Day
2.39079
Expected LPN Staffing Hours per Resident per Day
0.58352
Expected RN Staffing Hours per Resident per Day
0.98317
Expected Total Nurse Staffing Hours per Resident per Day
3.95748
Adjusted CNA Staffing Hours per Resident per Day
3.28421
Adjusted LPN Staffing Hours per Resident per Day
0.95228
Adjusted RN Staffing Hours per Resident per Day
0.51911
Adjusted Total Nurse Staffing Hours per Resident per Day
4.63700
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
2014-10-16
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
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-12-05
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
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2013-02-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
5.33300
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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