Oak Grove Retirement Home - Duncan Nursing Home
General Information
UPDATEFederal Provider Number
250000000000000000000000000000
Provider Name
OAK GROVE RETIREMENT HOME
Provider Address
209 OAK CIRCLE/P. O. BOX 198
DUNCAN, MS 38740
DUNCAN, MS 38740
Provider Phone Number
(662) 395-2577
Provider SSA County
50
Provider County Name
Bolivar
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
59
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1975-11-24
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
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
2.00508
Reported LPN Staffing Hours per Resident per Day
0.54153
Reported RN Staffing Hours per Resident per Day
0.24915
Reported Licensed Staffing Hours per Resident per Day
0.79068
Reported Total Nurse Staffing Hours per Resident per Day
2.79576
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00508
Expected CNA Staffing Hours per Resident per Day
1.78642
Expected LPN Staffing Hours per Resident per Day
0.49313
Expected RN Staffing Hours per Resident per Day
0.64522
Expected Total Nurse Staffing Hours per Resident per Day
2.92477
Adjusted CNA Staffing Hours per Resident per Day
2.75404
Adjusted LPN Staffing Hours per Resident per Day
0.91146
Adjusted RN Staffing Hours per Resident per Day
0.28853
Adjusted Total Nurse Staffing Hours per Resident per Day
3.85310
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
135
Cycle 1 Standard Survey Health Date
2015-03-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
135
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
92
Cycle 2 Standard Health Survey Date
2014-04-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
92
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
116
Cycle 3 Standard Health Survey Date
2013-05-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
116
Total Weighted Health Survey Score
117.50000
Number of Facility Reported Incidents
0
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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